Prenatal doctor appointments

[athomeontheprairie]

*please assume healthy mom, healthy baby. Assume precious pregnancies were healthy and easy.

If the above is not the case, I'm interested in your thoughts also. But I'm imagining it will change the answer.

 

Do you follow the "normal" time line? I mean, when they say come back in one month-do you come back four weeks later? Or are you okay with going 6 weeks? When they say come back in two weeks, are you ok with coming in at the end of the third week? Or do you drop everything to make it back in two?

[Tangerine]

I do it. I don't like it, but it isn't a battle I pick.

[heartlikealion]

I think my office just scheduled me. The receptionist would probably just say, "can you make it on X day?" and I'd say, "yes" and then we'd discuss morning/afternoon. I had what were considered healthy pregnancies.

 

Is there a conflict that's making it hard to come back within the recommended time frame or is it an insurance thing or you just don't want to come in that often? You don't have to say. I don't imagine it would be a big deal unless the dr. thought it was. Like come in at X time to drink some glucose drink.

[Ali in OR]

I wanted to go in as often as they would have me! I was thrilled to finally be pregnant and especially early in pregnancy, it didn't always seem real. Doctor appointments acknowledged that it was real and were absolutely focused on the one thing I was focused on--my pregnancy. Maybe my answer would have been different if I was paying a lot out of pocket, but I think I may not have even had to pay a co-pay. If I did, it was low.

[Ailaena]

I'd stretch it out because I'm like that. Everything is fine, they normally don't do much. Maybe I'd slightly worry about pre-e or diabeties later on and want that urine check, but I'm not sure.

 

With ds I had WAYYYYY too much anxiety after 2 miscarriages so the doctor would schedule me for a quick ultrasound every couple of weeks until I relaxed. Which happened AFTER he was born. No, I'm kidding, it happened once I could feel him moving. After that, i just scheduled them whenever was convenient, 4-5 weeks.

[Jean in Newcastle]

I had high risk pregnancies but my appointments were at the same intervals as every one else. I didn't find it a hardship to go in when the doctor wanted me to and would have gone at those times even if my pregnancies weren't high risk.

 

 

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[Bluegoat]

I mostly went when they asked, but it annoyed me.  I'd wait a lot longer if I could.  Especially when the whole of the appointment was pretty much dip a pee stick, weigh me, and take m blood pressure.

[DesertBlossom]

Absolutely. Especially at the very beginning of pregnancy. If something is going to go wrong and you miscarry, there isn't much that can be done anyway. For my last couple pregnancies, I went in every 6-7 weeks instead of 4. Toward the end, I would go weekly like normal. And obviously I would call or go in if something didn't feel right.

 

ETA: Part of the reason for it is because my midwife's office was a 30 minute drive away, plus I would need to find childcare for my older kids. I just wasn't worried about those firsr few appointments and when it's baby number 4 or 5 or 6, the appointments just get tiresome.

Edited September 15, 2017 by DesertBlossom

[rebbyribs]

My pregnancies have all been healthy mom, healthy, full-term babies, and the only "complication" was having fraternal twins.  I have pretty much declined extra screenings (e.g. nuchal translucency) and stretched appointments out a little with babies 4, 5, and 6.  I didn't really have anyone to watch the kids except in the last week or so.

[RootAnn]

I live 1 1/2 hours from my OB/gyn. With homeschooling full time, it is hard to get in on the exact schedule. I personally feel ok to stretch apts out some, but will make sure to make the important ones (time-sensitive). So, if testing has to be done between week x and y, I'll make that work, but I might stretch a week or two on the other sides of it.

 

I have had both healthy pregnancies and miscarriages. My doc has always been willing to work with me. I have run into when the doc is called out for a delivery. Either I get rescheduled for the next week or they try to get me in with a physician assistant (if possible) for the same apt time.

[Barb_]

I did for the first three. The rest I stretched. First appointment at the end of the first trimester then every 6 or so weeks. No complications except for extra long pregnancies.

[Hypatia.]

I'm seen at the complicated OB clinic in a military hospital due to some complications (pulmonary embolism) during my last pregnancy that risked me out of my usual homebirth midwife care. That being said, I've been seen less frequently than is standard. Early on most of my appointments were 6-7 weeks apart instead of 4. Next week will be my first appointment at the 2 weeks spacing (I'm due in early October), not sure if I'll make it to the one week spacing or not. All they do is check fetal heart tones and fundal height, along with refilling any prescriptions I need. I decline any internal exams or growth scans, so no need to be seen more frequently and if something comes up then I can call and be seen. The providers and I are all comfortable with it.

[Guest]

The midwives stretched my appointments quite a bit until 34+ weeks. It wouldn't have made a difference in the crazy that went down at the end with #6, for what it is worth. Without level two ultrasounds/biophysical profiles it would have still been missed. I feel the need to caveat lest anyone think the spacing was part of my problems ;)

Edited September 15, 2017 by Arctic Mama

[Tap]

With ds I went as instructed because he was my first and I din't know a single thing about being pregnant. (my family is very private, doesn't discuss medical things, so I knew nothing from my mom/sisters).  Everything I learned about pregnancy, I learned from books and my doctor.  

 

 

When I was PG 2 years later, I started going as ordered.  Then the genetic complications showed up so we had a lot of appointments, and then we lost her at 22 weeks.

 

DD18 was next and due to the above,  we were at the doctor several times per month for the first few months.  Once we got the genetic testing back and I hit the second trimester, things relaxed a bit.  I still had double the normal amount of appointments but the further into the pregnancy, the fewer we had. (kind of the opposite of most people).

 

If I was pg now, I would be more relaxed about it all.  But back in the day, I stuck to what the doctors recommended.

