Questions about first OB appointment

[Ellarae]

I'm due 3/13/06, and my first OB appointment is this Tuesday. I will only be meeting with a nurse, not the doctor yet. This is my first pregnancy, so I don't know what to expect. I know that they want to send me for blood work after the appointment. Does anyone know what the blood work is for? Are they going to try and run any tests that I may not want? I just want to be prepared, and right now I have no idea. Thanks!

[hunnybumm]

They will probably want to do a pap smear, take some culters, for STDs? Have you pee in a cup... Hmm I can't remember all of the tests they do, but it seems like a lot. BTW You don't have to have a pap or take any of the tests. From what I have heard a pap while you are pregnant isn't very accurate. I personally won't have one done if I am pregnant. I am also denying all the STD testing because I was tested while pregnant with my DS over 2 years ago, all was negative and DH and I have been faithful.

I am sure someone else can give you more accurate information! I will be 5 months before I go in for my first visit (due to Ins issues) next week, but I am going to a birth center with MWs so very little testing is done anyways.

[allismom]

I am also denying all the STD testing because I was tested while pregnant with my DS over 2 years ago, all was negative and DH and I have been faithful.



I am trying to learn and understand why so many of you are against the testing. (don't take that wrong......I just honestly don't know why). Anyway, I was thinking the same thing as fas the STD testing the HIV test.....they did all that with my first pregnancy and I have only been with DH, so what is the point?

[movingon]

If you are only seeing the nurse, you probably won't get a pap, this time. If you've had your routine exam recently, you can tell them, so that when you do see the doctor, they won't have to do a test. Or you can refuse the pap, - which if anything comes back out of the ordinary will concern you, and probably for no good reason.

The blood test is mostly about disease and the RH factor (to see if your blood may be different than your dp's which may cause your body to treat the pregnancy as a threat.) They may do other testing, like hormone level to see if you might need progetrone to supplement until your body does it on its own.

They may ask you to think about the cystic fibrosis test and the triple screen test. I declined both of these because I've known too many women with false positives that left them emotionally wrecked.

My nurse prescribed pre-natal vitamins, came up with a due date based on my last period, advised me about my diet, and scheduled my first OB appointment a couple weeks later.

There's not a whole lot they can do in the first trimester, except the tests.

Good luck to you. I'm currently finishing up my 30th week. Wheeeeeeeee.

:)

[Full Heart]

I am trying to learn and understand why so many of you are against the testing. (don't take that wrong......I just honestly don't know why). Anyway, I was thinking the same thing as fas the STD testing the HIV test.....they did all that with my first pregnancy and I have only been with DH, so what is the point?


Well, while we know our so has been faithful drs are more skeptical, and I am sure its because they have seen it before where a women thought their so was faithful and they weren't. Of course they shouldn't make us feel like we have no choice in the matter - which they do. The rest of the testing can be inaccurate, like testing to see if you are immune to Rubella. Its not an accurate test, neither is the pap.

They should tell you exactly what they are testing you for so you have a say in wether you want to be tested for it. Informed consent.

Michelle

[MrsMoe]

Every doctor is different. My past doctor always did whatever he felt like- didn't tell me what he was doing and always did vaginal exams. He also ordered a slew of tests as well and rarely told me what they were for nor did he share results.

My current doctor doesn't do vaginal exams - I am now 25 weeks and have not had a single vaginal check nor have I had a papsmear because I am not due for one. He only ordered the important bloodwork one time - glucose, iron levels, thyroid checks because I have thyroid condition, and he does check my urine with every visit. He also does not believe in the 3 hour glucose test either. I honestly belive very few doctors are like mine. I'm truly lucky, as I have no choice medically but to use an OBGYN and I have an excellent doctor who isn't an alarmist nor is he overly "medical." I'm not diseased, I'm pregnant! Thank goodness my Dr. respects this!

Every doctor is different. My two OBGYN's are polar opposites. If at any time you feel uncomfortable speak up. It is your body! Tell them you are a type of patient who needs to know everything - from tests to test results, and why certain things are done.

I hated my old OBGYN, and I kept wanting to switch, but didn't. Looking back, I wish I had found a doctor that suited my personal needs.

If you do not have a medical condition, you could also consider getting a midwife instead.

[Getz]

My first appointment was a normal exam (I was due for one), extensive health history and the pee in the cup routine.

I am not getting my blood work done till 16 weeks. I am only declining the CF test though.

[~Megan~]

For me with dd they took a medical history, checked my urine, bp, etc Gave me some handouts. The blood work was to test, I believe, for anemia and several illnesses including STDs.

