Hello everyone and welcome back to Your Birth Bestie podcast! This is episode 21 where I will be breaking down the first prenatal visit after you get that positive pregnancy test. So if this is you, first of all congratulations I hope you are feeling well, but also know the reality is you’re likely some fatigue, nausea, and probably have a ton of questions circling around in your head.
Or at least that’s exactly how it was for me! I remember calling my provider’s office the very first time I got a positive prengancy test and they asked for the date of my last period and scheduled an appointment for me out until 8 or 10 weeks of pregnancy. When you’re filled with excitement or maybe mixed emotions about the pregnancy and you have a lot of questions like…
What should I be doing until then? Is this thing normal? What shouldn’t I be doing? What should I be thinking about regarding my provider or birth plan or do I even have to think about these things at this point?
And then on the phone, you’re told you have to wait several weeks or months even to get an answer! I know this caused me a lot of stress, but hopefully I have helpful information and resources to share with you today to make it much more tolerable and enjoyable for you.
I want to reassure you that it is normal to have lots of questions, but the healthcare system is pretty messed up with neglecting to provide support until that 10 ish week mark. By this time in your pregnancy, your baby has developed nearly all of their body structures, their eyelids have formed, their facial features such as ears and lips are beginning to take on their final shape. And they’re the size of only a grape! So you probably don’t have a baby bump at this point, but so much has already happened without you even knowing! Yet you likely haven’t even had the opportunity to get the support you want or need, which I would love to help change!
I would love for you to have support before this first appointment and really throughout your entire pregnancy, your labor, and postpartum journey, wherever you might be. So I’ve decided to expand my support beyond my self-paced online birth course, Hands-Off Hospital Birth… so you can have personalized and timely support whenever you have a question. I use Voxer support to text moms in my business, and right now am looking for moms like you, who would benefit from unlimited text support in pregnancy, planning for birth, or navigating postpartum as well.
I know the default is going straight to Google for all your burning pregnancy and birth planning questions… But let’s be honest, that info often is biased, not relatable to your particular situation, and not interactive at all. It takes so much time to find what you’re looking for and for it to be actually be helpful.
So if this is you, I would love to support you in this way! Send me a message on Instagram @bethconnors_cnm and we can figure out the details and what it would be like to literally have me in your back pocket as a resource helping you and your partner talk through it all!
I will also be opening my most personalized Birth Bestie package that includes text support, video calls, live birth support either in-person or online depending on your location and preference, access to my comprehensive course, and so much more amazing value! So the details of that will be coming soon, but if you’re interested in my most personalized 1:1 program, I would love to meet you and your support team! You can sign up for the waitlist today in the link in the show notes to be the first to know all the details and receive special bonuses as well when the program opens in November!
But until then, I don’t want to leave you hanging at all… I want you to feel prepared and take control of your appointments and experience without anxiety or stress at all, so here’s exactly what to expect during your first prenatal visit.
The first prenatal appointment is important because aside from that initial positive pregnancy test where you’re celebrating the start of parenthood, this is a lot of times when the journey feels real… full of excitement, questions, and probably some nervousness too.
But I am here to help you feel prepared and confident to make decisions during your prenatal care that will affect the rest of your pregnancy and journey to motherhood. This first prenatal appointment is scheduled between 6 and 10 weeks of pregnancy and serves as the foundation for your healthcare provider to monitor your health and the health of your growing baby. It’s also a chance for you to establish a relationship with your healthcare team, gather essential information, and set the tone for the upcoming months.
But stepping into the unknown can bring up many concerns and anxieties, whether it’s your first pregnancy or not. From worries about health issues to feeling scared or uncertain about childbirth itself… I’m here to address these common fears and offer you some guidance on how to approach your first appointment with confidence.
So the first thing you’ll do when you get that positive test, and maybe you’ve already done this, is call around to those in your insurance network and see who is taking new patients. Then you have a decision to make, to who you schedule your first appointment with… but it’s so early at this point that if it isn’t a good fit, you can absolutely change providers, so don’t put too too much pressure on this. Of course it would be nice to stay with the same person throughout, but know that you can change providers at any point and it doesn’t have to be a whole stressful situation. And we can talk about that another time too if anyone is interested.
Then as you prepare for this appointment which is probably weeks away, you’ll want to gather a few documents or at least think through some of these things. Be sure you have your drivers license and insurance card. Know your medical history such as current medications–including the dosage, any known allergies or sensitivities, details of past surgeries or medical procedures, previous prengancies and birth outcomes if this applies to you, information on family medical history including genetic conditions. You’ll also be asked about lifestyle information such as history or current use drugs or alcohol, or if you have any dietary preferences or restrictions. You’ll also want to provide emergency contact details for yourself and list a preferred pharmacy. So those are just very basic things to have handy to determine any concerns or risk factors for your provider to be aware of during your pregnancy.
