How much prenatal monitoring in first trimester?

[JustLooking_30]

I'm newly (15 days post IUI) pregnant and need to figure out how much monitoring to ask for, and most importantly, when? I'm confused as to how you start calculating how far along you are, do you start the clock from the day you ovulated or from the day of your last AF?

I would love to get feedback on:
1) When was your first OB/GYN/ midwife consult?

1)how much bloodwork did you get done ,and when

3)when was your first ultrasound where you tried to look for gestational sac?

Thanks, I appreciate all feedback!

[MaerynPearl]

To date: LMP unless you know ovulation was not 14 days after LMP... then you take ovulation, subtract 14 days... and count from there.

1) When was your first OB/GYN/ midwife consult? I went to my doctor at 6 weeks (2 weeks past my bfp, 4 weeks past O/conception) to confirm pregnancy. First appointment was at 8 weeks. My midwife I flew down and met at 15 weeks, after my chance for miscarriage dropped. I have a big fear of this having had a missed miscarriage that ended at 13 weeks in the past, we did not want to have a weekend trip already scheduled before then and have me end up flying down to see DF and just be reminded that I am no longer pregnant.

1)how much bloodwork did you get done ,and when? For me, at 8 weeks we took several vials. However, I have a lot of medical problems that they wanted to keep an eye on. I think this is really up to your own body and your doctors choice... At 12 weeks I was tested for progesterone levels again because they were somewhat low at 8 weeks (a 7.3... at 12 they were at 17)

3)when was your first ultrasound where you tried to look for gestational sac? This is neither routine nor necessary for most women. I had one at nine weeks for two reasons: 1. to confirm that baby was growing (had had a missed miscarriage in the past, so I have a pretty big fear of it happening again) 2. to confirm that it was not twins. I was measuring ahead already at that point and with a family history of fraternal twins (2 sets born to females on my mothers side of the family in the past two years alone!) We wanted to be sure there was only one baby in there.

[~Demeter~]

1) When was your first OB/GYN/ midwife consult? With almost all of mine, 9ish weeks. Though with my daughter we were seen at 7 weeks because going off LMP, I was 8 weeks... most OB/GYN don't take into consideration that all women have variations in their cycle. I tend to have longer cycles.

1)how much bloodwork did you get done ,and when. I didn't really have bloodwork done, as in betas and whatnot... I think I was required to give some blood for typing (though I know my type) HIV test (even though I've been in a monogamous relationship for 12 years) and a couple other things. That was at my first visit.

3)when was your first ultrasound where you tried to look for gestational sac? Um. never? My first u/s with my first 3 were at 20ish weeks. My daughter we had an u/s at 7wks to date the pregnancy (only because my doctor doesn't listen).

This is my 6th pregnancy. I am 13 weeks today. I have not seen my mw yet, though I keep meaning to call her. I have had no bloodwork done and I don't think I will this time around. I also will have no u/s. None of that is absolutely necessary for a viable pregnancy.

[limette]

1) When was your first OB/GYN/ midwife consult?

Around 7-9 weeks I think.

1)how much bloodwork did you get done ,and when

Don't remember when for the previous pregnancies but I declined all bloodwork for this one.

3)when was your first ultrasound where you tried to look for gestational sac?

We looked around 6 weeks with pregnancy number 2 because I was spotting and had a previous missed miscarriage. With pregnancy #3 we looked around 10-12 weeks because we couldn't get a heartbeat and I was paranoid.

This one we didn't have one until 20 weeks, which is the norm.

[JessieBird]

1) When was your first OB/GYN/ midwife consult? With my first, it was at 9 weeks with my family doctor then transferred to midwife at 18 weeks. With this pregnancy, I skipped my family doctor and had my first midwife visit at 12 weeks. That would have been my first prenatal appointment except I ended up in emerg with HG at 8 weeks and admitted so saw the resident OB daily when I was in the hospital.

1)how much bloodwork did you get done ,and when? With my first, my family doctor did a blood draw at 9 weeks to check for iron and some other standard stuff (can't remember exactly what, though I know it included STDs and the cat poo bacteria). With this one, I probably wouldn't have had any blood work at all if I hadn't landed in the hospital. There they took blood twice a day and I have no idea what it was for (was too out of it to ask). It revealed hyperthyroidism though so now I am tested for that every two weeks to see if it resolves. No betas with either pregnancy though, and I'm glad for that.

