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What does your OB do at appointments?

post #1 of 31
Thread Starter 

Whats a normal Ob appointment for you?

I like my OB a lot...mostly because she does not do a lot and I have a fear of doctors so anything to keep it quick and easy but my husband went back with me for the first time last week and was like "Thats all she does?" so it has me wondering.

 

Normally when I go back her nurse (who I LOVE!) takes my weight and b/p and asks if I have any concerns.

 

Then my OB comes in, asks if Im doing OK or have any issues, checks the baby with the doppler and thats normally about it.

 

She has never done a physical/vaginal exam (Im going into my 34th week)...I dont want her to...should she?

 

 

 

post #2 of 31

I don't have an OB, but it sounds like your OB does basically what my midwife does. Take BP, and weight. Check urine. Palpate baby and listen on doppler to her heartbeat. Measure belly. Talk. My appts are usually about an hour, so more time than an OB would usually have, but if she's checking up on you to your satisfaction, all sounds well to me! I don't think vaginal exams are necessary or useful during pregnancy.

post #3 of 31

My 2nd trimester appointments were like that. Check BP, check urine, do doppler (or ultrasound if we had a problem with the doppler), run through my meds list, check for symptoms of preeclampsia (I've had it before so I get grilled every time)--so, they check my hands and feet for swelling, ask about headaches, etc. I had a full exam done at the beginning.

 

At this point I'm on twice weekly NSTs--the NP/CNM does one and the OB does the other, with urine dip, BP, and exam at each visit.

 

Cervical checks are up to the doc and do depend on your situation (I don't believe in driving women nuts with them, but there are reasons to check).They'll do a GBS swab soon. Everything else depends on your situation--they don't need to do other things routinely. In a normal pregnancy, there's not much to do. The OB is looking you over, and s/he does notice... but if everything's looking good, there's just not much to do.

post #4 of 31

this also sounds like what MWs have done in all three of my pregnancies to date. Routine vaginal exams are not necessary as far as I am aware and I have never had them. And you can always decline them if you don't feel like they are necessary (your HCP should always be able to explain why you are having an exam!). They may want to check your cervix as you get to full term, but I don't really think there is any reason to do this, at least not before you are in labor. And, during my labor for my second child, there was no time to check my cervix and my baby was born just the same, imagine that!

post #5 of 31

I go, I pee, they dip a stick.  If I was silly and peed before I left work, they just have me do it at the end of the appointment.  I get weighed.  They test my bp, ask about any drastic blood sugar changes.  They check her heart beat, and measure my belly, ask if I have any questions, and we schedule the next appt.  Nonstress tests and twice weekly visits start this week, but I imagine they won't be too different except for being hooked to the monitor.  I've remained fully clothed for everything but my initial visit that they did an overdue PAP.  They have told me they try to avoid those exams unless there is something that indicates otherwise, which I must say, doesn't bother me in the least!  Oh, and I have started having monthly growth check ultrasounds that take about five minutes.  They are actually some of the least stress-filled doctors visits I've had.

post #6 of 31

By "reasons" I meant not routine but if they think you might need to deliver (you definitely want to check before you induce someone!), or you've been having contractions, or something. Not just checking because it's 37 weeks and we need to know if you're dilated.

post #7 of 31
Thread Starter 

Does NST mean non-stress test?

Im suppossed to have one of those soon due to my high blood pressure and stuff....

 

I shared my birth plan with her at this last appointment and she was really open and positive about it (Im hoping for a natural/no meds birth) but did warn that if it looks like Im developing Pre-eclampsia she will want to induce but even then she is confident I can get through the rest of it naturally barring and emergencies.

 

 

post #8 of 31

Sounds like my appts. Pee check, weight, BP, listen to baby's heart and check my measurments. No internal exams. Chat about any concerns. I'm bringing my birth plan to my next appointment. I never had any internal exams with my last pregnancy until I was at the hospital in labor. I never did a non stress test either. I'm 33 weeks tomorrow.

post #9 of 31

Yep, non-stress testing. Pain in the proverbial! (it's not a hard test... just that it's Murphy's law in action: you go on the monitor and baby falls asleep. then baby wakes up, and moves around so much they keep losing the signal. Or baby is in a weird position, and you wind up doing the test lying on your side with the table pulled flat.) But as a chronic hypertensive with a history of severe pre-e, they're taking no chances. I'm also getting regular growth u/s (Both HTN and the meds used to treat it can cause IUGR. Fun times!)

post #10 of 31

Weight, bp, measuring, doppler, questions. No urine ever.

post #11 of 31

I show up, they send me to the bathroom to dip my urine and weigh myself (I just give them my weight from that morning at home for consistency).  I come out and tell them if there was any issue with protein or glucose on my dip.  They take me to a room and take my blood pressure, ask how much the baby is moving, measure my belly, feel for baby's position, use the doppler for his heartrate, and then we talk.  My midwife usually leads the conversations, and her two apprentices usually do the measurements and stuff.  They have a checklist of things to ask at each visit depending on how far along I am, and they let me ask any questions I have.  Then we schedule the next appointment.  Usually totally uneventful and under 30 minutes, but I've found that we talk about a LOT more when I go by myself (without DH).  Lately it's been breastfeeding and cicrumcision discussions, and me freaking out that I somehow forgot to ever go interview pediatricians (that's my goal for the next two weeks - FIND A PEDIATRICIAN).

post #12 of 31

I've never had my urine checked on a regular basis.  Is that for protein/pre-e?  They did bloodwork & took urine around 20 weeks, but that's it.

