First Trimester Health

1st Trimester Health...

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To keep track of baby progress, body changes and health updates

Of course one of the first things you will do once you get past the shock, excitement, fear - any combination of these really - is to go to your family physician to confirm your pregnancy and provide you with the next steps.

Family Doctor will take care of your concerns for the first trimester. To continue with a family doctor isn’t usually an option because your doctor may not necessarily specialize in this field and they will refer you to an OB or midwife.The family doctor usually takes care of your overall health and pregnancy related concerns in the first trimester. They will usually take over your newborn checkups once baby is born barring no complications.

One of the next steps is deciding who will be with you to help in the pregnancy (2nd trimester onwards) and delivery from a choice of basically 2 options.

Obstetrician (OB) or Midwife..?

Midwives tend to take care of your whole well-being. Not only physical, but emotional and psychological concerns. They provide you with additional support that you may not find in a doctor and take their time with you. They also tend to really emphasize on natural births and help guide you on whichever method you do choose. Midwives are covered by OHIP and have been gaining popularity. They can work with you in the hospital settings (usually affiliated with a specific hospital), birthing center or home births. This can depend on if they are a certified nurse or direct-entry midwife. Midwives also provide advice on nutrition and breastfeeding. They provide follow up appointments postpartum at your home and check the health of you and your newborn initially. If you are a low risk pregnancy, want a focus on natural birth and emotional support this could be a good option for you. High risk pregnancies are individuals in lower or higher age groups, have diseases that could cause complications in pregnancy, gestational conditions (i.e. diabetes brought upon by pregnancy), drug use, obesity etc (look at below link for more information). I have heard only positive things from friends and family who have gone the midwife route.

http://www.nichd.nih.gov/health/topics/high-risk/conditioninfo/pages/factors.aspx

Obstetrician are practitioners who specialize in pregnancy, labor, delivery & postpartum.

You can find one at your local hospital or if they have their own practice (more likely an Obstetrician-gynecologist). A lot of woman choose this route and so did I. If you are a high risk pregnancy this would be your best choice and there are OB’s that specialize in high risk pregnancy. You can easily be referred to one by your family doctor if you don’t have one already. Once accepted by an OB (if they have room to accept more patients) the practices can be solo- operated, group or combined practice. Hospitals are usually combined practice where you have your official OB you see at your check ups, but you are not guaranteed to have that OB for delivery. Basically depends on if they are one of the doctors on call for that day. Group practices is when you see the few doctors on a rotational basis so you have a chance to meet the possible doctors for your delivery. With solo practice you have your OB with a back up OB in case he/she is not available to be there for labor and delivery.

With the hospital set up, at first it seems that it’s unfortunate that you may not have your OB when the baby comes. But honestly on delivery day, I believe it is more important to have great nurses - the doctors are rarely there. They only come to check on how dilated you are, if they are any complications and when the baby starts crowning (not even for the whole pushing). If your doctor is on call, obviously a bonus since it’s someone you are at least familiar with. But in all the whirlwind and chaos, you will barely remember their presence and be extremely grateful when you have some awesome nurses.

And if your OB is around during your stay, the nice one’s will always stop by and check up on how you & your baby are doing:)

I chose Sunnybrook Hospital as my place for delivery for all babies and I would definitely recommend it! They have a newer updated birthing wing - the birthing suites are huge and comfortable. All the nurses that I encountered were extremely helpful & supportive. Most of their nurses migrated from Women’s college which has a stellar reputation. They have a dedicated high-risk OB floor and team. They have an OB triage lounge always open if you have any pregnancy-related emergencies or think you may be in labour. For my husband and I it was a great choice for us since it was right down the street from my parents home so we just stayed there closer to delivery date with the first 2 babies. 3rd baby we lived only 15min away from the hospital. Even though we were closer to another hospital, we wanted to stick with Sunnybrook due to our positive experiences there and my OB was there. Before I gave birth at Sunnybrook, I also volunteered for this hospital in the past and was already familiar with it and it’s great reputation. Most of the other patients there were from all over the GTA. Choosing a hospital accessible and close to you is important especially when it comes closer to the due date since..

