Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0040/00404.txt

Text File | 1993-06-14 | 14KB | 248 lines

$Unique_ID{PAR00404}
$Pretitle{}
$Title{Pregnancy:  The First Month:  Ask the Doctor}
$Subtitle{}
$Author{
Editors of Consumer Guide
Ellis, Jeffrey W
Ellis, Maria}
$Subject{First Month Ask Doctor Prenatal Visit Visits pregnant pregnancy
examinations laboratory tests menstrual period due dates morning sickness
breast tenderness frequent urination Calculating Delivery Date Medical History
previous Complications Family Social Physical Examination Blood Urine Test
sugar glucose protein albumin Counseling Medications}
$Log{
Estimated Date of Delivery*0040401.tab}

Miracle of Birth


The First Month:  Ask the Doctor


What Happens at the First Prenatal Visit?


     Your first prenatal appointment with your doctor should occur as soon as
you think you are pregnant, usually about two weeks after you miss your
menstrual period.  Since the well-being of your baby will depend on your
health during pregnancy, it is always best to place yourself under the care of
a doctor as soon as possible.
     During the first visit, your doctor will take a thorough medical history
and will perform a complete physical examination.  Certain laboratory tests
will also be performed to detect any abnormalities in your blood, urine, and
reproductive organs.
     You will also have an opportunity to discuss with your doctor any
questions and concerns that you have about your pregnancy.  It's a good idea
to jot these down before you actually visit the doctor.
     To help you prepare, here's a summary of the types of questions,
procedures, and tests that are generally part of the first prenatal visit.

Current Symptoms

     The first question that your doctor will ask you is "When was your last
normal menstrual period?"  Since this information is very important for
calculating your expected delivery date ("due date") and for performing
certain tests on you and the baby, you should bring an accurate record of the
dates of your periods.  Also, you should note any other spotting or unusual
bleeding and report it to your doctor.
     Your doctor will ask you about other symptoms of pregnancy--such as
morning sickness, breast tenderness, and frequent urination--that you may be
experiencing.  He may also ask you about other symptoms--such as a sore throat
or coughing--that may indicate illness.

Calculating Your Delivery Date

     Once he has determined the dates of your last menstrual period, your
doctor will be able to calculate your expected date of delivery and tell you
how far along you are in your pregnancy.
     The average length of pregnancy is 280 days from the first day of the
last normal menstrual period.  Of course, conception may actually occur one,
two, or three weeks after the start of the last period.  But since it is
difficult to pinpoint exactly when conception occurs, the first date of the
last menstrual period has traditionally been used as the starting point for
calculating the length of pregnancy and the estimated delivery date.
     One way to determine your due date is to count 280 days forward from the
first day of your last menstrual period.
     A simpler way to calculate your due date is to add nine months and seven
days to the first day of your last menstrual period.  For example, if your
last menstrual period began on January 10, adding nine months and seven days
would give you a due date of October 17.  Still another way to determine your
due date is to use the Estimated Date of Delivery chart.
     Very few women actually deliver their babies exactly on their due date.
Usually, it's a few days before or a few days after.  However, nearly 95
percent of babies are delivered within two weeks of their calculated delivery
date.

Your Medical History

     Next, your doctor will ask you questions about current illnesses,
previous illnesses, and previous pregnancies.  Certain illnesses and problems
in the mother may cause complications during pregnancy, so your doctor may
need to perform special tests or examine you more frequently if you have any
such illness.  Among the illnesses that may complicate pregnancy are heart
disease, kidney disease, diabetes, high blood pressure, and certain
infections.
     Complications that occurred in a previous pregnancy may also repeat
themselves in your current pregnancy.  For this reason, your doctor will ask
you many detailed questions about any previous pregnancies or miscarriages.
Your answers will help your doctor to anticipate complications and either
prevent them or treat them early.  The information that your doctor will need
concerning any previous pregnancies includes:

  -  Date of delivery
  -  Length of pregnancy
  -  Length of labor
  -  Complications, if any, that arose in pregnancy, labor, delivery, or
     postpartum (after delivery)
  -  Type of delivery (spontaneous, forceps, or cesarean section)
  -  Condition of the baby at birth

     If you had any complications with a previous pregnancy and you are now
seeing a different doctor, try to obtain your previous medical records and
bring them with you to the first visit.
     Your doctor will also ask you about any medications that you are
currently taking.  In some cases, he may ask you to stop taking them if there
is any chance that they may be harmful to the baby.  If you are unsure of what
medications you are taking, bring the prescription containers with you.

Family History

     During your first visit, your doctor will inquire about the health of
your husband, brothers, sisters, parents, and other close family members.  The
purpose is to determine if there are any illnesses that may first become
apparent during your pregnancy.  Diabetes and high blood pressure, for
example, tend to run in families and may first produce symptoms in a woman
during the stressful period of pregnancy.
     Your doctor will also want to know if any family members have birth
defects or other illnesses that may be inherited by your baby.

Social History

     Your doctor will ask you questions about your social history, including
your occupation, your physical activities and hobbies, and your habits, such
as cigarette smoking and use of alcohol or drugs.  These questions should
always be answered honestly, since the purpose is to determine if the baby
will be exposed to any harmful substances or physical injury.  Your doctor
will counsel you to stop certain activities or discontinue the use of certain
substances if they are potentially hazardous to your pregnancy.