 

My Dr's office: weight, BP, temp check. Ask about any concerns. Measure fundal height, check heartbeat.

 

 

post #13 of 31

Yep.  The one my doc runs checks protein, glucose, and ketones.

post #14 of 31

My midwife appts sound a lot like what everyone else's are like.  Pee, weight, BP, talk/questions, measuring fundus, doppler.  No internal checks yet.  What I remember from my last pregnancy is they start offering at 36 weeks, but always left it up to me whether I wanted to be checked or not. 

post #15 of 31

So yeah, now I read your post more carefully Dragonflymom. If your OB wants to do an internal exam, make sure she can explain really well why she wants to do it. If its just to check dilation, I would personally refuse. I know I went from not dilated at all to holding my son in my arms in under 12 hours the first time... b/c I happened to start having regular contractions at my regular weekly MW appt, she did a check (basically was, I think, ruling out just sending me on to the birth center). I had him in the wee hours of that same morning. In fact, even under 4 hours before he was born, when I showed up at the birth center, they did an internal check and said I could go home or stay, I was right on the line of what they "require" for being admitted (4cm I think?)... (I knew I needed to stay, and I was right!). And I know plenty of people who walked around for a long time a couple of cm dilated... so whatever. It doesn't mean a whole lot unless you are in labor, or they suspect labor, or you are planning induction, stuff like that. In which case, the dr/mw would be able to explain to your satisfaction why it is needed.

post #16 of 31
Quote:
Originally Posted by livacreature View Post

Yep.  The one my doc runs checks protein, glucose, and ketones.

 

The value of these dips is pretty hotly debated, though. You won't reliably spill sugar till your BGLs are over 200 (which is why providers have begun using GTTs instead of relying on dips). The protein measures concentration, so is not terribly reliable (if your urine is particularly diluted or concentrated, it won't give you a reliable result... though if you're coming up 3+ or 4+, chances are you'll fail a 24 hour) and I've heard of preeclamptics who passed random dips. That's why a lot of OBs will have you do a 24 hour collection for any raised BP--it measures the total protein and is much more reliable.

post #17 of 31

Same as everybody else. Pee check, blood pressure, back to the exam room to listen to the baby's heartbeat, basic "How are you feeling? Is the baby moving okay?" questions, measure the belly, ask any questions I have, out to schedule next appointment, done. I spent more time in the waiting room than I did actually seeing the MW. No internals offered/required until the last few weeks, and I usually refused them then. .

post #18 of 31

Pee check, weight, blood pressure, nurse asks questions (along the lines of "feeling baby moving?", "how are you feeling?" type of stuff). Then dr comes in and checks the heartbeat, asks if we have any questions, discusses anything we want to, then we schedule the next appointment. The dr doesn't measure the fundus every time, which is fine with me.

post #19 of 31

Sounds like what my OB does but each appointment is spent reviewing bloodwork/labs too because I am high risk. 

 

I don't think it's necessary for your OB to check you. If you thought you were in labor/having contractions, etc. then I could see why your OB would want to check or if there was some concern with your cervix changing prematurely I could see routine checking or ultrasounds to look at length. Other than that, there's really no reason to be checked-you could be at 1 CM until your water breaks or be at 3 from now until 38 weeks. 

post #20 of 31

Until recently mine were:  assistant (super nice girl) does weight, BP, review meds, then midwife come in to do fundus check, doppler, and ask if I have any questions.  This is at a clinic in a huge hospital but somehow they run extremely efficiently for routine visits and I never wait more than five minutes or so.

 

Now:  all of the above, plus I'm doing scans and NSTs - for the NST, I go back to a long room with a bunch of comfy chairs and monitors, with curtains that can close off areas, and they strap two monitor disks on my belly (using reusable straps that I bring back every time) and stick another monitor on my finger for my O2 and heartbeat measurements, then the test proceeds.  I have been kinda pushing the monitor this way and that into my belly to make sure the signal is strong, and I have to go 20 minutes or through two fetal heartbeat accelerations, whichever is longer.  So far 20 minutes has been plenty of time.  

 

For the scan, I go back to the US room, get lubed up and they do their thing very efficiently and inevitably give me a printout picture of baby's spine because she's hiding her face, then I wait for a long time while they chase down an MFM fellow or high risk OB to tell me what my AFI means this week.  

 

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