[hunnybumm]

If you are only seeing the nurse, you probably won't get a pap, this time.
At the Ob office I went to with DS the nurse is the one who did the pap. Well she was a Nurse Practitioner, so I guess this just depends on the office.

As far as why to deny the tests. My main reason is that there are way too many false positives, and even if later down the road they found out the positive is false, they will generaly still treat you as if you were positive, even though you aren't. I have heard stories about woman testing positive for HIV then a more indept test showed they were negavite, yet when they were scheduled for a c-section and weren't allowed to breastfeed. I am sure such cases are rare, but I trust myself and my DH enough to not want to put myself in that situation. Plus, I think all these false positives cause more stress than needed.

I did get tested for cystic fibrosis last pregnancy and since I was negative that is something I will never have to worry about. I don't mind my blood pressure being taken or peeing in a cup. I see these as reasonable 'tests' that are beneficial to me.

[orangebird]

I am trying to learn and understand why so many of you are against the testing. (don't take that wrong......I just honestly don't know why). Anyway, I was thinking the same thing as fas the STD testing the HIV test.....they did all that with my first pregnancy and I have only been with DH, so what is the point?
I'm against the HIV testing because pregnancy increases false positive results and then you are stuck with them not letting you breastfeed and managing your birth- c-section- until you clear it all up and prove you are negative. All that hassle isn't worth it. Small chance of it happenning, but still.

[supakitty]

To the above comment: Actually if the Elisa and Western Blot come back as positive or indeterminate we order an HIV pro-viral DNA test to confirm the presence or absence of the actual virus.

As for the prenatal labs/tests: CBC, ABO blood type, antibody screen, TSH, rubella, syphilis, hepatitis panel, HIV, offer CF screening, PAP (if due), Gonorrhea/Chlamydia screening, complete urinalysis with culture and sensitivity.

[merrick]

As for the prenatal labs/tests: CBC, ABO blood type, antibody screen, TSH, rubella, syphilis, hepatitis panel, HIV, offer CF screening, PAP (if due), Gonorrhea/Chlamydia screening, complete urinalysis with culture and sensitivity.

Do they always test for all of these? I read somewhere that they do not test for all STDs and that you have to ask for them specifically?

[hunnybumm]

To the above comment: Actually if the Elisa and Western Blot come back as positive or indeterminate we order an HIV pro-viral DNA test to confirm the presence or absence of the actual virus.

I know the woman who I have heard about having a positive reading, then getting a negative from the more indept test, still have issues with the doctors trying to force a c-section and no BFing. Better safe than sorry right? :irked:

[stafl]

you should write down all your questions and bring them to the appointment. Make sure they are all answered before you agree to anything. You have the right to be informed before you consent. I would advise you refuse a pap test because of the high rate of false abnormal results during pregnancy, and refuse any of the blood tests you are not comfortable having. Why charge your insurance to test for your blood type if you already know what it is? Why charge to test for whatever, rubella immunity, if you already know you do not have it? Make them tell you what they are going to do! How far along are you? Do you really need to go in for this appointment? Ask lots of questions. Ask about all the things you don't want to happen, like certain interventions during birth. Ask about when they would consider induction, how far "post-dates" they would let you go. Ask about their cesarean rates. and if they act like they don't want to answer your questions, or take the time to make you feel better, or if they give you the wrong answers, go find a different practice.

[supakitty]

I completely agree that it's better to be safe than sorry. I would never force any tests upon anyone (though I know those who would make a person very uncomfortable if they decided against testing). I was just giving the information on the prenatal panel. If a person doesn't need a PAP we don't do it. If a person refuses the GC/Chlamydia testing we don't do it. As for the rubella titer... If you had an immunization or had the virus then you would most likely have immunity. If you're susceptible then the vaccine is offered post-partum with the instructions that because it is a live virus one should not become pregnant within 30 days thereafter.

In my naive mind, honestly, I have always seen many of these tests as a means to safeguard the health and safety of mom and baby. It wasn't until I started reading at MDC that it ever occured to me that it may be unnecessary and perhaps in some cases, harmful.

We live and learn, yes?

-Laura

[hunnybumm]

supakitty - I hope I didn't sound mean or sharky, I definitly wasn't trying to be! I am very greatful to heard from a medical professional on the topic. I was just stateing what I had hear horror stories about. ;)

[chiro_kristin]

If you had an immunization or had the virus then you would most likely have immunity.

where's the "I just choked on my own saliva" smiley?

[supakitty]

I know, I know.. the "V" word. I'm just saying, many people are vaccinated against rubella. That's another topic I've learned so much about here at MDC.

hunnybumm- I never thought that at all! :)