Just saw the two pink lines in the home urinary pregnancy test kit? Great news, You are pregnant! From here starts your journey of motherhood, an experience that’s unique and fulfilling for any woman. Let the feeling sink in and then fix the appointment with your Gynecologist. In this article, we will discuss what you should expect when you go for that first visit.When you visit the doctor, remember to carry any significant past medical records such as the discharge summary of your previous child’s birth or the prescriptions of any medical treatment that you have been on or reports of any recent blood investigations that you might have done. First, as you meet your Doctor, you will be asked some questions, which we call medically as ‘history taking’. This is perhaps the most important part of your visit as this enables the doctor to know about you in detail. Some of the questions that you can expect to come your way have been highlighted here.
1. The first day of your last menstrual period: This helps to calculate your due date and also how far you currently are in your pregnancy i.e. your period of gestation. You will be asked about the menstrual cycle length and it’s regularity as this can have a bearing on your actual gestational age.
2. Previous Obstetric history: If this is your second or subsequent pregnancy, the details of previous pregnancies and childbirths become very important. For example, if you had high blood pressure the last time, we need to be watchful this time as well. If your mode of delivery was by Caesarean Section the last time, this could have a bearing on the mode of delivery in your current pregnancy.
3. Medical History: Any chronic medical illnesses will have an impact on the current pregnancy and pregnancy can have an impact on the medical illness. Chronic conditions of the kidney or heart or having type 2 Diabetes Mellitus, or Chronically raised blood pressure can all have an impact on the growth of the baby. Also, it’s very important to tell about the medications that you have been taking for any medical conditions. Certain drugs are not safe during pregnancy and can lead to malformations in the baby. These need to be stopped/changed while you are planning to conceive or once you have conceived, at the earliest.
4. Family history: Conditions like high blood pressure or Diabetes tend to run in families and so a positive history makes us more cautious.
5. Any drug allergies: Don’t forget to tell about any allergies. This small information can prevent catastrophes!
6. What medicines are you currently taking: Folic acid should be taken periconceptionally, meaning 1 month before getting pregnant and continued in the first 3 months of pregnancy. Also, you need to continue thyroid supplements if you are already taking them.
Taking ‘history’ can actually occupy the majority of the time of your appointment but this helps the doctor to gather all the necessary information that is needed to formulate your care plan.
Once through this part, you will be examined. The examination will usually include:
1. Checking your weight
2. Measuring the blood pressure
3. A general examination from head to toe, examining for anaemia (low haemoglobin), any thyroid enlargement, the breasts, lungs, heart and tummy.
4. Internal examination: This may not always be done as the Ultrasound is more informative at this stage of pregnancy. However, if you have significant pain in the lower tummy, any bleeding through the vagina or feeling dizzy, then you might be subjected to an internal pelvic examination.
After the examination is the time for discussion. You will be told on what to expect during the course of pregnancy, what are the usual and common symptoms in the first three months. What precautions you need to follow and what changes you should bring about in your lifestyle to take care of the growing baby and yourself (the details of these points are outside the purview of this article). If you are not a first-time mum, the experience comes in handy and you already know a lot of things. You will also be given a prescription for medicines that you are supposed to take. In the first three months, we avoid any unnecessary medicines to prevent harmful effects on the growing organs of the baby. Folic acid is a must however to prevent any malformations of the brain and spine. You might be given additional medicines if you are having excessive vomiting or have had any miscarriage in the past.You will be told about the investigations that need to be done. These will include blood tests for blood group, haemoglobin, thyroid, sugar, thalassemia (a blood disorder), infection screen (HIV, Hepatitis B/C, syphilis and Rubella) and a urine test for infection. An ultrasound is usually done around 6 weeks of pregnancy to confirm the baby’s heartbeat. At the conclusion of the first visit, Doctor will tell you the care plan for your pregnancy and when the next visit is due.
Remember, Medicine is Faith. When you go to meet your Doctor, go with complete trust. Feel free to ask questions (jotting them down in a diary prepares you for the visit and makes sure you don’t forget any) and clear all doubts. This helps to build a rapport and makes you feel comfortable.The ‘Obstetrician’ is not just your doctor but your guide and companion as well. After all, you both take this journey together!