why pre-natal care?

[lovebeingamomma]

I was just wondering, what is pre-natal care doing for you? "There's the heartbeat", "ok bye see you in 4 weeks". Early on before any tests...what do you think the benefits are? I don't have an agenda here I've just been thinking about this.

[HeatherB]

I my MW and most of our visits are spent sitting and chatting. It's also a regular time to bring up any non-emergent questions I've had for her.

In a midwifery conference I attended last month, Gail Hart made the point that, in midwifery, prenatal care is really all about prenatal "caring." It's about the relationship between midwife and mother, and meeting the varying needs of the mother, including the physical, emotional, and psychological. These are things that one *definitely* misses out on with an OB (I've done it both ways!). I think having that sort of relationship and building that trust is at least as valuable as tracking physical signs and symptoms and ensuring nothing is sneaking up on you.

[isras1]

Well said HeatherB.
I would add, I've noticed that my prenatal visits helps me to stay on track. Life can get busy and the visits reminds me that, "oh yeah, I'm pregnant." Not that I forget it so easily as I now begin the 3ed trimester but earlier on, it helped me to assimilate the process of being pregnant. The bonding with my MW is very beneficial for both my DH and I. Especially for me, being a shy and rather modest person, it helps me to visualize her at my birth as I get to know her better from each visit.

In addition, the visits also aid me in staying accountable. I write down questions or topics I want to ask at our visit. I exercise as much as I can and try to eat well, so that when my MW asks, I can be honest with her.

I look forward to my prenatal visits.

[Ellen Griswold]

Originally Posted by HeatherB

I my MW and most of our visits are spent sitting and chatting. It's also a regular time to bring up any non-emergent questions I've had for her.

In a midwifery conference I attended last month, Gail Hart made the point that, in midwifery, prenatal care is really all about prenatal "caring." It's about the relationship between midwife and mother, and meeting the varying needs of the mother, including the physical, emotional, and psychological. These are things that one *definitely* misses out on with an OB (I've done it both ways!). I think having that sort of relationship and building that trust is at least as valuable as tracking physical signs and symptoms and ensuring nothing is sneaking up on you.

I agree with all of this. The only thing I will say is that it depends on your ob. My ob is a sit and chat kind of girl. I also find it reassuring to be measured (though you really could do this on your own) to know that growth is progressing at a regular pace.

[MaerynPearl]

My doctor is the same. We have been known to sit there and talk for an hour (luckily not holding up other patients lol) about our pregnancies and kids... it really helps when you feel that close to someone, I think. I was nowhere near afraid of my first birth as I would have been with a doctor I didn't personally care about that I knew actually cared about me as well.

[JTA Mom]

To be honest, I don't really see the point before 12 weeks or so. This is definitely influenced by my first pregnancy where I was consistantly told that 'if I lost the baby, I lost it' they wouldn't do anything. So, imo, if they can't 'do' anything, there's no point to it.

From their perspective, I guess it gives them a nice baseline to compare later pregnancy with in terms of weight gain, bp, etc.

Ami

[Sagesgirl]

I actually agree with your assessment, which is why this is my second UP pregnancy. I turn down every single prenatal test, so prenatal appointments are honestly not a big deal to me. I am far too much of an introvert to have the slightest interest in chatting with either a midwife or an obstetrician.

[oakparkveggie]

I am seeing a RE right now for my prenatal care due to my history of PCOS and m/c. So, right now, I am on a progesterone suppository and have had 2 u/s to make sure that the embryo is still viable. The last u/s just showed a possible Velamentous insertion of the umbilical cord, so I will be monitored more closely in the future.

I am hoping that things calm down and my prenatal visits will be "ok bye see you in 4 weeks." Sounds perfect to me

[JessieBird]

Originally Posted by HeatherB

I my MW and most of our visits are spent sitting and chatting. It's also a regular time to bring up any non-emergent questions I've had for her.

In a midwifery conference I attended last month, Gail Hart made the point that, in midwifery, prenatal care is really all about prenatal "caring." It's about the relationship between midwife and mother, and meeting the varying needs of the mother, including the physical, emotional, and psychological. These are things that one *definitely* misses out on with an OB (I've done it both ways!). I think having that sort of relationship and building that trust is at least as valuable as tracking physical signs and symptoms and ensuring nothing is sneaking up on you.

