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20 Questions The Doctor Needs To Answer For Every Pregnancy

The moment a woman discovers that she's pregnant the first thing most people, especially women who have walked that path before, will tell her is to start going to the prenatal clinic. While most women start the pregnancy test stage using home kits, going for clinic visits ensures that the pregnancy is checked every step of the way. This helps mom and her doctor know her physical, emotional and mental status, as well as that of the growing baby. At each visit, the doctor will have to know different things, from what mom eats, how she's resting, and do various tests.

The fun part comes when mom gets to do the ultrasound and see how the unborn child is doing. Sometimes they move a limb or two, or they're just lying still to sleep. So going to the clinic visits is both fun and informative at the same time. There are many things the doctor will want to know at each stage, from day one when a mom first walks into the clinic to the last day when she's in the delivery room. This, by the way, will include mom's social life, her physical status, and a lot more that can be good or bad for the unborn. Here are just 20 things the doctor should know about every pregnancy he or she handles in the course of the medical profession.

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20 What's your lifestyle like?

https://thrive.kaiserpermanente.org/easier-health-care/maternity/healthy-pregnancy/prenatal-care

Are you smoking, drinking, partying? Are you around people who smoke? How is work? Are you sleeping well? These are some of the questions your health provider is likely to ask about. Drugs and smoking either actively or passively can have direct effects on your unborn baby. They can cause your baby to be born with health complications. It is always advised however that you avoid any of these things from the moment of conception all through to delivery. This ensures a less complicated journey and health of the baby and the mother are kept in check. However disclosing such information gives the health provider ensures they are well prepared of any complication that may arise during the pregnancy or childbirth.

19 How Are Your vitals? And What's Your Entire History?

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Vital signs are measures of the body's most basic functions. The doctor will majorly measure body temperature, pulse rate, breathing rate and blood pressure. Vital signs are the best ground for comparison of the later prenatal visits. Blood pressure usually goes down slightly during the 1st and 2nd trimesters, this could be because of the high levels of progesterone and then goes back to normal or slightly above normal during the 3rd trimester. As part of the procedure the time your doctor takes your vital signs, your doctor will ask you some questions like the date of your last menstrual period, your menstrual history, the recent birth control methods used and the length and regularity of your menstrual periods, as well as the severity of your premenstrual symptoms.

18 How's Your Overall physical health?

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The first physical exam provides a starting point for your overall physical health. In this exam, particular emphasis is made to checking your sense of sight, hearing and breathing. Other internal organs like throat, chest, lungs, heart, abdomen, and reproductive organs are also given attention. Your arms and legs too. Special attention is paid to your chest, abdomen, and pelvic exams as these are bound to change during the pregnancy. Problems in your chest, abdomen and pelvis have high chances of complicating childbirth and carrying your baby to full term. This exam further includes a background check on your family’s medical history as well as that of the father to establish the possibility of potential genetic conditions that your baby could inherit. This is done to ensure measures are put in place to ensure the safety of the baby.

17 Is there protein Coming out down there? There shouldn't be

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There should be no trace of protein in your urine at any point during the pregnancy as this could be an indication of a bacterial or urinary tract infection (UTI) or even bladder or kidney infection. due to hormonal and pH changes in the body UTIs are quite common during pregnancy. Some of these infections if left untreated for example a UTI could develop into a kidney infection, which are harder to treat and could possibly induce early labour. That is why, it’s best to have your urine tested at each prenatal check-up and ensure you adequate consumption of fluids, especially water. Some of the measures advised by doctors to be implemented to prevent UTI include, consumption of plenty of fluids, use of unscented soaps and wearing of cotton undergarments.

16 What About Ketones? Those Shouldn't Come Out Either

Ketones are chemicals made in the liver and are produced when there is not enough insulin in the body to turn sugar into energy. Presence of high levels of ketones in urine is a big red flag during pregnancy. As stated by the American Pregnancy Association, “Ketones occur when your body is breaking down fats instead of carbohydrates for energy.” This can lead to dizziness and dehydration. High levels of ketones could also mean there is insufficient intake of food and fluids and that there is need for the mother to eat more snacks and light meals regularly. However it is never a very serious complication as it is easy to treat and the doctor can advise on how much food and liquid should be taken to control the problem.

