Between six and eight weeks have passed since the first day of your last period. You’re pregnant, and it’s time to visit your obstetrician. Of course, you’ll have scheduled your appointment as soon as you found out you were pregnant (we discussed this in our last post, “What to Do When You Find Out You’re Pregnant”) to ensure there’s no delay in your prenatal care.
The first prenatal appointment lasts a bit longer than most of the other appointments—you’ll see your obstetrician once a month until week 28; two times a month between weeks 28-36; and, weekly after week 36. This first appointment takes more time, because of the background information your doctor needs to discuss with you.
At my office, we ask our patients to access the digiChart Electronic Medical Record Portal available through our website two or three days before the first appointment. Once on the site, you would carefully answer a series of questions that will help us determine your due date and identify any potential risk factors.
During the appointment we’ll discuss that information and I’ll take time to answer your questions and to go over important prenatal care issues. More specifically, we’ll cover the following.
Dietary recommendations and restrictions during pregnancy
A healthful diet will make a difference in fetal development and your overall well being. We will discuss the importance of protein, calcium, grains, seafood, fresh fruits and vegetables as well as the avoidance of unpasteurized dairy products, unpasteurized juices, cold cuts, and seafood containing PCBs and Mercury.
Prenatal vitamins
I will prescribe prenatal vitamins (if you’re not already taking them), which are paramount to your baby’s health.
Genetics consultation
While not all screening and diagnostic tests will be completed during the first prenatal visit, we will discuss your options for various first and second trimester diagnosis and molecular genetics testing for autosomal recessive traits such as Tay-Sacks, SMA, Fragile-X, Cystic Fibrosis, etc. Specific prenatal genetic tests to cover include:
• NT scan
• CVS
• Amniocentesis
• APF test
• Genetic ultrasound
It’s important to note that each genetics test is optional. I offer my patients a formal genetics counseling visit to discuss the nature of these tests, so that each pregnant couple can decide if testing is right for them.
Prenatal education
I am affiliated with the Norwalk Hospital here in Connecticut and I recommend their prenatal education program to all my patients. Programs begin as early as the first trimester and include hospital tours, childbirth classes, infant CPR, and more. Prenatal education will be discussed at your first appointment, but you can also learn more on the Norwalk Hospital website.
Coverage arrangement
It’s important that you have an alternative physician to serve as backup in the event that your obstetrician is not available when you have questions or need to see him/her. In my office, we discuss this at the very start to ensure your prenatal care is completely covered.
Physical exam and testing
At this first prenatal appointment we will complete pap, blood, and urine tests. We will be looking for abnormal cervical cells, certain infections and sexually transmitted diseases (including HIV), the Rh factor, anemia, and proof that you have immunity against rubella and chicken pox, among other potential health issues. If any of the tests cause concern, we may proceed with diagnostic testing to rule out any potential problems.
Influenza vaccine
Not only will an influenza vaccine prevent the likelihood of you getting the flu, but there are a number of other medical benefits for your baby. Studies show that an influenza vaccine will decrease the chances of premature birth, low birth weight, and your baby needing to be hospitalized. During your first prenatal visit we’ll talk more about influenza prevention.
This post is the fourth article in a series of articles dedicated to expecting moms here in Connecticut. Visit us every two weeks to learn more about prenatal care.
Dr. John Garofalo, M.D., is an obstetrician and gynecologist located in Fairfield County, Connecticut. For more information on Dr. Garofalo and his medical practice, go to http://www.garofaloobgyn.com/. Dr. Garofalo can be reached for a personal consultation at 203.803.1098.