3)when was your first ultrasound where you tried to look for gestational sac? Never. With DS, first ultrasound was at 12 weeks because I did the Integrated Prenatal Screening (for Down's and Trisomies), otherwise it would have been just the standard anatomical scan at 20 weeks. This one would have been the same except again for being in the hospital - they did a scan to rule out multiples or other anomalies that could have been causing me to be so sick.

As for dating, weeks are counted from the first day of your last period. However, if your IUI/ovulation was not around day 12-16, this will be off. As Maeryn said, take the number of days since your IUI, add 14 and divide by 7 and you will get your number of weeks. If you have very early medical appointments (ie. in the next 2 weeks), they may continue to say x days past UIU.

Were you seeing a fertility specialist for the IUI? If so, they may want to monitor you a lot more closely than is typical. This would include bloodwork for beta numbers (personally I would not want this as it just seems to lead to stress) and an early ultrasound to check on what's growing where in there. For a normal pregnancy with few risk factors, there is very little or no monitoring in the first trimester. There is no need for an ultrasound and there isn't any bloodwork that is truly essential. I found prenatal care with my first to be much more low-tech and laid back than I expected. This time around I knew there was no need to see my family doctor at all and I didn't feel any urgency to see my midwife. In the vast, vast, vast majority of cases, nature takes it's course and there's very little that the medical professionals can contribute.

[MaerynPearl]

Originally Posted by JessieBird

This would include bloodwork for beta numbers (personally I would not want this as it just seems to lead to stress)

but if the doctor feels it would make THEM feel better and you are okay with giving the blood... I would request they not tell you the actual numbers until they confirm that it is okay. Because all too often they tell you one number... and you can NOT tell anything by one beta number as long as it is still above a 5 (anything below 5 is considered not pregnant)

[jennica]

1) When was your first OB/GYN/ midwife consult?

About 13 or 14 weeks.

2)how much bloodwork did you get done ,and when

I just got the standard prenatal screening. I declined the drug test but accepted an STI test in case for some reason I need to deliver in the hospital that will clear me to use the tub. They took 4 viles of blood! I had this done recently, at about 24, 25 weeks or so.

3)when was your first ultrasound where you tried to look for gestational sac?

I'm not really sure why that would be necessary? I try to only do prenatal testing that has a clear benefit. My only ultrasound was the nuchel translucency scan at 12 weeks. I did that because I was worried about chromosomal abnormalities since I am 35 and higher risk. We ended up not being able to complete the scan. I don't plan to do any other ultrasounds, and only had the heartbeat checked by doppler once. I'm not one to get too paranoid about ultrasound, but I also haven't seen any conclusive studies on it's safety so I try to really limit it.

[honeybee]

If you know when you ovulated, calculate your due date based on that... but make sure you're calculating based on ovulation, not LMP. LMP is the standard because most docs figure women don't know when they ovulate.... or they don't know about charting and don't realize women can even figure out when they ovulated. Depending on your caregiver, they may still stick a date in your chart based on LMP, even if you know when you ovulated.

I don't do bloodwork. I don't get a routine ultrasound at any point. I'm 16 weeks and haven't seen my midwife yet (although previously I have had my first prenatal around 13 weeks---this time I'm just busy).

If I had a couple of miscarriages in a row, or some other indications, I would probably get bloodwork done and see if I needed progesterone or something. But otherwise, I just try to live a healthy lifestyle. Really, if something goes wrong, there isn't anything anyone can do about it early on, anyways. I think relying on tests and measurements just subverts our own intuitions and can provoke needless anxiety. At least, that's how I view them.... not saying everyone else should feel the same.

(oh, and I do do general monitoring throughout pg, such as blood pressure, pee on stick, etc. I just don't think most of that is necessary early on).

[JustLooking_30]

Thanks for the responses everybody. That was very useful. None of the treatments with my RE were covered- so I will definately not be doing beta blood draws under his care.

The only thing that may be a cause for concern with me was progesterone- the test is still out, and blood was drawn very early (at 11 DPO). If not for that, I would relax and just wait to see the doctor during my first consult, which I think should be between 5-6 weeks. But because I'm concerned about progesterone, I was wondering if I should monitor betas. My day 11 beta was very good- 50, and it appears to be increasing quickly.