Originally Posted by isras1

Well said HeatherB.
I would add, I've noticed that my prenatal visits helps me to stay on track. Life can get busy and the visits reminds me that, "oh yeah, I'm pregnant." Not that I forget it so easily as I now begin the 3ed trimester but earlier on, it helped me to assimilate the process of being pregnant. The bonding with my MW is very beneficial for both my DH and I. Especially for me, being a shy and rather modest person, it helps me to visualize her at my birth as I get to know her better from each visit.

In addition, the visits also aid me in staying accountable. I write down questions or topics I want to ask at our visit. I exercise as much as I can and try to eat well, so that when my MW asks, I can be honest with her.

I look forward to my prenatal visits.

Yup to both of these. About 2/3 of the way through my first pregnancy I really wondered what the medical point of prenatal care was but I wouldn't give it up because of how special my MWs and all the staff at my birthing centre make me feel. They give my pregnancy honour and respect that often I don't take the time to give it myself. They draw me out of my shell and get me to talk about things I wouldn't otherwise want to even think about. The fact that they care so deeply about my well being as a whole person during pregnancy has definitely made me a more loving and more confident parent after pregnancy. (I'm not sure if this is what the powers that be who manage our government-paid (well, tax payer paid) health care system had in mind in terms of results but it works for me!)

This time around, I am getting all of this plus the diagnosis of a underlying medical condition that I wouldn't otherwise have known about. It could lead to some pretty serious complications down the road so I have to be monitored very closely. It took a while for the fact that I am a "sick person" for the first time in my life to sink in and to accept that prenatal care does in fact serve a physiological medical purpose as well as psychological. I used to think all the tests and poking and prodding were frivolous but I now appreciate my MWs on a whole new level.

[lovebeingamomma]

Thank you for all of your input, I see that in general it's serving women's emotional health more so than the physical (unless there are medical issues to being with). I guess looking back on my perfectly healthy two births, if I had known the outcome beforehand I would have probably done a homebirth, if not an Unassisted and just forgone the care all together. I think I feel like after every visit I just threw a co-pay down the drain as well as had the inconvenience of having to plan the day around the apt. Anyways...I've also had two m/c, and I'm realizing that there really is nothing they can do, and so if I had another pregnancy, I think I'd wait til past 12 weeks, if not later. I do love my midwives, but I've never had an experience of chatting about other stuff for a long period of time...I think I'm an introvert.

Anyways, thanks for the discussion!

[GoBecGo]

My midwife is independent (non-NHS, i'm in the UK) and she spends 1-2.5 hours with me in my home at my appointments (shortest ever was 50mins due to her having a woman in labour she had to go check on). We talk about lots of stuff (though hardly every actually my labour or anything! lol). We trust each other, i am used to her touch, i know she could walk in when i was in labour and i won't stall or balk. My baby knows her voice, which is immensely important to me since hers might be the first hands which touch him/her. She knows the sort of personality i am, and thus when to worry about me and when not (for example she knows i'm a labile person, emotionally, and doesn't panic if i have BP at 140/85, because she knows in 20mins after talking about something that doesn't annoy me i'll be back at 120/70) and is able to give APPROPRIATE care much more easily because of that. I genuinely trust her, so i know if i need to transfer for any reason i can rely on her to spot if and when and not have to second-guess everything she does (my NHS midwives were understaffed, overworked and not used to the home setting).

Because of her i'm having a wonderful healthy pregnancy and really looking forward to my birth. With a poor care-provider i would absolutely skip prenatals unless absolutely necessary, but with her, i look forward to her visits immensely!

[Magali]

I am doing a mostly UP, but am birthing in a hospital. I recently had my first prenatal visit at 18 weeks. I did this because I don't want eye drops for my newborn so want to make sure there is a record of me being std free, to set up an ultrasound, and so I have a file started and a relationship with a DR. should I need to see one during my pregnancy. Also to scope out the hospital and make sure there aren't any huge red flags as to why I shouldn't birth there. (Oh there are flags....but those I can deal with )I will go back in 4 weeks for results and then unless there is a problem it will be goodbye until around 3oish weeks when I will want to go over a birth plan. I can check urine and blood pressure at home. I hate Dr.'s offices and I am not comfortable in them, so this is working for me. Also, it is not my Dr. who will be at the birth....there are 6 Dr.s who are in call in labor and delivery..so I don't feel the need to have much of a relationship with this particular Dr.

[Magali]

Originally Posted by HeatherB

I my MW and most of our visits are spent sitting and chatting. It's also a regular time to bring up any non-emergent questions I've had for her.