YOU’LL also want to have a list of questions for your healthcare provider. They are assessing you, but you’re also interviewing them to see if they’re a good fit to care for you and your unborn child. I have an entire worksheet about conversations with you provider, questions to ask, understanding and assessing their answers, and when or how to change providers if it comes down to that… But here’s a few things to definitely ask during that first appointment.
What is the structure of the practice? Do they share call with other doctors? And if so, will you get to meet the other providers during your pregnancy? A lot of times clinics encourage you to schedule at least one prenatal visit with each doctor so you have met everyone by the time you have your baby. This isn’t ideal for all moms to have someone new every time, but others it doesn’t bother them at all. But having a heads up on who will actually be potentially delivering your baby is good to know ahead of time.
How often do you attend non-medicated births? This answer gives you some insight on their thoughts about unmedicated birth and if they do or don’t support it.
How will you help me avoid a cesearean? This is a way also to get a good idea of your providers values and how they will support you in a physiologic birth if that’s your goal.
What are your recommendations for labor positions, and pushing positions?
When would you recommend inducing labor? All good things to know ahead of time because it could save you some frustrating conversations way further into your pregnancy when it’s more difficult to find another care provider. So being sure the provider you are seeing is truly a good fit is very important and hopefully helps reduce any uncertainty and nervousness! And if you want the full list, I can link that in the show notes as well, bethconnors.com/questions.
You’ll also of course ask questions about any concerns or unusual symptoms you’ve experienced and talk about those at that first visit.
You should be taking a prenatal vitamin at this point also, so having information about the prenatal vitamins and supplements you are taking is important to make sure it has everything you need. I’ll link the ACOG daily recommended amount for vitamins and minerals during pregnancy. Definitely compare your prenatal nutrient facts against this list and supplement where necessary. Folic acid though is one of the most important to reduce the risks of neural tube defects that all prenatals should have. I like to recommend though finding a prenatal vitamin with L-methylfolate instead of folic acid, due to L-methylfolate eing easier for your body to work with and get the full effects from rather than relying on your body to properly convert folic acid to it’s acitve form. It’s not a requirement, but I do recommend it.
Also be sure you’re taking a prenatal with iron. Rethink taking the gummy vitamins if you can tolerate anything else because those do not contain iron. If it’s all you can handle due to nausea, anything is better than nothing, but do consider switching to one with iron as soon as you can. The prenatal that I have been taking for years now through two pregnancies and breastfeeding my babies is Pure Encapsulation Prenatal Nutrients. These are high quality ingredients that follow ACOGs recommendations. Also taking an Omega 3 supplement with DHA for brain development, supporting a full-term pregnancy, and healthy birth weight. I like Nordic Naturals. Also Vitamin D is something to think about too.
You’ll also want to calculate the first date of your last period and/or date of conception. The more information you have, the more accurately you’ll be able to date your pregnancy… but of course if you don’t know that’s okay too! Usually OB clinics will have you schedule a dating ultrasound with that first prenatal appointment or even a week or so before to confirm everything is alright, baby or babies if you have a surprise multiple pregnancy, that they are doing well and are in the uterus, not someplace else like a fallopian tube or an ovary, something like that would be dangerous and potentially life-threatening.
And that dating ultrasound is the best time to “date” the pregnancy which is estimating how far along you are. As baby gets bigger, the results are less accurate. This again never means anything is mandatory, but if you want the most accurate prediction this would be the test to tell you that information. Remember though even if you do have a dating scan, a due date is just a guess, baby will come between 37 and 42 weeks most likely. And as you can tell that is a very large, 5 week window… so we are really really bad at estimating when your baby will be born.
Okay so you’ve scheduled your first appointment and let’s say your dating ultrasound too. And now you’re anticipating what will actually happen at this appointment?
So when you get to the office, they’ll take your weight and blood pressure, and probably have you provide a urine sample to rule out infection like a UTI. In pregnancy, urinary tract infections often don’t have any symptoms, but can put baby at risk and increase the chance for things like preterm labor, so that will be ruled out. You’ll then see your provider and chat about the questions that I had mentioned before like medical and surgical history, medications, stuff like that… and then you’ll get into the actual physical exam.
They’ll do a full head to toe assessment which is a good baseline for any concerns and to identify any potential risk factors for the pregnancy that would need to be monitored or managed. Two things that aren’t always expected by moms is when a provider recommends doing a pap smear and a vaginal swab for sexually transmitted infections like chlamydia, gonorrhea, and trichomonas.
These are not mandatory, as nothing is of course. But pap smears are recommended every three years to screen for cervical canver and if that time happens to be while you’re pregnant, there has been shown to be no risk to your baby. But that doesn’t mean it’s something you want to do, you may want to wait until your 6 week postpartum visit and do it then, it’s up to you and your risk factors and your discussion with your provider. If you are considering a pap smear and are leaning that direction, it is normal to have some light spotting after the procedure because naturally when you’re pregnant there is more blood flow to that area, causing the cervix which is what is swabed to bleed more easily when touched. It can feel a little crampy too, which of course paired with the bleeding can worry pregnat moms. So know this ahead of time that it’s normal, but also know that it’s not required and you can say no or if you’re not sure, say no in the moment and reconsider it for the next visit maybe. There should be no pressure!
