Pre-conception appointment?

[Jill123]

I've done a search, and while a few of you have touched on having pre-conception appointment with your doctors, it wasn't really mentioned in-depth.

I stopped taking the pill last month in order to conceive. I called my ob-gyn to make a pre-conception appointment (based on what I'd read here on the BB), but she said it wasn't necessary -- I've had a perfect annual exam since I was 16, and my last exam 8 months ago was no different. But I'm wondering if I still need one -- just in case.

What thoughts do you all have? How important is this? (I know it's not mandatory, since there have to be quite a few "surprise" conceptions, so obviously the mothers weren't planning to conceive!) How many of you had pre-conception appointments?

Details needed!!

[LaraW]

I had a regular check up during the time DH and I were trying to get pregnant, so I guess that would count for me. She did a pap smear, etc. I had been off the pill for a couple of months by that time, and she just told me I should be taking a prenatal vitamin, cut back on alcohol, etc. I don't smoke, so that was not an issue for me.

At that time we hadn't conceived yet, and we talked a little bit about what would happen if we weren't able to, that sort of thing.

If you have questions, it might be worth a phone call, but if your doctor is comfortable with your health and doesn't have any issues with your getting pregnant, I tend to trust the dr. If there is some health concern that has come up in the time since your last appt, I'd certainly share that with her, but if not I would not worry about it.

Good Luck!

[MrsReber]

I didn't have a pre conception appointment with either child. The only thing you may want to do is start taking folic acid. I simply asked the people at the GNC and they told me what strength was appropriate. I also started eating more things with folic acid, such as spinach.

[MinEaston]

My last Drs appt coincided with when I went off the pill, and I asked him about what I should do. He just said to take folic acid (which I've been doing for quite some time) and to quit smoking (which I don't do) and drinking (which will be harder) when we actively start trying to get PG.

Editing after I read RunnerKim's comment. If you've never had chicken pox, be sure to get tested for immunity to that. I was not immune, so I got the shot a few years ago since I was hanging out with many friends' children.

[RunnerKim]

I had a pre-concepiton appt. scheduled but ended up PG before the appt. However one thing that came up during my pregnancy that could have been dealt with before was that I was not immune to rubella (I think it's rubella but it could be something else they test for). I gather most people are immune. It wasn't a huge deal that I wasn't immune - being my first child I wasn't around other kids much anyway and rubella is not very common. If you're not immune and not pregnant then you can get immunized (but then I think you need to wait several months before getting pg). I received my immunization at the hospital shortly after delivery so I won't have to worry about it next time.

Otherwise, as others have said start on the folic acid (you could probably have your doctor prescribe something without an appt.).

Kim

[cchhbb]

DH and I both had appointments. We went to our GP's and had total work-ups done. We just wanted to make sure we were both healthy. We hadn't had physicals for years.

I also went to my OB and she started me on prenatal vitamins. The great thing was she calculated for me when I would ovulate and we got pregnant that month.

Cheryl

[newtricks]

Jill-

Some areas of Colorado have a fairly low rate of vaccination compliance so the rubella thing is something you might want to check out or at least talk to your doctor about.

I was surprised at how blase my obgyn seemed the first time I got pg. I did a home test and called her right away and the admin didn't even schedule me for an appt until I was something like 8 weeks! Kind of funny.

Best of luck.

[MrsReber]

I think that the norm for the first appointment is at 8 weeks. That's when my first appointment was after I took my home pregnancy test. I know it seems crazy because you'll feel like you have all these questions. However, I think there's little they can do until about that time. They won't even be able to hear a heartbeat until several weeks later. I think they just do an internal exam to get an idea of how far along you are. I also had bloodwork done before the appointment. I guess since the office deals with newly pregnant women everyday, it's not such a big deal to them. Good luck with things!

[Jill123]

Thanks for all your help!

I was away from my computer yesterday, so I was hoping there'd be good advice when I got back! There was, so thanks again.

I've been loading up on folic acid already, so that's one less thing I'll have to start. I've also stopped drinking alcohol (wasn't drinking that much, anyway) and since I've never smoked -- not a problem there.

