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First prenatal visit

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Everyone, this is Dr. Mark Boyd from parently. What to expect your first prenatal visit? That's a big deal. A lot of women are ecstatic or scared to death, about what to expect at the first prenatal visit. Sometimes women have never even been to the doctor. Other women have been to the doctor many times, but they're still Hey, what should I think?

What should I do? What should I expect and coming into the doctor's office? So I want to give you a plan here. And then hopefully, that will alleviate a lot of your anxiety. First of all, it's important if you're going for a first prenatal visit, to establish whether you're pregnant. I know that sounds kind of crazy, but I've had patients come into the office thinking they were there for their first pregnancy visit and they weren't even pregnant.

So we will oftentimes do a urine pregnancy test at the office to establish whether you're pregnant. Now, not every patient wants a urine pregnancy test at the office. office or blood pregnancy test at the office so you can decline if you are adamant that you're pregnant. So, let's go through what to expect. Now the first thing we'll do is we'll do a detailed history and physical. So it's important to have information for your chart.

And I kind of wanted to go through what that entails. First of all, your own medical history, you have medical issues that need to be discussed, for example, high blood pressure. We'll talk about your obstetrical history, how many times you've been pregnant, how many times you've had miscarriages? What problems existed in pregnancies in the past? Did you have a vaginal delivery to get difficult deliveries? Did you have a C section where there are issues related to bleeding or infection after your last c section?

If you had a C section, do you want to be considered for a vaginal birth after cesarean section VBAC in this in this pregnancy? Those are all issues that will be discussed many times during your pregnancy. However, knowing that information early on, help establish a plan for you as a patient, family history, and this is important. Specifically, if you've had issues related to your mother having problems in pregnancy that may cause problems for you as a patient. For example, my mother had three c sections because her pelvis was too small. That's important for me as a provider to know because oftentimes, you will follow in your mother's footsteps.

The next issue is medications. And many times patients will come into the office, knowing that they're on a medication. In fact, one of my favorite sayings is I'm on a little blue pill. Now, they don't know what that little blue pill is for. They don't know the dose. Those are all things that are important for your healthcare provider to know so know your medications, know your dosing, and know why you're on it.

The next issue is allergies, specifically drug allergies and if you have a drug allergy, why you think you have a drug allergy? Let me give an example. penicillin common common allergy for patients to have. But patients will oftentimes Tell me, I've never had penicillin that I know of, but my mother told me I had an allergy to it. Those are important things for the doctor to know. The next issue to discuss is your physical exam.

Now, I want to say that for a lot of women, this was a scary process, but it does not have to be a good healthcare provider will do an exam on you with minimal to no discomfort. And that's important to understand, discuss with your health care provider if you're anxious, though. And if you've had exams in the past, that were painful, or very, very uncomfortable explained to them why and what happened, the health care provider will examine your entire body. This will include a breast exam, and a pelvic exam. Now the pelvic exam will entail a complete exam of your genitalia, your vagina, your cervix, your you uterus, your ovaries, and it will include a pap smear a pap smears to identify abnormal cells from your cervix. This is an important process for all women, but specifically early in pregnancy.

Now the other issue is STD checks. This can be a very uncomfortable position for a lot of women. But it's important to understand that STDs sexually transmitted diseases are not uncommon for women in the United States. The STD chlamydia is a silent STD. And it's very important that that be identified in all pregnant women so we can treat you appropriately. So don't be angry.

Don't be frustrated if STD checks are performed on you as a patient. This is a COC standard American College of Obstetrics and Gynecology standards, and we perform it on all Pregnant Patients. After your exams, perform, oftentimes, your doctor at that point will have you Get dressed. And then we'll discuss future concerns that you have as a pregnant patient moving forward in your pregnancy, ultrasounds or sonograms. This is not always performed on your first prenatal visit. In fact, in my practice, it was not performed on the first prenatal visit, we establish whether the patient was pregnant.

That was done either by urine or blood testing. We tried to establish dating how far along you were. And then at that point, we made the determination of when we would perform your sonogram. Now, why is this important? If we do the sonogram too early, we cannot establish whether the pregnancy is inside your uterus. And what that does is it creates anxiety for the patient by doing ultrasound on you too early.

