Things to discuss with your doctor

You are bound to have a bunch of questions to ask over the course of your pregnancy so here is some of the information that you may be expected to supply.

It is very important to trust your gut when it comes to your care in pregnancy. Just because a doctor was amazing with your friend does not mean that they are the right person for you. It is ok to shop around until you get the care that you want

Information to tell your doctor

  • Any previous surgeries.
  • Any hereditary conditions.
  • Any previous pregnancies.
  • Your job as some may be a health risk.
  • Your contraception that you were using – a doctor needs to know if there is an IUD still in place.
  • If you are not immune to Rubella – increasingly rare these days but it can pose a real threat to your unborn child.
  • Any history of hepatitis.
  • Any mental health issues.
  • Any issues with conception of the baby.
  • Any cultural beliefs that may impact your care or the way you want to birth your baby.
  • Details of your family structure.
  • Any medication you are currently taking.
  • Any previous negative medical experiences.
  • Any history of sexual, physical or mental abuse.
  • Heavy use of alcohol, tobacco, recreational drugs or harmful substances.

It is important to remember that you are not sick – you are just pregnant!

Pregnancy is totally natural, totally normal. It is is not an event that necessitates all sorts of UNNECESSARY interventions.

Questions for your providers

You will have questions to ask them about your pregnancy support so here are some things to consider about any tests that may be carried out.

  • What is the procedure?
    • How is the test done?
  • What are the benefits?
    • How reliable or accurate is the test?
    • Will the results have any impact on my prenatal care?
  • Are there any risks to me or the baby?
  • Do we need to do the test?
    • What would happen if we decide not to do the test?

You would also need to consider how you would feel about any tests results. For example if tests show something that can be treated such as gestational diabetes then you need to make sure that you’re prepared to follow the medical advice given.

Would they determine a different outcome to the pregnancy? How would you feel then? If tests showed that your baby had Downs or Spina Bifida you would need resources to help you cope with whatever decision you made.

There should be no need for a breast exam unless you feel that there its a particular issue that you wish to discuss such as previous surgery, worries over flat or inverted nipples or if you have had previous issues in other pregnancies. If you have any concerns about breastfeeding then a preparation for breastfeeding class may be an idea or have a chat with a breastfeeding counselor before baby is born so you know what to deal with.

Types of test

Tests are done to eliminate any cause for concern or risk to you or your baby. There are basically two types of test – a screening test checks to see if you are at risk of having something and a diagnostic test confirms that. Most tests will be for screening and if an issue is detected you’ll be sent for a diagnostic test to verify if there is cause for concern.

Routine test

These tests are generally done at most appointments

Urine test Helps detect bacteria, protein or sugar.

Blood pressure check to screen for healthy blood pressure

Weight check to help monitor your health and also sudden weight gain can be an indicator of pre-eclampsia.

Abdominal Exam to measure growth and position of the baby.

Listening to babys heart beat helps to confirm that all ok with baby.

Legs, ankles and hands will be checked for any sign of swelling.

These tests are done at set times in the pregnancy.

Pelvic exam generally done towards the end of pregnancy. Can be used to detect changes in the cervix, also a pap smear can be used to test for infection (Group B Strep is confirmed this way).

Blood test determines blood type, any anaemia, sickle cell or checks for infection. Generally carried out at the first appointment but may be done at other times if there is a risk of infection. It also checks if your blood types are compatible – if you have negative RH in your blood and your partner is positive then it can lead to complications (these are treatable by injections in the third trimester).

Other tests

Ultrasound helps to show how far along you are and can also be used to rule out any complications. They can also be used to determine the sex of the baby.

Genetic screening are tests that check for cystic fibrosis, Tay-Sachs, thalassemia, or sickle cell. Depending on your family history or ethnicity then your care provider may offer these tests.

Glucose Screening is a check for gestational diabetes carried out between 24 – 28 weeks.

Group B strep is detected by a vaginal swab as it is carried in secretions from the vagina and anus.

Amniocentesis if the 12 week scan shows any abnormalities then the doctor may offer this accurate test for diagnostic purposes. A needle is inserted into the amniotic sac and some fluid removed for analysis. The results should take a week or so to arrive. This test is not done unless there is a reason for it!

Other questions that you need to ask

Aside from testing and routine checks in pregnancy there are a whole host of other things that you need to be comfortable with. This is a good sample of things that you may like to consider.

  • What interventions do you routinely use?
  • Will my birth plan be observed?
  • What prenatal vitamins should I take?
  • When should I call you or get help? Is cramping or spotting normal? When is something normal and when is it an emergency?
  • Can I have sex whilst pregnant?
  • If I get a cold or allergies can I take over the counter remedies?
  • When should I get worried about any weight gain (or loss)?
  • What is your policy on episiotomies?
  • Will I get vaccinations whilst pregnant?
  • What methods of non medicated pain relief do you recommend?
  • What support am I allowed? My Husband? A Doula? A family member?
  • Do I have to birth on my back?
  • When do I come into hospital once labour has started?
  • When would you induce me?
  • What is your preferred method of induction?
  • Do you have qualified breastfeeding support available 24/7?
  • How long would I have to stay in hospital after birth?
  • Does the hospital have a special care unit?
  • If I had my baby early would I be able to have it here?
  • Can my partner stay in the hospital with me?

Any decision in your pregnancy is worthy of special attention and I cannot stress enough as a doula, childbirth educator and parent that you must be comfortable with things that are happening. Taking the time to choose your caregiver can really help ensure that you have a supported and validating birth experience. You’re not being demanding or needy – you are just wanting the best for you and your baby.

Sources

The Best friends Guide to Pregnancy – Vicki Lovine. Simon and Schuster inc ed. pub 1997

What to expect when you’re expecting – Heidi Murkoff. Simon and Schuster inc ed. pub 2009

The Expectant Father – Armin A.Brott and Jennifer Ash. Abbeville Press ed. pub 2010

Your Pregnancy Bible – Dr Anne Deans. Caroll and Brown Ltd ed. pub 2010

Pregnancy, Childbirth and the Newborn – Penny Simkin et al. Meadowbrook Publishing ed.pub 2010

The Complete book of Mother and Baby care – Elizabeth Fenwick. Dorling Kindersley ed.pub 2001

https://www.webmd.com/baby/questions-about-pregnancy

https://www.whattoexpect.com/wom/pregnancy/11-crucial-questions-every-woman-needs-to-ask-her-ob-gyn-during-pregnancy.aspx