You’re 8 weeks pregnant and you’re going to your first OB appointment. If you have questions on what to expect, we have answers. This blog and accompanying podcast will go over what a baby doctor is looking at when you first show up in their office, the 9 physical exam components of your first prenatal visit, and 10 questions you need to ask to find your perfect provider to deliver your pride and joy.
Your First Pregnancy Appointment
Overview of your First Visit to the OBGYN
Congratulations you’re pregnant! Now you’re preparing for your first of at least 10 appointments. By now you have probably already missed a period, took a pregnancy test, and called your doctor to make an appointment at least a month or two out. Just a warning, your first prenatal appointment will probably be your longest. These appointments take time getting used to as you’ll constantly be giving blood, giving urine and being examined “down under”. But keep in mind it’s to make sure both you and your baby are healthy.
When you arrive at your appointments, make sure you’re well hydrated because you will constantly be asked to pee in a cup. As a side note, buy CareFull Catch! It’s a spoon looking thing that you put the specimen cup in and hold the handle so you don’t have to get pee on your hands. Only a few OBGYN offices supply them, and as your tummy grows it’s an awesome invention to make sure you don’t miss (CareFull Catch specimen cup holder (10 pack)). And pee on your hands is gross. That’s another thing, always wash your hands after giving a specimen or going to the bathroom. This sounds like common sense but you have decreased immunity while pregnant and become susceptible to a lot of germs you otherwise wouldn’t be.
At your first prenatal appointment, you will also give your complete health history. Make sure you know when your last period was, your up-to-date shot records, and all surgical history. You will likely learn what your estimated due date is during this appointment too. Once they make this first assessment it is very hard for your due date to change.
The 9 Pregnancy Physical Exam Components
Be prepared to wear 2 disposable gowns, a sheet for the bottom and a gown open in front from the top. The physical exam components include:
- pelvic exam
- pap smear
- breast exam
- blood work
- pregnancy test
- urine screen for protein and sugar
- blood pressure
- possibly an ultrasound
- An ultrasound is usually only done if you are having pain, bleeding, or underwent fertility treatments.
How to find the best OBGYN
Finding your perfect doctor is another task. You will want to see an obstetrician (OB), a doctor that specializes in pregnancies and deliveries. If you live in a rural area your doctor that will deliver your baby might also be your family practice physician. However, you'll usually see a doctor that specializes in birthing. You will be with this doctor for 40 weeks (that’s 10 months) so you better like them!
Once you find the perfect OB practice, you may be wondering who will actually deliver your baby. After all you’ve already met the receptionist, spoke to your insurance liason, met a medical assistant who has taken your vital signs including weight, blood pressure, and asked you when was your last experience, and finally you’re sitting in a patient room with a hospital type gown on wondering if you’ll ever see the doctor or midwife. YES, OF COURSE YOU WILL! You need to be just as prepared to find the group or solo practice provider who will be delivering your baby that shares with the values you want to uphold. Here are 10 of the most important questions to ask and some have come even before you see the physician.
10 Questions for Your Prospective OBGYNs
- Do you accept my insurance?
- How many doctors are in your group or are you a solo practice? (If a solo practice, who covers your deliveries when you’re on vacation and can I meet them? If you think it doesn’t happen, it does. It happened to our very own Dr. Darna!)
- Which hospitals are you affiliated with? Where will I deliver? Is that hospital on my plan?
- How many babies do you deliver a month? What is the ratio of vaginal births to c-sections? (You want someone experienced in both because about 1 in 3 babies born are via cesarean according to the 2017 Consumer Reports.)
- How many patient appointments are scheduled in a day? How much time do you allot for each visit? (Translation: this is you making sure you’re not waiting for hours every time you have to have an appointment.)
- What are your after-hours policies? What’s the best method to reach the doctor? (Phone, email, or a nurse to provide advice and answers in between visits or for pregnancy emergencies.)
- What are your view about pain medication, natural childbirth, epidurals?(Formulate your birth plan but understand that things do not always go as planned and modern medicine isn’t a bad thing, so stop all the misconceptions and get well informed.)
- Do you perform vaginal birth after c-sections (VBAC)? What’s your VBAC success rate?
- Do you have experience with high risk pregnancies?
- Are you comfortable working with a doula if I decide to hire one?
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Difference Between Midwife and OBGYN
The difference between an OBGYN and a certified midwife (CNM) is that an obstetrician gynecologist (OBGYN) is a medical doctor that went to four years of medical school followed by 4 years of residency and is trained to deliver all types of births even high-risk pregnancies. A midwife is a nurse (2 or more years of education) and has gone through a graduate program to become certified. Physicians still deliver most of the babies across the country (about 74%) while midwives have delivered the other 26% of uncomplicated births. The choice is yours as long as your pregnancy is normal, and nurse midwives are usually more advocates for natural birth, but rest assured that OBGYN’s are always there too.
What will my next pregnancy appointments look like?
Once your first checkup is out of the way, the only difference between the first and the eighth (between 26 and 36 weeks of pregnancy), is that they will
- listen with a Doppler to your baby’s heart rate
- Measure your fundal height to check the baby’s growth
- Ultrasound near the end to check for the baby’s position (vertex, breech, posterior, etc)
I know these sound like big words but let me break them down for you. Doppler is a form of ultrasound the transduces sound waves by having you listen to the baby’s heart rate. The fundal height is measured when the doctor presses on top of your belly. They press here because your uterus houses your beautifully growing baby and the fundus is the area of the uterus where your baby is growing. So as the baby grows, it will get higher and higher up. A visual ultrasound uses the same sound waves as the Doppler but translates them into a visual picture.
Now you know the behind the scenes of your first prenatal check-up, questions you should ask to find the right doctor, and what to expect so there are no surprises. If you want more of your pregnancy answers check out our other blogs and podcasts at nomonausea.com and our Pregnancy Pukeology Podcasts hosted by our very own Dr. Darna! Click below for Episode 17: Everything You Need to Know for Your First Pregnancy Appointment.