Your pregnancy journey: what you need to know.
Pregnancy is a journey that carries a woman through many ups and downs and twists and turns.
From the discovery of being pregnant, the physical changes that your body goes through, and the psychological changes that many may not see, it's a lot!
That is why having support along the way makes a huge difference in how the mom-to-be will navigate this journey.
An Obstetrician who you are comfortable with is also paramount along this journey.
This will allow you to be able to express any concerns you may have about the pregnancy.
Even before baby is born, it truly does take a village to raise a child.
Antenatal visits
The number and frequency of visits will depend on the patient’s risk factor profile. Patients who are high risk will have more visits than low risk patients.
What to expect at the first visit
Your Obstetrician will ask you a few questions such as when your last period was and if you are sure about the date.
This information is important for establishing the estimated date of delivery, known as your 'due date'.
They will also ask about any previous pregnancies.
This information is very important to determine if the patient has any risk factors from the previous pregnancy that may impact the current pregnancy, and it may also impact choice of delivery - vaginal delivery vs cesarean section (c-section).
Medical history
They will also ask about any medical conditions or previous surgery (e.g. Hypertension, Diabetes Mellitus).
Depending on the condition or the nature of the surgical procedure, the patient may need additional tests or referral to another specialist so that these conditions can be controlled.
Based on all the information gathered, the Obstetrician will then schedule your visits and advise you about any tests and ultrasounds that will need to be done (more on that below).
As the pregnancy progresses into the third trimester, visits will become more frequent.
Ultrasounds
Patients with no other risk factors or complications during the pregnancy will most likely have three ultrasounds.
- Dating and Viability: This is the very first ultrasound which is done in the first trimester. This confirms the presence of a live pregnancy, the location and the due date
- Anomaly Scan: This is the ultrasound that everyone is looking forward to. “Is it a boy or girl?” This ultrasound is done in the second trimester and during this scan your obstetrician is looking for any abnormalities in the structural development of the fetus. We can also determine gender at this time!
- Third Trimester Scan: This ultrasound allows us to confirm the presentation of the baby, “head down” or not, calculate an estimated fetal weight, and location of the placenta. This information will help to guide the plan for delivery.
If the need arises, then more ultrasounds to assess fetal wellbeing will be scheduled.
Blood Tests
At various points along your pregnancy journey, your Obstetrician will request that you do blood tests.
These tests are done to screen for conditions that may impact the pregnancy.
Other investigations may be required if the mother has other health conditions or on maternal request.
Antenatal screen
This most commonly includes:
- Complete blood count: to assess for anaemia and platelet abnormalities
- Blood Group and Rhesus status: to determine if mommy is Rhesus Negative or Positive
- Sickle Cell Screening: this is a condition seen commonly in the Caribbean
- Human Immunodeficiency Virus (HIV)
- VDRL: This is a screening test for Syphillis
- Hepatitis B Screening
- Rubella Virus screening
- Glucose Challenge Test (O’Sullivan’s Test): This is a screening test for gestational diabetes and is done at 28 weeks.
Delivery
During the pregnancy, you and your Obstetrician should have open dialogue about the birth plan - both timing and route of delivery (vaginal vs c-section).
Ideally, delivery is targeted after 37 weeks of pregnancy.
Factors that may impact the route of delivery include if the baby is “head down” or not; the presence of a mass - for example a fibroid and the location of the fibroids/s; the location of the placenta; any coexistent medical conditions and previous surgery such as a previous cesarean section or myomectomy (removal of fibroids).
During these discussions, the availability of an epidural may also be discussed, and a pre-labour consultation scheduled with the anaesthesiologist.
Conclusion
Navigating the pregnancy journey may seem daunting but with good family support a supportive obstetrician, the numerous visits, tests and the obstacle of delivery can be made that much more manageable.