Questions Before Getting Pregnant

[BeckyM]

This topic may look similar to the one titled "Babies", but I have a different question. My husband and I are close to trying to start a family, and I have scheduled a "consultation" appointment with an OB/GYN. This will be my first time meeting this particular doctor, because my previous OB/GYN was "let go". (I didn't think she was that great anyway.)

My question for you all -- especially those of you with experience in this area -- is what questions should I ask this doctor at the "consultation"? I have a list I've started already, but I don't want to overlook anything. Could you all look over my list of questions and let me know if there's anything else I should be talking to him about? Of course if any of you have your own comments/answers to these questions, those would be welcome too. From reading all the "pregnant Susans" posts, I know there are quite a few of you out there who have great advice for "first-time mothers". Thanks!

1) How long should I wait after going off the pill before trying to get pregnant?

2) When should I start taking pre-natal vitamins? Before getting pregnant? Once I think I'm pregnant?

3) What concerns are there about exercise? I'm planning to continue to exercise during pregnancy, but I don't want to overdue it or do anything that might cause stress to the baby.

4) What foods/drinks/medicines should I avoid while pregnant? Caffeine? Nutrasweet? Headache medicines?

5) What is the normal routine of appointments once I become pregnant?

6) Should I also get a complete physical exam before trying to get pregnant?

7) Any book/magazine recommendations for a first-time prospective mother to read?

[MrsReber]

Becky, I had many of the same questions. I can tell you to start taking folic acid NOW. It is proven to prevent many spinal birth defects. I started taking it before I came off the pill. I just went to GNC and asked them how much I should take. They were very helpful. As for pre-natal vitamins, the doctor will give you a prescription for those after you become pregnant. They will normally tell you to wait about three months after coming off birth control, but, well, it just sort of happened in one month with us. The doctor said there is really no danger and many women even get pregnant while on the pill without any side effects.
You should avoid caffeine, though I hear a little won't hurt. I never drank any to begin with. They prefer you don't take any medications at all for the first 14 weeks of pregnancy. Exercise is fine, but nothing lying on your back after the first trimester. Remember, you are only maintaining weight at that time so don't overdo it trying to gain muscle or lose weight! And don't let your heart rate go over 140. I was having alot of back pain so my chiro told me to cut back to 20 minutes of cardio (I do 25) and go a little lighter on the weights. My sister continued to do aerobics throughout her whole second pregnancy and had no problems at all. As far as books- everyone will have recommendations for you! One book I really got a kick out of was "How to be a Pregnant Husband". I don't think my husband read it, but I was laughing the whole time while I read it! There are so many books that I became very confused. There's also a ton of information on line and in magazines. You really have to weed through it, though. For instance, I have read that it's bad to sleep on your back since it can disrupt the blood flow to the baby and your lower body, however, I wake up on my back all the time and everything is just fine. Some books out there make you so scared to do anything at all!

I didn't do anything special before trying to get pregnant as far as a physical. I asked the doctor about it at my normal yearly visit and then didn't see the doctor until I was 8 weeks pregnant. Then they did a whole exam and sent me for blood work. And more blood work!

I'd still aske the doctor these questions and whatever else you want to ask. You are smart to write them all down since you won't remember your questions once you get there!

I wish you lots of luck!

[BeckyM]

MrsReber, Thanks for your response! I was hoping you would see this and write your thoughts, since I know all these things must be very fresh in your mind.

A question about the folic acid -- did you continue taking that separately after the doctor gave you a prescription for pre-natal vitamins? Or is that something included in the pre-natal vitamins? The last time I went for a gynecological exam, I asked a few questions about all this to the Nurse Practicioner (I'm not sure about that spelling) who was seeing me. She told me when I decided to start trying to get pregnant to just call up, and they would give me a prescription for pre-natal vitamins to take then. I wanted to ask the doctor more about that, but if he agrees and gives me a prescription for those right away, should I supplement that with folic acid? I'll ask him that question too, but any additional thoughts/info you have would be helpful.