Physical Examination

     After the doctor has completed taking your medical history, you will be
asked to undress and put on a gown.  Your doctor will then give you a complete
physical examination.  Usually, a nurse will have determined your height,
weight, and blood pressure before the doctor begins.  The doctor will
carefully and systematically check your eyes, mouth, chest, heartbeat,
breasts, abdomen, and legs for the presence of any abnormality that may
indicate illness or complicate pregnancy.
     Next, your doctor will perform a pelvic examination to determine the size
of your uterus and to detect any abnormality of the ovaries, fallopian tubes,
cervix, vagina, or external sexual organs.  He will also carefully feel the
bones of your pelvis to determine if the pelvis is large enough for a safe
delivery.  At this time, the doctor will also take a Pap smear from your
cervix to detect any cancerous cells and may perform cultures to detect any
infections of the cervix or vagina that may affect the baby.
     If it has been more than 12 weeks since the start of your last menstrual
period, your doctor will also listen for the baby's heartbeat using a
microphonelike instrument called a doppler.  If you are past the fifth month,
he may be able to hear the heartbeat with a stethoscope.
     After the first visit, the doctor will not need to repeat a complete
physical examination.  However, at each subsequent visit, he will check your
weight and blood pressure, measure the size of your uterus, listen to the
baby's heartbeat, and, toward the end of pregnancy, check the position of the
baby.  He may also examine other parts of your body if you are experiencing
discomfort, such as soreness of the legs or headache.

Blood and Urine Tests

     During your first visit, your doctor will also order certain tests to be
performed on your urine and blood.  The nurse will generally ask you to
urinate into a small cup before you undress for the physical examination.
Some doctors may instead ask that you obtain your urine sample at home and
bring it with you to your appointment.
     Your urine will be checked for the presence of sugar (glucose) and
protein (albumin).  The presence of sugar in the urine may indicate that you
have diabetes; the presence of protein may indicate kidney disease.  If you
have either of these conditions during pregnancy, it is important that they be
diagnosed.  A small portion of the urine sample may also be sent to a
laboratory to check for signs of kidney or bladder infection.
     If you are early in your pregnancy, the nurse will usually perform a
pregnancy test on your urine.  If, however, you are quite advanced in your
pregnancy, with an obviously protruding abdomen, the pregnancy test will not
be necessary.
     Several small tubes of your blood will also be drawn by either the nurse
or a laboratory technician.  The samples of your blood will be sent to a
laboratory to determine your blood type, Rh factor (see The Sixth Month:  Ask
The Doctor), glucose (sugar) level, blood cell count, and immunity to German
measles (Rubella).  If your blood does not indicate that you are immune to
German measles, you will be advised to avoid contact with anyone who has this
disease.
     Your blood may also be tested for the presence of syphilis, AIDS, and
other sexually transmitted diseases.  If you have a personal or family history
of certain illnesses, additional blood tests may also be performed.
     Some of these tests will be repeated during future office visits.  During
each visit, the nurse will check your urine for sugar and protein.  During the
fifth month of pregnancy, another blood test will be done to check your blood
sugar level.  Your blood count will usually be checked again during the eighth
month.

Counseling

     After you dress, the doctor will sit down with you and offer practical
advice for the early stages of pregnancy, discuss any abnormal findings, and
answer any of your questions.  At this time, it is also best to discuss any
plans that you have made regarding childbirth education classes, use of
anesthesia during labor (see The Eighth Month:  Ask The Doctor),
breast-feeding, and so on.
     During this discussion, the doctor will also talk about your diet, weight
gain, physical activity, clothing, and hygiene.  He will describe to you the
"warning signs" of pregnancy that may indicate that a complication is
developing.  Be sure to get the doctor's emergency telephone numbers and the
telephone number of the hospital just in case you need to reach him when he is
not in the office.
     Your doctor will also tell you when you should return for future visits.
Generally, during the first 28 weeks of your pregnancy, you will be seen by
the doctor once a month; from weeks 29 to 36, you will be seen once every two
weeks; and from 36 weeks until delivery, you will be seen once a week.  If you
become ill or if complications develop, your doctor will examine you more
frequently.

Medications

     Before you leave his office, the doctor will usually write you
prescriptions for an iron tablet and a multivitamin that is made specifically
for pregnant women.  Because the baby makes many nutritional demands on your
body, you will normally need these supplements to your diet.  Be sure that you
take them as directed.


This Month's Visit

During this month's office visit, the doctor will probably:

  -  Ask about symptoms of pregnancy.  By now, you will have missed a
     menstrual period and may have morning sickness, breast tenderness, and a
     need to urinate more frequently.
  -  Calculate your expected date of delivery.  The doctor will need to know
     the first day of your last normal menstrual period.
  -  Take a complete medical history and ask about current illnesses, previous
     illnesses, and previous pregnancies.
  -  Take a complete family history and ask about illnesses or birth defects
     in your husband, brothers, sisters, parents, and other close family
     members.
  -  Take a complete social history and ask about your occupation, physical
     activity, hobbies, and use of cigarettes, alcohol, and drugs.
  -  Check your height, weight, and blood pressure.
  -  Perform a complete physical examination.
  -  Perform a pelvic examination.
  -  Perform a Pap smear and take cultures from the vagina and cervix.
  -  Perform a pregnancy test, if necessary.
  -  Take blood samples to test for your blood type, Rh factor, blood count,
     sugar level, and immunity to German measles.
  -  Take blood samples to test for syphilis and AIDS.
  -  Give advice about symptoms of pregnancy.
  -  Discuss diet, weight gain, activity, clothing, and hygiene.
  -  Describe the danger signs of pregnancy.
  -  Prescribe multivitamins and iron tablets.