Ahh, the prenatal visit, it’s elusive as no one really seems to talk about it until, well, until that day has arrived! At least this was my experience. Everyone loves to tell moms-to-be about their birth horror stories and how having a newborn will be, but no one really seems to talk about what you do before all that?
How do we get from “congrats on being preggo” to “what’s the birth plan here?” This middle part is most of the experience, and it’s always good to know what to expect so couples don’t go in there feeling a little overwhelmed.
I remember stepping into my first appointment with my OB and not having a clue what to expect, thankfully another mom, who’d clearly done this enough times now, pointed me towards a small cup with some tiny sticks in it and pointed me towards the restroom. Yes, I was just supposed to know about this very common procedure.
I was also expected to have questions ready, instead I just stared blankly unsure what to ask about or say. I really just wanted to be told what to do, and have my handheld, as I had no idea what things would be like with my first child. OB’s are high in demand and if a mom-to-be is healthy and baby is healthy then they sort of rush her along and out the door.
So here are 8 things to expect from the visits and 7 things moms-to-be should definitely ask before they leave the OB’s office that will leave them looking like a seasoned professional preggo!
15 Urine Tests
This will be the most common thing you do! From the first pregnancy test confirming your preggo status to the many urine tests you will do along the way, everything you do will be centered around pee, the holding of during ultrasounds and release of for multiple endless tests!
You will have to pee on a stick every time you visit the OB, sometimes a few times if the results come back wonky. Why do they do this you ask? The simple answer is doctors and midwives are looking for early signs of conditions that may put you or baby at risk. They look for proteins, nitrates, or sugar in your urine.
The great thing about these tests is that they’re the easiest ones you’ll do and the results are immediate. After the urine is taken mid-stream and the dipstick is placed in it, it will change colour and the nurse or doctor will either give you the all clear or send you for more testing, either way this is only the beginning of your prenatal journey.
14 Weigh In
Definitely the least fun part of pregnancy is seeing the scale go up and up and up, beyond expectations sometimes, and not in the good way! Weigh in is a necessary evil for tracking how big your baby is getting as well as tracking a healthy weight during pregnancy.
Your height, frame and current health status will gauge what the “normal” or “acceptable” weight gain will be for your pregnancy. Some doctors will break it down by how much weight is acceptable to gain each month and others will give you an acceptable weight range for the entire pregnancy.
The standard is usually 25 to 35 pounds for the entire pregnancy, but if you’re on the heavier side, or even on the lighter side and/or have a health condition, the doctor will adjust the numbers accordingly. If we’re talking month to month, after the first three months of pregnancy about 1 pound a week is typical until delivery.
13 Blood Pressure
Every time you greet your OB, they’ll be quick to strap your arm up with a blood pressure cuff. Blood pressure can be very telling and it’s important to know if it is low, high or normal. This simple test, as uncomfortable as it is for a few moments, is probably one of the most important one you’ll do at each visit.
It’s not uncommon for blood pressure to drop slightly during pregnancy, but if blood pressure is extremely low it can lead to dizziness, lightheadedness and possibly fainting. If you feel dizzy when you get up a little too quickly it doesn’t necessarily mean you’re in danger of fainting, unfortunately this is just a long list of things that go under “normal.” The OB will know if it’s more severe.
On the other end, high blood pressure, also known as hypertension, can be a sign of “Preeclampsia” which is a toxic condition that can harm the mother as well as the baby, so it’s extremely important to catch this early sign with regular blood pressure tests.
12 Measure The Baby Bump
At each visit you can obviously expect the growing bump to be looked as well as poked and prodded a bit. The OB will perform a Fundal Height Measurement which is really just a fancy way of saying that they are measuring the fetal growth.
Your OB will take a small measuring tape and measure from the top of your growing belly all the way down to the pubic bone. The measurement is then written down at each appointment and compared to the previous measurement to see if it matches the amount of weeks you are.
If you are a bit bigger or smaller than what is considered average for your timeline, the OB will usually insist on further evaluation. This doesn’t mean something negative, per say, but further testing, such as an ultrasound or a gestational diabetes test might be ordered just to make sure all is well and good.