Blood tests are also recommended, including checking for your blood type, anemia, and infections like rubella, hepatitis, syphyllis, and HIV. So those are usually ordered at the first prenatal visit by your provider.
After the initial evaluation questions and physical assessment, you’ll have the chance to discuss how the care during your pregnancy will look from here on out… talking about the frequency of your appointments as you progress through each trimester, recommended or routine screenings offered like genetic testing, and address any concerns or questions you have.
Ideally, you’d have plenty of time with your provider during this meeting, but the reality is often appointments are rushed and if that happens to you, I am so sorry I wish this wasn’t the case. This was my experience as a patient being rushed along each visit, but as a clinician I felt pressed for time as a too… it comes down to a problem within the healthcare system and is absolutely a huge part of why I am supporting moms planning for a hospital birth in a nontraditional way. There is just so much information and support that needs to be individualized for expecting parents, that we are doing a disservice to families by not providing this support from the get-go. So if this has been your experience at all and you have lingering questions or don’t feel listened to fully, please message me and let’s chat about how I can help fill the missing gaps and truly explode your confidence in what to expect in pregnancy, birth, and postpartum. You deserve all the info so you’re navigating this experience with confidence, not fear!
I did want to also mention a few things you may think are “too soon” to ask your provider right away, but I promise it’s not. When it comes to navigating the journey of pregnancy and parenthood, it’s natural for many questions and concerns to come up. One of the most empowering aspects of this journey is the opportunity to seek answers and gain insights that can shape your experience.
While some topics might seem “too soon” they are actually super relevant and can absolutely impact your birth experience. So just as a reminder, I’m encouraging you to not hesitate and ask the questions that truly matter to you. It’s easier said than done sometimes, but something I want you to consider.
It is so important to make informed decisions that align with your preferences and values… and that’s where early conversations about pain management options, the role of doulas, plan for induction or scheduled c-section, newborn care and procedures, breastfeeding support, and so much more are crucial to start a conversation about early on.
Like I said, you might be in the early stages of your pregnancy, but these are discussions that can provide clarify and confidence as you move forward for sure.
For example, pain management during childbirth is a part of the plan that deserves careful consideration. You’ll want to explore all the options available to you – from medical interventions like an epidural or IV pain meds… to natural pain relief techniques… helping you make choices that resonate with your birth plan. When these conversations are initiated sooner rather than later, it allows you so much needed time to research, reflect, and ultimately make a decision that feels right for you, and then prepare for it!
Diving into the role of doulas can be a game-changer too. Doulas offer physical, emotional, and infromational support to expecting parents during pregnancy all through the postpartum period. Deciding whether to include a doula in your birth team is a personal choice, and starting this conversation early ensures you have time to explore the benefits, connect with potential doulas, and find the right fit for your needs. Seeing if your provider supports your decision of having a doula, if that’s what you’ve decided is a critical piece too. I’ve heard moms say before that their provider doesn’t work with doulas or that they are offended by having a doula because it shows you don’t trust the provider or that the doula just gets in the way… This is not a provider that you want to have if you’re planning to have that supportive presence, so knowing that ahead of time is helpful. Hopefully that doesn’t happen though of course, doula support is amazing for many families.
I just wanted to make the point that there is no harm in seeking information early on… and it actually shows your commitment to a well-informed and fulfilling journey into parenthood. So, embrace the opportunity to explore these topics, ask questions without hesitation, and set the foundation for a pregnancy and birth experience that 100% aligns with your vision. Your empowerment begins with your curiosity.
And now that you have everything you need before your first appointment, it’s important to continue thinking ahead to what is coming next. Discuss any follow-up appointments and upcoming tests, and when you’re ready begin looking into supportive classes or resources to lean on when you have questions. There are so many benefits of staying informed and prepared and having a smooth, freakout free birth! You can absolutely have their be no surprises and be prepared for the next thing, every step of the way. Complete confidence and control!
And the best part is that you are not alone at all. There is a whole community of soon-to-be parents just like you, all navigating the same things right now. I am on your side also and would love to meet you and support you, one question at a time, until you’re holding your sweet little one in your arms! I will be cheering you on every step of the way so don’t hesitate to reach out!
Thank you so much for tuning in to Your Birth Bestie podcast today! If you found this episode helpful, don’t forget to subscribe to the show to get a notification every Tuesday when I release a new episode. If you know someone also planning their own hospital birth, please spread the love and support of having an informed and autonomous pregnancy and birth their way. Until next time, stay curious, stay informed, and be authentic in this birth journey that is uniquely yours. Bye everyone!