Thanks for the compliment on my idea to write down all these questions. I just know I have so many questions running around in my mind that there is no way I'd remember even half of them if I didn't write them down. This "consultation" appointment is scheduled for half an hour, which is longer than I think I've ever had with a physician, so I want to take full advantage of the time. Since being pregnant is something I've never done before, I feel like there is so much I don't know about it!

Good luck with the rest of your pregnancy! Though I don't post all that often, I always read the posts about the pregnant Susans and am excited for you. Thanks for your support!

Becky

[mightyh]

I'll answer on behalf of Mrs. Reber... When you're trying to conceive or are pregnant you need (I think-this is from memory) something like 800 mg of folic acid a day--that's how much is in most prenatal vitamins (even the over the counter ones). Women in general need about 400 mg a day (which is in most women's formula vitamins).

My ob-gyn recommended that I start taking prenatal vitamins as soon as I went off the pill trying to conceive. He recommended a regular multi-vitamin even before that.

Best of luck--it's an exciting time and not as cookbook as it may seem at first http://www.cookinglight.com/bbs/smile.gif

[Jen]

One thing I would recommend to check is...have you ever had chicken pox? If you had it mildly, you might want to think about getting your immunity checked before you think of trying to conceive. I had a very mild case when I was only a month old, which I caught from my Dad (my Mom has always called it "chicken pock", since I got only one in the middle of my forehead!!). I never thought too much about it until it came up in conversation at work one day, and my boss was completely shocked that I had never had my immunity checked. It's one of the things they check in the bloodwork when you first become pregnant (at least here in Canada), but at that point if you're not immune you can't do anything about it but worry for nine months that you might get it (since it can cause devastating birth defects). It turns out that I have ZERO immunity. I just had my first shot today - ouch! I'm a big baby when it comes to needles. As an adult you need a second "booster" about 4-6 weeks later. Then you need to wait a minimum of 3 months before trying to conceive. However, I know I feel a lot better knowing I won't have to worry about it when I'm ready to get pregnant!

Just something for you (or others out there) to think about.

Jen

[MrsReber]

I was already taking a multi-vitamin so GNC recommended that I take an additional 400mg for a total of 800mg, as mightyh pointed out. I asked that same question on my first consultation after I was pregnant (I also had a 1/2 hour visit). They told me that the pre-natal vitamins had enough folic acid in them and I should only take the prescription vitamin and not supplement it with anything else. Even though vitamins are good, too much can be harmful to you and the baby!

Yes, everything is very fresh in my mind now. I'm glad I can pass on some information. I am now at exactly 5 months, just starting month number 6 and I've been feeling great. You pretty much have to listen to your body as far as exercise goes. Your body will tell you when you've had enough. I stopped exercising for almost one whole month due to nausea (I can't spell that!) and tiredness, but I slowly resumed and it really does help me mentally. I'm glad you enjoy the pregnant Susan posts. It's so neat to have another pregnant woman on the BB to share stories with!

Oh, as far as immunity, I didn't have that checked until after I was pregnant. They do a few routine blood tests within the first couple of months and that is one of them, but I'm sure they'd check now for you. I had all the shots when I was younger so I wasn't too concerned about it.

[SusanD]

About folic acid...I know that a lot cereals are fortified with it, plus orange juice is very rich in it so if you have either of those things for breakfast then you're on the right track. I know spinach is high in FA as well - you might do some research and see what other foods you can incorporate into your diet that would help you out in that area. Like MrsReber, my doc recommended that I be off the pill for three months but things happened a little faster than anticipated (just call me fertile Myrtle) and she said not to worry. I was taking prenatal vitamins before I got pregnant though. One thing that scared me was that I'd had a cold and had taken some Tylenol Cold before I found out I was pregnant. She also said not to worry about that - first of all because Tylenol and Sudafed are OK, and also because you have about a 2-week "grace period" before the egg attaches to the placenta.