I can't see anything in the uterus, and then you leave the office having anxiety of whether you're truly pregnant or not. So we want to establish if the pregnancy is occurring, if it has a positive pregnancy or urine pregnancy test, trying to establish appropriate dating We want to have you at least five weeks pregnant. And then at that point where we can perform a vaginal ultrasound or vaginal sonogram to establish dating at that point. Now there's two types of ultrasounds that we perform as healthcare providers. One's called a vaginal or pelvic or internal sonogram. That's where we take an ultrasound probe, place it in your vagina, and we established dates based on that early internal sonogram.

That's the most accurate for determining dates. The second type of ultrasound is called an abdominal ultrasound. Every pregnant woman loves about abdominal ultrasounds. First of all, nothing's being placed in your vagina, it's placed on your belly. And as the pregnancy advances, it's a lot of fun senior baby grow inside your uterus. And obviously the most important thing for many, many women is am I having a boy or girl.

Those dates of that ultrasound will be discussed here shortly. sonograms or ultrasound performed several times through your pregnancy. The first ultrasound will be an internal sonogram badge and ultrasound or pelvic ultrasound. And this will be performed between six weeks gestation and 10 weeks gestation and most obstetrical offices. Those will establish you're dating the second ultrasound or sonogram, or will be performed between 16 and 20 weeks in most obstetrical offices. This is called a level two ultrasound.

We will look to define whether there's problems with the baby, whether there's problems with the placenta, whether there's one baby two babies, this is a low risk ultrasound, and at that gestational age, we can determine the baby's sex. Some offices will have another ultrasound performed around 28 to 30 weeks. This is mainly a sonogram for growth to determine if the baby's growing appropriately Some offices perform a fourth ultrasound. This will be done around your 36th week, again to determine if your baby's growing and the manner that is consistent with their gestational age. Now, for low risk moms, for which encompasses most women, the United States, most women will only have two ultrasounds, they'll have their dating ultrasound, and they'll have their second ultrasound around 16 to 20 weeks. As we discussed earlier, gestational dating is about most important, very, very confusing to a lot of patients on what gestational dating means.

Everyone knows that pregnancy is nine months long. They've also heard that it's 40 weeks long, but what does that mean? Prior to ultrasound, we tried to go back and tried to establish the point of when women had their first day of their last period. And this is the date that we use to establish pregnancy from the first day of your last period to conception to delivery when you determine that full term was 40 weeks long. It's also 280 days long, it's also nine months long. It's also 10 lunar months.

But those are all very, very confusing. So I want to try to give you some dates, understand them. And this will help you through the process of knowing what the doctor and the healthcare provider means. Now, the first day of your last period moving forward, you can see approximately two weeks after that. So when pregnancy occurs at that point, biologically, you're day one. However, from a gestational age standpoint, you're already two weeks along because we're using the first day of your last period to establish the length of time that your pregnancy is at that point, we move forward and your date established by your first ultrasound a doctor will give you a date and say, Mrs. Smith, you're now eight weeks along.

Now, you say to yourself I only had sex once. And that was six weeks ago. That's when I got pregnant. So why am I not six weeks? Why am I eight weeks? Well, that's because we establish those dates of eight weeks based on the first day of your last period.

So even though you can see six weeks ago, we add two weeks to that. And we come up with that date of being eight weeks. So again, moving forward with some examples. So now we're all the way to 40 weeks, your due date, that's 40 weeks from the first day of your last period biologically, you can see two weeks after that. So from a biological standpoint, your baby is 38 weeks at that point, but it's important to understand why we use the dates that we do, because it's very, very confusing. So again, just to reiterate, pregnancy is 40 weeks long.

I encourage you to use that description and describing how far along you are. You will always hear weeks at the office. You will never hear months and you You'll never hear days. So pregnancy is 40 weeks long, from the first day of your last period, to the day that you deliver. This encompasses what to expect on your first prenatal visit. Obviously, questions that you have will also be provided by your health care provider at that point.

The whole purpose of prenatal care though is to follow you as a patient, for your health of your baby. Whether your baby's growing appropriately, those are all issues that need to be addressed as you move through your pregnancy. Many many questions will be need to be answered. We're here to provide information. We'll have many more videos moving for Have a great day.

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