15 Any Lumps, swelling, puckering, dimpling or other unexplained changes?

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Your bosom is given particular emphasis as these are your baby's main source of food during the first few months of life. Doctors check for presence of any lumps, swelling, dimpling, puckering and any unexplained change in the general texture. The exam provides a level area for all the changes that will happen during your pregnancy and also an important indicator for breastfeeding once your baby is born. Some of the changes advised to expect during the journey to motherhood include growth, tenderness, dark nipples and veins, leaking fluid (colostrum), larger nipples and raised bumps on the surface of the areolas. The doctor may advice to continue with self examination during the pregnancy at least every 4-5 weeks.

14 Does Your Abdomen Have marks, lumps, stretches and masses?

The abdomen is also checked for any masses or lumps other than the baby. Further examination includes the scars and stretch marks. There is an initial measurement of the height of the upper part of the uterus to give a basis of comparison for future height measurements as the baby grows in the uterus. Fundal height is measured from the top of the pubic bone to the end which is somewhere near your belly button. The length in centimeters roughly corresponds to how far along the pregnancy is in weeks; for example 4cm roughly equals 4 weeks. The position of the baby is assessed to find out which way the baby is lying, which is either longitudinal, transverse or oblique.

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13 How far along are you? Time for a pelvic exam

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The pelvic exam normally confirms your pregnancy and how far along it is. In this exam, the doctor checks for any pelvic abnormalities that may bring about complications during pregnancy or even childbirth. Things are checked on the outside, the opening and the cervix are examined with a speculum. A Pap smear is also done at this point and a specimen is sampled to test for chlamydia and gonorrhea. The size, shape, and position of the uterus, whether the uterus is enlarged an indication of pregnancy or fibroids, tenderness or pain, swelling of the Fallopian tubes which could be an indication of an ectopic pregnancy and enlarged ovaries, cysts, or tumors are some of the aspects examined. This is called the bi-manual exam.

12 Anything wrong down there? Downstairs organ examination

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The strength and irregularity of the walls and cervix are the key areas of concern in this exam. The presence of hemorrhoids and fissures are checked for while presence of hernias and masses are checked for. The muscles between your downstairs parts are checked by your health provider inserting a gloved finger. This also checks for any tumors behind the uterus, on the lower wall, or in the other side. The perineal tissues are also examined in the same way more thoroughly. During these tests, it is very normal to feel the need to have a bowel movement during this part of the exam. However it only lasts a few seconds.

11 Are there any changes in pressure? It could reveal something wrong

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Blood pressure is very vital during pregnancy. It should be measured during every visit to the doctor. This provides a ground for comparing the blood pressure on every visit. It tells what your normal blood pressure is and therefore it is easy to know if there is a slight increase. This is because pressure differs from person to person, what is normal to one person may be considered not normal to the other person. It is also good t note that sometimes you may come into pregnancy with an already high pressure so it is of utmost importance to ensure measures are put in place to have it manageable and ensure a safe pregnancy and childbirth for you and your baby.

10 Every mom's favorite: the baby's heartbeat

Using a Doppler, you get to hear one of the most amazing sounds - your baby's heart beat. This is normally from around 12 weeks. However, maternal fat stores, positioning of the uterus can get in the way, and the heartbeat may not be heard that soon in some cases.So don't panic if it takes a bit longer to hear. At around 18 when the baby has grown further, weeks a fetoscope or regular stethoscope can pick up beats of your baby's heart. It is a good and wonderful experience ,and a recording can of course be made as a memory. An ultrasound can also be used, depending on the age of the pregnancy, your body shape, the amount of subcutaneous fat, and the location of the uterus.

9 Are you Wide Enough For A safe delivery?

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To ensure the safety of your delivery as the baby passes through the birth canal, the measurements of the size and shape of the pelvis are done. The pelvis measurements are obtained by measuring the diameter of the brim which extends from the sacral promotory to the upper inner border of the symphysis pubis, the diameter of the cavity which extends from the brim above to the outlet below and the outlet diameter which extends from the sacrococcegeal joint to the lower border of the symphysis pubis. Based on the measurements a cesarean section may be advised. However, these measurements are normally taken later into the pregnancy as the perineal muscles are more relaxed and there is less discomfort while taking the measurements.

8 How are your Sugar levels?

http://www.justmeandmyrunningshoes.com/2016/01/my-glucose-test-weekend.html

A lot of sugar in the urine can be a sign of gestational diabetes which is a temporary condition in which the body isn’t producing enough insulin to regulate blood sugar levels adequately, and therefore needs to be monitored carefully. A common misconception is that those with weight problems and those who eat too much sugar are at risk of gestational diabetes but this is never the case. Gestational diabetes has a strong genetic link, so if you have a family history of the condition, you’re at risk of the same. Therefore having your urine tested regularly is advised by the doctor to ensure this condition is noticed the moment it sets in and is monitored and controlled from the onset of the pregnancy.