As for foods to avoid, I've almost completely cut out caffeine (and that was TOUGH) with the exception of an occasional coke. I've also stopped eating/drinking anything with aspartame (Nutrasweet). I had half a glass of wine with Christmas dinner - I was 5 months along at that point and I asked the dr. first.

Exercise...prior to getting pregnant I was running about 2.5 miles every other morning and continued that until the fatigue took over. My dr. recommended avoiding anything too high-impact so I slowed it down to a walk, but have been continuing it regularly since then.

Dr. appointments have been pretty non-eventful. Saturday I'll be at week 28, 7 months, and I've been going once a month. The appointments usually only last about 15-20 minutes - they do a urine test each time (I'm getting really good at aiming straight for the cup! http://www.cookinglight.com/bbs/smile.gif), check my weight & BP, listen for the baby's heartbeat, and then answer my questions and just tell me what to expect/look out for during the upcoming month. This next appointment will be my last monthly one, then I'll start going every 2 weeks till the last month and then every week.

As for books - I've been reading "What to Expect When You're Expecting". It's pretty good. Beware, though, there's a TON of books out there, and they tend to give conflicting information and scare the crap out of you with everything you can't and shouldn't do. Don't read too much!!! I'd recommend sticking with one or two, and take what they say with a grain of salt. Personally I think the best information comes from your doctor.

I hope that helped a little! Good luck & keep us posted! I know I've really enjoyed sharing my experiences and hearing other people's...kind of a mom/mom-to-be sisterhood! http://www.cookinglight.com/bbs/smile.gif

[BeckyM]

Thanks again for everyone's help! I'll be sure to ask the doctor about checking my immunity NOW instead of waiting until I'm already pregnant. I did have chicken pox when I was in third grade (I still have a few scars, because I couldn't stop scratching them http://www.cookinglight.com/bbs/redface.gif ), and I believe I've had all my immunizations, but it doesn't hurt to double-check.

I am already taking a multi-vitamin, but I'll ask the doctor for a prescription for pre-natal vitamins to start taking as soon as I go off the pill. That's especially good advice in case something happens sooner than expected, like several others have reported. I just hope I don't have problems GETTING pregnant once the time comes. I have heard so many sad stories of women trying everything without success. But I guess I can only wait & see . . .

Thanks again for all your support & advice. Any other pointers will be appreciated!

Becky

[MelissaAS]

Hi Becky,

I just had this same conversation with my midwife- and that's what I'd like to suggest as an option: a midwife instead of an OB/GYN. I started seeing her now to get to know her since we're considering starting a family soon as well. She is fabulous. I'm sure there are also great OBs out there, too but I cannot express how comfortable she made me feel.

I asked a lot of questions about the difference between a midwife and an OB and what to expect. She said that basically the difference is in the training and the philosophy. Training-wise, midwives are not MDs- they don't go to med school. They're CNPs with an extra graduate degree in midwifery. The philosophy difference is that midwives believe that pregnancy and birth are completely normal and natural- not a "condition" that needs to be controlled or fixed (as is the traditional medical approach to all "illnesses"). Basically along the line of women have been doing this for 1000s of years etc. etc.

In my case, my midwife works in a joint practice with OB/GYNs (I think it's 4 midwives and 6 OBs) so it's the best of both worlds. They work closely and would transfer you to an OB if complications that require intervention (surgery, C-section, etc.) arise, either during the birth or before during pregnancy.

Finally, the big difference that I've heard from friends and family that have been down both roads is that midwives take a lot more time with you during pregnancy and during the birth. Your scheduled appointments are never rushed and questions are encouraged. And your midwife stays with you through the entire birth process (not just popping in for the delivery, as some docs are known for- though I hear the OB nurses can be great too).

Anyway, it's just something you might want to consider! Best wishes!