A) You have weekly appmts (every other day when it goes past your due date)
B) It is suggested to not travel more than 15 minutes away the last week or two close to your due date. Even though labour takes a long time especially for 1st time mothers, it is better to be close to your hospital to ere on the safe side as well as be able to come in if you have any concerns.

Once you make an appmt with your family doctor and confirm you are pregnant, you and your doctor set up who will take over your care throughout the pregnancy. In this case, I got a referral to an OB.

*****In the mean time while I was waiting for the referral to go through, I arranged my 8 week ultrasound appmt at a local lab. I went with my husband and I would recommend bringing your significant other because this is the first time you will hear the babies heartbeat. Even though the ultrasound doesn’t show much, it is surreal to see & hear your baby for the 1st time. Once you hear the healthy heartbeat, the chance of miscarriage is very low. That’s why they recommend waiting till at least this ultrasound before letting people know of your pregnancy.

The first OB we contacted couldn’t accept any more patients (May is a popular month for babies- end of summer romance..?!?), but the 2nd one did. Dr. Barrett, who is a specialist for high risk pregnancies, but I guess he had an opening for me. He was very kind, reassuring, but also very straight to the point - which was good for me. I was his easy case. My first appointment meeting him, I brought both Dylan & my mother (she had some questions of her own). She asked my OB if I should seek out some counselling for being such a young new mom with unexpected pregnancy or see a therapist. My OB responded saying I’m at the optimal age physically to have a baby and maybe that she should see someone haha!!

For my second baby, Dr. Barrett wasn’t available due to him focusing on research. But the OB that originally didn’t have any space accepted me. Dr. Grace Liu.

She was fabulous! Also very straight to the point, but she takes a little more time with you and is overall a very personable doctor. And her secretary is so sweet which helps with making appointments etc.

The only potential issue with OB’s is that they tend to rush through the appmts since they have so many patients. It didn’t bother me too much because I prefer straight to the point answers and

I would have all my questions written down ahead of time - IMPORTANT TIP

I would make sure when meeting your OB, he/she is a good fit for you and you are able to understand them and be able to communicate with them easily. Since they will be answering a lot of your pregnancy and delivery concerns.

Some people also opt for a doula (not in lieu of midwife or OB). They are non medical person that act as a birth coach, offer companionship during pregnancy and assistance postpartum. Your body is going though a lot of changes and it is definitely an option to hire if you are finding you need some extra assistance during and after pregnancy. They also assist you after baby is born to help through the transition. Especially nice if you mesh well during your pregnancy. They help with anything from watching and caring for your baby, helping with breastfeeding, cleaning and cooking….basically a nanny. Amazing option if you can afford!

NOTE

A common term you will hear a lot especially at the beginning of your pregnancy is LMP- Last Menstrual Period. This is what doctors use to initially calculate your due date essentially 40 weeks from then (later ultrasounds can show a more accurate date). They date it from the first day of your last period. The day you actually conceived is later -generally 2 weeks later according to your ovulation cycle.

Your body is going through some MAJOR changes when you are pregnant. So it’s no surprise that you may have some concerns when some odd things happen. You freak out thinking it’s not normal- when in actuality it usually is totally normal. Of course always check up on it- look it up in your books, check with another pregnant friend and check with your doctor. But alot of the times everything is fine. Things you don’t even think has anything to do with your pregnancy, but it probably does. For example I got lots of nosebleeds. It is because your body is producing more blood volume and you are more prone to getting them.

I remember one night when I was in the first trimester, I had such a painful cramping sensation I’ve never had before! I was terrified that something was happening to the baby. I didn’t go to emergency because I wasn’t bleeding. Usually painful cramping + bleeding could mean miscarriage (more than spotting because spotting is normal even when pregnant) - But you can imagine I was inspecting my pee everytime I went to the bathroom. I was by myself and in so much pain. Early morning I woke up, at my worst, and I went to the bathroom this time for #2 - and I swear right after I felt so much relief, I actually started leaking tears while laughing because I could not believe what just happened....

And trust me, it happens probably more than you think…