In a midwifery conference I attended last month, Gail Hart made the point that, in midwifery, prenatal care is really all about prenatal "caring." It's about the relationship between midwife and mother, and meeting the varying needs of the mother, including the physical, emotional, and psychological. These are things that one *definitely* misses out on with an OB (I've done it both ways!). I think having that sort of relationship and building that trust is at least as valuable as tracking physical signs and symptoms and ensuring nothing is sneaking up on you.

This. I was an emotional wreck after my first prenatal visit. I don't have access to a midwife and this Dr. certainly doesn't understand where I am coming from. So I will do my care for myself. As much for my emotional care as anything.

[Greenlea]

With my first pregnancy I started seeing an OB and felt he did a lot of unnecessary pre-natal "tests." He was always rushed and we never got to talk. Most of the time I only saw the nurses, and then him at then for questions. So I switched to a midwife.

I saw her a lot more and got to have actual conversations with her. Once a month isn't that bad to see a midwife, but I felt it unnecessary to see her every week near the end.

This time around I am already 15 weeks and have not seen my midwife yet. I have an appt to see her at 17 weeks. She said there's really no reason to come in earlier, unless I wanted early testing done, which I didn't.

[Magali]

Originally Posted by Greenlea

This time around I am already 15 weeks and have not seen my midwife yet. I have an appt to see her at 17 weeks. She said there's really no reason to come in earlier, unless I wanted early testing done, which I didn't.

This is interesting. I didn't have my first visit with a Dr. till 18 weeks. And the receptionists at the office acted like I was freakin' nuts!

[McMandy]

With our third baby, we had prenatal care from 18-24 weeks. He was a UC baby, which we planned.

We thought about foregoing prenatal care with this one, but something in me said, "YOU NEED IT."

And I'm glad I decided to seek it out. Otherwise, we would probably never have known our baby has a heart defect- a three chambered heart instead of four.

What if we would have skipped prenatal care, had our unassisted birth, and never known? From what I hear, it wouldn't have been obvious at first- she might have been fine for a few hours, a day, a week... you never know. But she could have died in her sleep, she could have turned blue and we might have not reached the hospital in time. We don't know.

So, I've definitely CHANGED my opinion on prenatal care now. The technology is available- we don't need to go overboard (I generally do not do all the tests OBs recommend), but I now recommend ultrasounds for everyone!

[BlackSheepPDX]

Originally Posted by Magali

This is interesting. I didn't have my first visit with a Dr. till 18 weeks. And the receptionists at the office acted like I was freakin' nuts!

Reminds me of when I called the Family Practice office when my DD was 6 weeks old to make her first doctor's appointment. The receptionist on the phone clearly thought I was out of my mind. I think the conversation got off to a great start when she asked "what hospital was she born at?" and I replied, "none." That graduated to explaining several times what her birthdate was, and that, yes, this was her first doctor visit. Fortunately our doctor is great.

As for prenatal care, no, I don't think there's a lot that happens in the first trimester, especially if you're not into all the tests. I think the monitoring of urine and BP are valuable, and as a midwife client, I very much value the depth of conversation and getting to know each other that takes place in our 1 hour plus appointments. If I'm going to trust someone to watch over my birth, I need to be very comfortable with them. Yet another of the many, many reasons the OB/hospital structure doesn't work for me.

[Kelly1101]

Originally Posted by lovebeingamomma

I was just wondering, what is pre-natal care doing for you? "There's the heartbeat", "ok bye see you in 4 weeks". Early on before any tests...what do you think the benefits are? I don't have an agenda here I've just been thinking about this.

I love a "there's the heartbeat, ok bye see you in 4 weeks" appointment.

Ideally they never get much more complex than that. But, I like to go regularly because you never know when things could get complex. I think even those who UP check their blood pressure, weight, fundal height, urine, etc.

Sure, in most cases early on there is nothing they could do even if there is a problem. But I think it would be good to go from the start just to build up that relationship with the OB/MW, get to know them, and have someone to call and ask if an unusual symptom has you freaked out.

[squibbylicious]

I'm in kind of a similar but opposite boat. I recently (as in... 3 days ago) decided to stop seeing my OB at 30 weeks. All my tests and scans have come out perfect, I refused the GD test, and I plan on going to a walk in at 36/37 weeks for the GBS test.

I'm planning a VBAC, my OB didn't deliver at my hospital of choice, and even if I had gone to her hospital, her practice does on-call on rotation and I probably wouldn't have gotten her for labor anyways. It's easier doing it on my own and walking into the hospital to birth, IMO anyways. Everything the doc/nurses monitor at prenatal visits I can do at home. I may ask my GP for a referral to someone who delivers at my choice hospital just for convenience sake.