7 How Tall is the baby? It can reveal the baby's health

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This is the measures of the size of the uterus and is also an estimate on the growth of the baby. It begins at around 20 weeks, where the uterus measures 20 centimeters from the pubic bone. The numbers change as the baby changes position and grows. It is often the best indicator for a potential problem or an unexpected surprise, like twins which is normally noted if the numbers make dramatic and unforeseen changes. It is considered safe and normal when the height of the uterus matches the gestational age of the fetus, i.e. the number of weeks or months of pregnancy (gestation) and the top of the uterus rises in the mother’s abdomen by about two finger-widths, or 4 cm every month.

6 Cervical thinning/Effacement: Is Dilation Going Okay?

This is the process by which the cervix thins down and prepares for delivery. It is a term you will hear when you are closer to the end of your pregnancy. The doctor also uses terms like ripens or cervical thinning to mean the same. The typical cervix is 3 to 4 centimeters in length, and your provider usually reports this measure as a percentage. For example, you are 0 percent effaced if your cervix is not at all thinned out. On the other hand, you are considered 100 percent effaced if your cervix is completely thinned. Some women tend to efface first and then dilate, like first-time-moms, while the opposite is true for women who have given birth before. But this generalization is not always true.

5 The fetal station: How Far Is The Baby From The Doorway?

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This happens when your baby's head is in level with the ischial spines, the fetal station is therefore said to be zero. This is estimated in relation to the ischial spines. The purpose of measuring baby’s station is to tell how far through (or above) the pelvis baby is. Your baby's head fills the opening, just before birth, the fetal station is then said to be +5, -5 (5 centimeters above the ischial spines) to mean the baby is above the pelvis. The purpose of measuring baby’s station is to tell how far through (or above) the pelvis baby is. Each positive number usually meaning your baby has descended another centimeter into your pelvis. However, assigning a number is an estimate

4 What's The baby's position? Hopefully it's head down

When you are approaching your due date, it is important for the fetal position to be identified. Your provider can be able to tell this by feeling your abdomen. However in some cases a cervical exam is required to help clarify if the baby is head down or not. The baby's position can also be felt when the cervix is more dilated. The baby should be head down by week 32. This is very important as it ensures a safe delivery from the baby's position and also prevents any complications that may arise. It also gives the a lot of information on how to best handle discomforts and pain during the pregnancy as well as how to speed labor once the time comes.

3 Are things softening up to get ready for delivery?

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During pregnancy, you will experience changes in your cervix, which is located between your uterus and opening. The position of this can change during pregnancy, and it is possible to tell when conception occurred by looking at the position of the cervix. In addition to changes in your cervix position you’ll also experience changes in the position of the mucus around the cervix. During early pregnancy the cervix usually feels soft and rises up. This feeling of softness comes because during pregnancy the cervix contains more blood due to rising levels of estrogen in your body. Cervical length is usually associated with labor that begins before you are 37 weeks pregnant commonly known as preterm. The cervix should be normally rigid and closed but opens up as the baby grows. There is a risk of premature birth if it opens up too soon

2 Is The opening Getting Ready for show time?

Cervical position can be reported as either posterior, mid-position, or anterior. A cervix that is not yet in active labor is a posterior cervix. During early pregnancy the cervix is usually feels soft and rises up. This feeling of softness comes because during pregnancy the cervix contains more blood due to rising levels of estrogen in your body. It is examined by being in a lying flat position , or having pillows under your hips to allow for accessibility by your doctor or midwife. Cervical length is usually associated with labour that begins before you are 37 weeks pregnant commonly known as preterm. The cervix should be normally rigid and closed but opens up as the baby grows. There is a risk of premature birth if it opens up too soon.

1 Dilation: Is it time to deliver yet?

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Dilation refers to how open the cervix is. A cervix is either closed or fully dilated. A fully dilated cervix is 10 centimeters open. During delivery, you need to be fully dilated in order to start pushing, but if you are a preterm you can be able to deliver with a cervix that is not completely open as the baby is not fully grown. It is also important to keep in mind that this single measurement is not enough to tell your doctor or midwife if you are in active labor or not. Some women are still at 3 or 4 centimeters dilated a week or more before they deliver. It is therefore, important to take all the other measurements into account as well to observe if there is any change over time to assess if you are really in labor.

References: healthpages.org, livingandloving.co.za, americanpregnancy.org, birthbeyondbias.com, verywellfamily.com

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