11 Listen To The Baby's Heartbeat
This is the best moment of any visit, the moment you get to hear your little one being active, even if you can’t see them right then. It’s music to an overwhelmed momma’s ears, because it tells us, even with the struggles of pregnancy, little one is doing just fine and completely oblivious to any of our strife (you can always remind them of that when they’re older).
If it sounds really fast when you hear it the first time, don’t be alarmed, that’s completely normal! Their little heart rate can range between 110 to 160 beats per minute (bpm), sometimes a little higher, sometimes a little lower, but always quick sounding.
The heart rate will be monitored more often if you are a high risk pregnancy and it’s not something to worry about, monitoring the heart rate is a great way to know that baby is doing just fine.
10 Find Out A Tentative Due Date
Your OB will ask you a number of questions at your first appointment. They’ll ask about your healthy and your family’s history of health. What they’ll also ask is when you discovered you were pregnant and when your last period was. With this information the OB will use a Due Date Calculator to determine when that little baby will arrive.
In the early stages it’s more of a tentative date, as you begin to do ultrasounds the date may be adjusted depending on the size of the baby. It usually doesn’t shift significantly though, at most, by about a week.
Due date will also depend on if you deliver naturally or via C-section. If you’re having a cesarean birth, the doctor will schedule you during their availability and usually a little earlier than your due date so that you don’t go into labor beforehand. Even with this magical date, we all know that baby does whatever baby wants.
9 Order Tests
There are many tests you must complete over the course of your pregnancy. There are standard urine tests to check for proteins in the urine that might signify preeclampsia, there’s blood work to check glucose levels and test for gestational diabetes, as well as rule out anemia or any other blood related issues, blood work will also determine your blood type and your HCG levels.
Ultrasounds will be ordered to check to see if it’s one baby or two babies, or more, my goodness! The ultrasound will check for anatomy as well. If, after all these tests, the doctors see something odd or uncertain, they may ask for an amniotic fluid sample, this is called amniocentesis. The test will rule out any disorders or genetic defects.
This can also be performed if your family history shows something that could possibly be passed down to your child.
Stanford Children’s Health has a great breakdown of what you can expect to have tested during each trimester.
8 Questions Or Concerns
Before your prenatal appointment is over, the doctor will always use these magical words: “Do you have any questions or concerns?”
What I have learned from my experiences is that it’s a really good idea to create a list of concerns you have for your OB, not only because baby brain might step in and make you forget everything you meant to ask, but also because the appointment can fly by so fast sometimes that you race out of there before even noticing you never even broached the subject.
A list will keep the appointment on track and put your mind at ease.
There are many questions we’re embarrassed to ask, mostly because we’ve never been quite so vulnerable before. Pregnancy sure alleviates us of our “shy” muscles, so there’s no need to hide concerns like “I can’t poop, help!” Trust me, your OB has heard it all, so don’t be shy, get those answers! They’re there to help!
Here are 7 important questions you should ask during your appointment, don't be shy:
7 Are Digestion Issues Normal?
This might seem like an embarrassing set of questions but many pregnant women suffer from digestion issues and there’s no shame in that! With a baby pressing on your insides, there’s no wonder why your tummy is acting up!
Due to all the hormonal changes that occur during pregnancy, a woman's gastrointestinal system has a decreased ability to break down food and keep food and gases contained within the stomach. These types of changes can cause discomfort. Most of the time they start off as nausea and vomiting, or what is more commonly known as morning sickness.
These problems are also responsible for bloating. About 85 percent of expectant women experience one or even all of these symptoms early on in their pregnancy and again in the last trimester.
If you’re constipated your doctor will advise high fiber foods and to drink lots of water. Perhaps they’ll have other tricks up their sleeve as well, but you won’t know unless you ask.
If heartburn is driving you crazy and interrupting your sleep, ask the doctor about options for helping to ease the irritation, although pregnant women have a very short list of medications they can take, there’s always Tums and other natural remedies the OB can advise you of.
6 Is A VBAC Possible?
If this is your second or third baby, and you weren’t able to deliver vaginally before, but want to try it for your next baby, then this is something you’ll definitely need to discuss with your OB. The OB will direct you to the safest form of delivery for your body and your baby. The OB will advise you of the pros and cons, as well as point out risks, since multiple cesareans aren’t exactly advised.
