We had a great visit with the midwife this morning to talk about baby #3. I feel so at home with Sharon (our "hospital" midwife, and the woman who delivered #2), having a personal and professional relationship with her, and I know she really listens to me. I dragged the hubby along for our preconception appointment, somewhat for moral support, but mostly because he is completely clueless about pregnancy and childbirth and I want him to glean some info from our meetings. Of course being so clueless means that he doesn’t understand why we would even need a preconception appointment. Silly goose.
Preconception appointments might seem trivial to some, but for a woman nearly DYING to have a baby, it can mean all the difference. First and foremost, in order to conceive a healthy baby, you first need to have your own health squared away. Your care provider may ask you questions about your general lifestyle such as diet and exercise, if you have a family history of high blood pressure or thyroid disease, if you smoke or drink, or even if you regularly soak in a hot tub or sauna. These may not seem like super important issues, but they can all affect your ability to conceive- and once pregnant, can affect the health of your baby. Your doctor or midwife will also ask you questions about your cycles. Are you periods regular? How long is your cycle? Do you know when you ovulate? (All of these questions and more can be easily answered if you practice FAM (Fertility Awareness Method)! I can often tell you exactly when I ovulated, sometimes down to the hour, and without wasting money on those pesky and notoriously misleading OPKs.)
If this is your first baby, you might be asked about genetic screening at the preconception appointment. But since we already have 2 healthy babies, this isn’t really something we’re too worried about.
After all the paperwork and Q and As are done, you will most likely have a physical exam. My appointment today got cut short by a meeting among the midwives so I’ll go back tomorrow for the physical part. It’s mostly typical stuff that you’ve already experienced if you’ve ever had a PAP smear. They will check your blood pressure and take your weight. They may take a swab of your cervix. If it’s been less than a year since your last OBGYN appointment, they might skip that. I have a history of ovarian cysts and cervical problems so my midwife will check my ovaries for lumps and bumps and use the speculum for a glimpse of my cervix.
As with most appointments you’ll probably be asked to leave a urine sample so they can check for pregnancy (wouldn’t that be easy?!), your blood sugar level for a diabetes test, or for UTI (urinary tract infection).
And the least pleasant part is the blood draw. While this step is entirely optional, I highly recommend it. Your care provider can use the blood sample to check your iron levels (being pregnant can make anemia much worse, so it’s best to catch it early), HIV and STDs (of which can be very dangerous and potentially deadly to both you and the baby), and your immunities to rubella and varicella (chicken pox). I’m a complete needle-phobe and I suffer through it.
If you’ve been trying to conceive for a long time, you might consider getting your thyroid checked, especially if you have issues with hormonal imbalances and the inability to gain/lose weight reasonably. Your thyroid not working up to par can certainly effect your ability to get pregnant.
All in all, the appointment should be pretty straight forward. Of course, the most important part of this appointment should be for you to ask any questions you might have about conceiving or the early days of pregnancy. This is an especially good time to talk about and problems or concerns you might have. Don’t be shy. No matter how embarrassing you think your question might be, your doctor or midwife had heard it all before. They will be able to offer you advice or refer you to specialists that you might not receive if you don’t speak up.
Here are some great questions for you to ask at your preconception appointment:
- What, if any, methods of family planning do you recommend?
- When should I start taking a folic acid supplement?
- Are there any vaccines or screenings I might consider before getting pregnant? Am I due for a PAP smear? Should I be tested for HIV or any STDs?
- Discuss any existing health problems you may have or foresee having. Ask how pregnancy or childbirth may affect or be affected by these health problems.
- Discuss any medications you are using, including prescriptions, OTC medicines, and herbal or natural supplements.
- What are the ways you can improve your overall health and avoid illness?
- When should you quit smoking, and how?
- How will drinking alcohol affect your ability to conceive?
- Are there any hazards in your home or workplace that could affect pregnancy?
- Are there any genetic disorders that you should be concerned about? What about hereditary concerns such as blood pressure, depression/anxiety, and diabetes? What about in your partner’s family?
- Discuss any problems you have had with previous pregnancies, such as miscarriage (or abortion), gestational diabetes, preterm labor or birth. Discuss the births of your previous children, such as were they vaginal or surgical deliveries? Any complications? How long should you wait in between births?
- And be sure to discuss any support concerns or domestic violence. If you have a history of trauma, such as sexual abuse, it is also important to be honest and open with your care provider about this as well, as it can greatly affect your emotional well-being during pregnancy and childbirth.
Another reason to book that preconception visit is to use it as an opportunity to shop around for your care provider. If you are on the fence about home birth v. hospital birth or are unsure about which doctor or midwife you want there for you on your big day, this is an excellent opportunity to take them for a spin. You might walk into your appointment and be disappointed by the lack of attention you receive or you might feel like your doctor isn’t really listening to your concerns. You might even be surprised by how quickly they rush you along and out of the office. These are all huge red flags that you might want to find a different support team. It’s much better to find this out before you are pregnant. Of course the decision of who and where can always be addressed later, but I like to be prepared.
A healthy pregnancy and eventually a healthy baby all starts with a healthy mommy, so get that preconception appointment in the books!
Peace and love,