The beginning of your pregnancy can be an exciting time, full of possibilities – and it can also be a period of worry, of not feeling well, or general uncertainty. In addition to the physical and emotional roller coaster, there is a lot of “work” to do – making plans for your desired place of birth, choosing a provider to care for you and your baby, and then comes getting established with your prenatal care routine.
That’s what we’re going to talk about today.
Your first official prenatal visit with us usually happens at around 11 or 12 weeks. Prior to this, we have had an interview, during which we have discussed your general and pregnancy health history, and your wishes in regards to early prenatal testing, such as genetic screening and early ultrasound. If you have opted to have early blood work done – for HCG or progesterone, for example – your first clinical visit might happen much earlier. There are a lot of other timing details here that we won’t go into, but suffice it to say that while the actual scheduling for your first official visit depends a lot on what options you have chosen, for most people, it is, as we said, at around 11 or 12 weeks – the magical time when we will probably be able to hear the baby’s heartbeat.
The first thing that happens when you arrive at our office for your first visit is that we will all sit down to talk about what’s been going on for you in your pregnancy so far. How are you feeling? How is your appetite? Do you have any concerns? Any questions at all about anything that is happening, or going to happen? During this discussion, we will also go over the paperwork we sent home with you at your interview – these include an overview of our scope of care, informed consents and some state required forms, contingency plans, and the financial agreement. We will also go over the information you have filled out in your online chart (which you will have access to for the duration of your care.)
This part of your visit will probably take around 30 minutes, and when there is a natural pause in the discussion, we will move into our exam room for the physical assessment portion of your visit.
For your first visit, we will start with a brief physical exam to assess overall health. You do not need to remove any clothing for this visit, unless you have requested to have a pelvic or a breast exam. After this, we will have you recline on the exam table so that we can get to the fun part – listening to the baby. At this stage of pregnancy, the baby is very small, and will be hanging out close to the pubic bone, so at this point, we will ask you to lower or open the waistband of your pants a little bit so that we can get to the right spot. We will apply gel, and listen for heart tones with a doppler. Most often, we are able to hear the baby without difficulty at this time, but it is important to note that it is possible that we won’t be able to, and that it can be normal. If this happens, we will discuss with you a couple of options, including returning to the office the next week to try again, or ordering an ultrasound to take a look.
After we have heard heart tones, we will draw your initial prenatal labs. Tip: If you come to this visit well hydrated and well fed, it will make the blood draw easier. And then, we will have you step on the scale. There is never judgment about weight in our office, of course, and we want you to feel free to enter your own weight into your chart, if you don’t wish to vocalize it. Weight is just one factor in a big clinical picture – it helps to determine if you are eating enough and expanding your blood volume in a healthy way.
When we are done in the exam room, we will move back into the consultation room, where we will go over any other questions you have, and then schedule your next prenatal visit in four weeks. In the intervening time, we will get your lab results back, and upload them to your online chart. You will get notifications by email of updates to your chart, so you can sign in any time to see notes and results, or send us non-urgent questions.
On this day, and during your future visits, we will look forward to talking with you about your wishes for your birth, and of course, your questions or concerns. Our wish is for you to feel comfortable, and be an informed partner in your care.