The following information deals with healthy,
normal pregnancy only. Women with complicated pregnancies require
additional monitoring and testing, which are not covered here.
Selecting a Physician And Hospital
Be sure to ask your OB about how often they are
in the hospital and who covers for them when they are not available.
Go on-line and check out the back up physician as well as your
primary doctor. Your local medical board can tell you if the doctor
has lawsuits pending; if your doctor has three or more, delve
further into the circumstances. Choose a hospital with a 24-hour
in-house anesthesia team. If you choose a midwife, make sure the
birth will be in a hospital and not a birthing center so you will
have immediate access to an OR in case an emergency C-section is
necessary.
Pre-Natal Tests
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If you are over 200 lbs., be sure you are screened for
diabetes in both the first and second trimesters.
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If you are of Eastern European, Mediterranean or
African-American descent, you should receive special screening for
conditions related to these genetics.
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If you are over 35, you should consider genetic counseling.
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A 16 weeks you will be offered a “triple screen” for genetic
abnormalities. Be aware that these are prone to false positives.
Prior to this, parents should talk about how they will handle
information that their child may have problems. If the answer is
they will carry the baby to term no matter what, decline the “triple
screen” and any additional testing, as many of the diagnostic tests
are invasive and put the baby further at risk for miscarriage.
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An ultrasound should be conducted during the first visit to
most accurately determine the due date. A repeat is done in the
second trimester, however, you should insist it not be performed
before 18-20 weeks, when the fetal anatomy becomes clear enough
to see anomalies.