From there the decision is yours. Chances are, if you’ve had a cesarean, you’ll most likely need another, but if it’s something you desire to try, always ask your OB about your wishes and have them point out your options. Birth plans a huge part of the prenatal visit and although they change often, because baby has its own plans, they should always be discussed so that you can be as prepared as possible.
5 Where Can I Find Childbirth Classes?
Your OB will be the endless supply of information you need, all you have to do is ask! They will know about local programs as well as birthing programs at the hospital that can help you prepare for birth. The office will most likely have a million pamphlets for you to take home and peruse about additional information available in your area.
That being said, your OB has many patients, and their job is only to assist with the pregnancy portion, they won’t have time to attend to things like breastfeeding, diapers, rashes, baby’s first week of life, baby sleep cycles (if any), how to swaddle, how to soothe, etc.
You will also want to know more about your healing after baby in more detail, it will help you prepare yourself mentally as well as your bag for the hospital. Your OB is always more than happy to direct you to amazing classes, they know being a first time mom is daunting, and navigating the information we find can be equally as daunting.
4 Any Travel Restrictions During Pregnancy?
Travel turns into a big scary word while pregnant, especially now with Zika warning zones. Moms have every right to ask where it is safe for them to travel to and if they are at all “at risk” if they travel while pregnant. In all cases the doctors will advise you not to travel close to your due date, which is fair, unless of course you are planning on having a baby on a plane?
As long as a patient is having a healthy pregnancy, most doctors won't object to travel during pregnancy.The 18th and 24th weeks of pregnancy are the best times for travel because most pregnancy symptoms disappear during this time, and most fetal development is finished and now babies are in the growth phase.
These weeks are also recommended because they're least likely to result in obstetric emergencies.
Ultimately you should discuss where you're going and for how long as well as any activities you have planned and whether you have any medical or pregnancy related complications with your doctor. Definitely ask your doctor for their contact information and you may also want to find a hospital or doctor that is willing to take foreign patients on short notice in the city of your destination.
3 Should I Make Changes To My Beauty Routine?
While this might seem a tad vein, it’s completely realistic! We as women have beauty regiments and it’s important to note if anything can be toxic to our unborn babies. Expectant women should be asking their doctors whether it's safe for them to dye their hair, use a sunless tanner, go for a massage, paint their nails and even go to the spa. These questions are all fair game!
Truth is different doctors will give you different answers, the hair dye matter still has doctors on the fence, some say avoid any chemicals that might absorb into the skin until after 3 months, others don’t see it as a big deal.
Still, I say ask your OB, they’ve seen more cases and heard these questions before, they can always guide you to more information and then ultimately, the decision is yours. Here is a list of chemicals that OB’s commonly suggest you avoid: 12 Chemicals To Avoid During Pregnancy
2 How Much Weight Should I Gain & At What Rate?
We all know we’re supposed to gain weight while pregnant, but the question is always, how much? This may seem like an awkward thing to ask, but it is actually a common question that women ask during pregnancy and if your OB doesn’t mention it, it’s important to make sure you do, even if only for peace of mind.
The OB will give you a healthy weight range for your age, height, and prepregnancy weight. This will keep you on track with having a healthy pregnancy as well as not having to worry about extra pounds to shed after pregnancy.
If you put on too much weight, chances of gestational diabetes, high blood pressure and complications may arise. If you don’t put on enough weight, then you increase your chances of premature birth or a small birth weight. So you can see, weight matters, ask your OB if you’re on track.
1 What Kind Of Diet Should I Follow?
What should I eat? What should I drink? What should I completely avoid? We’ve all read the books and searched through the internet for what to eat and what not to eat during pregnancy. Truth is, a lot of the information out there is false and purely based on old wives’ tales. This is why it’s so important to ask your OB about limitations, to which surprisingly, there aren’t too many.
There are the obvious ones, like avoiding alcohol, raw foods and cutting down on caffeine, but other than that, ask your OB if you’re ever unsure. If you have issues with food allergies a prenatal appointment is a good time to let the OB know about this important information.
The OB might advise you to stay away from all high allergy foods depending on how severe your allergy is, they may also tell you to continue to avoid these foods when breastfeeding, but every case is different, and your OB will know more about next steps.