I also don't get that much caffeine anyway, but I'm trying to cut that out of my diet entirely. I also read that I shouldn't consume artificial sweeteners -- is that necessary?

But basically, I'm just trying to take better care of myself -- making sure I'm getting all the rest I need, and trying to eat healthier.

Did any of you experience an increase in sex drive once you got off the pill? I don't know if it's excitement at trying to start a family or just a side effect, but what ever it is, DH is LOVING it!!

[zippy478]

Good luck on trying to start your family. DH and I have been trying for about two months now as well and when I called my doctor, they told me to finish the pill pack before I stopped taking it and they also called in a prescription for pre-conception vitamins for me.

The increased sex drive is probably because you are off the pill and your hormones are adjusting back to "normal" again. I do plan on asking my doctor about it when I see him the next time, though because I found that curious as well.

[MrsReber]

He he he--- yes, my DH loved that side effect, too! He told me that there was something wrong with me! Then he told my friend "I hope you don't have what she has!" I had to explain that one !!

[JillC]

Hi Jill123,
Congratulations on making the decision to start your family!!
I work in OB and so I have to keep up on this stuff. Preconception appointments are becoming the norm now. Also, studies have shown better pregnancy outcomes when women are seen very soon after realizing that they are pregnant, rather than waiting until later in the first trimester.
Here are some of the things that a preconception appointment can address:
1. Folic acid!!
2. Environmental concerns--not only drinking and smoking but potentially dangerous exposures at work or home.
3. Rubella titers, so that you can get an MMR booster (or other vaccinations), if needed, before pregnancy.
4. Family history issues. If you have any genetic risks, it is much better to address them prior to conception.
5. Social issues. Are you ready for pregnancy, do you feel safe at home, etc.
6. Medical issues--chronic medical conditions (e.g. diabetes, epilepsy, fibroids) and review any medications you are taking.
7. Info on conceiving--how long it takes the average couple, best time in cycle to conceive, nutritional issues, etc.
I hope I'm not forgetting anything. If you and your doctor have already addressed these issues in previous appointments, then you're covered!
Also, I recommend the book The Unofficial Guide to Having a Baby by Douglas and Sussman. It's very thorough, accurate and unbiased.
Good luck and have fun!!
Jill

[RunnerKim]

Jill - you reminded me with how much domestic violence information was around. DH accompanied all my appts and one time had to leave the room so they could ask me if I felt safe at home etc. Later we read that domestic violence is the #1 cause of death of pregnant women (prior to birth/delivery). :mad:

[Jill123]

Kim --

I was really confused for a while -- I thought something I'd said reminded you about domestic violence!

I had an MMR vaccination in high school, so I think I'm covered there. And I don't know of any genetic risks, or chronic health problems.

Although you might be able to help me with one -- I already talked to my pharmacist, but what are the risks when taking Prevacid while pregnant? I've been taking it for a couple of years now (I have GERD), and I'd like to continue, but I don't want to cause any harm to the baby.

My pharmacist said it should be fine, as she's filled out prescriptions for small children, but said it should be a topic of discussion with my OB when I conceive.

Do you know anything about Prevacid?

[RunnerKim]

Whoops - guess I should have said JillC! Sorry about that
Best of luck - it's a wonderful adventure.

Kim

[MrsReber]

Jill, if you have concerns about it, I'd simply call the OB/GYN office now and ask them. The group that I went to was very helpful with all of my questions and one quick call would put you at ease.

[JillC]

Kim--often domestic violence worsens while a woman is pregnant. Definitely something that's better to address prior to pregnancy.
Jill123--2 ways to check on Prevacid. Like MrsReber said, you could just call your OB. Another good place to get info on exposures of concern (medications, chemicals, viruses, herbs, etc.) during pregnancy is a Teratogen Information Service (a teratogen in any agent known to cause birth defects or health problems in the baby when mom is exposed during pregnancy). Many states have an 800 number you can call and they'll give you detailed, up to date info.
Here's a website that can tell you if there's one in your state:
www.otispregnancy.org
Oh, and about the MMR, it's possible to lose your immunity from the vaccine so your doctor will probably check your titers.
Jill