[Sara in AZ]

For the first three I went when they said. For the 4th and last....I was so not thrilled to be pregnant and I wanted to do a home birth that time, but I had to talk DH into it and then we had to interview a few midwives. So I was probably at least 16/18 weeks before I had a proper exam. But everything was fine.

[kiwik]

I was 37/38 with my first and 39/40 with my second who was also a VBAC. In NZ you are only funded to see a doctor until 12 weeks and they recommend you transfer to a midwife even sooner. I saw the doctor with ds10 because I was bleeding but not at all with ds8. They were planned pregnancies so most stuff was under control. I saw the midwife as requested and had a 12 week nuchal scan and a 20 week anatomy scan (they seem to do more now and the 12 week is standard rather than just 35+). I would probably have turned down an amnio but it was never suggested.

[gardenmom5]

I always went with the normal timeline.  

if things needed to be more frequent - I went with that - usually because something else was going on.

 

[desertstrawberry5]

My pregnancies were high risk. I started care late with a couple because of insurance, but once I started, I did what was asked, including weekly appointments and specialists. With my last one I asked for less monitoring, fewer appointments, because they were stressful for me. I ended up needing them anyway. 
With number three. I went to be with my dying mother, so I missed a few months, but that was extenuating circumstances. 

[Laura Corin]

I went on the normal time line, but in both the UK and Hong Kong most were midwife meetings, so they were friendly and helpful, not intimidating.

Edited September 15, 2017 by Laura Corin

[barnwife]

I go as my midwife asks. However, I love my midwife. I look forward to appts. with her. And she is totally used to people bringing other kids along to appts. So I never stress about childcare. (I do try to leave the others with DH, but if he has to work, oh well, with me they come.) And I am also fine with stretching this out assuming healthy mom/healthy baby.

I've done that a few times when my MW was traveling and would have had to see her backup.

[Elizabeth86]

I go as scheduled. Probably not needed, but Im a rule follower.

[Carrie12345]

I had scheduling conflicts that dragged things out, so it wasn't an intentional choice.  But I think that's a big part of having regular intervals to start with.  4 weeks turned into 5 or 6 weeks never made my obs or mws seem concerned. Intentionally planning 5 or 6 weeks that turn into 7 or 8 weeks over the course of 40 (or 42, lol) weeks because of scheduling issues/deliveries/weather/zombies is half as many as 4 week intervals. 

 

(And I realize the time frame shifts. Just trying to use easy numbers.)

[lavender's green]

My midwives actually suggested stretching out the appointments, since I was coming from an hour away and had previous healthy pregnancies. They just reminded me of time-sensitive tests and urged me not to go longer than they had already suggested between appointments. I was so grateful to not have to drag toddlers along more than necessary!

[ktgrok]

Yes. That makes a difference. I had home births with the last three and midwife appointments were times to be cherished. Hour long appointments with a friend who did way more than check my urine and blood pressure. (actually, I checked my urine myself at each visit). She also TALKED with me about what I was feeling, stress levels, how I was sleeping, were things going okay with my writing career, energy levels, my feelings about the pregnancy and birth, nutrition strategies, concerns I might have, etc. AND she had a play area for my other kids if I brought them, so I never felt I needed to find childcare. 

 

That said, a few times either she or I was going to be out of town on the day of the regular appt, so we just did it a few days later or the following week. This was more in the beginning of pregnancy. By the end I was there fairly often, plus doing biophysical profiles, etc. Silly late baby!

I went on the normal time line, but in both the UK and Hong Kong most were midwife meetings, so they were friendly and helpful, not intimidating.

 

Edited September 15, 2017 by ktgrok

[ErinE]

I went on the timeline with my first. I got to listen to the heart beat and just enjoy the focus on me. I never found the appointments intimidating, but I had great OB/GYNs.

 

The next three were all high-risk. The appointment timing was no different, just a few more ultrasounds and blood tests. I do think checking in, no matter the risk status, once a week towards the end is important. I didn't realize I was severely dehydrated with #4 until the doctor listened to my complaints and made a diagnosis. I thought feeling terrible was just part of the last trimester.

[Zinnia]

With my last (4th) baby, I did not. Childcare was a real issue (my kids were 1, 3, and 5, and they were Cray-zeee that year).

 

I got a few comments from the nurse practitioner, but I laughed them off (I am sort of a laughy, jokey person IRL), and it was fine.

 

I had my first appt at around 16 weeka, then another around 22, 26, 30, 33, 35, 37, 38.5, then had the baby.

 

I also declined the viability ultrasound (I was already 16 weeks), and I declined the late 3rd trimester ultrasound (I was having a repeat c-section, my placenta location wasn't an issue, and I told the doc the weight of the baby within ounces; anybody could have guessed, she was that obvious).

Edited September 15, 2017 by Zinnia

[Heatherwith4]

Usually yes. Particularly at the end of the of the pregnancy.

 

The visit I have coming up on Tuesday my dr actually stretched to 5 weeks, because he wants to go ahead and do my 20-week ultrasound. I don't really mind waiting in this case because i can feel the baby moving, and it's several months before I typically have any complications (high blood pressure.)

[Paige]

I'm fine with making appointments on the recommended schedule assuming that the schedule assumes a give or take of about a week or so in the beginning. I go much more often than I'd prefer this time because of AMA but it's not onerous. I thought about asking to space out the appointments, but decided that the doctor probably had reasons for her schedule based on experience I don't have, and coming in a few extra times was no big deal. I have a few L&D nurse and midwife friends and after listening to their stories I understand why they and some doctors may seem overly cautious. 

 

I may feel differently if it were truly a burden. My co-pays are not significant and my kids are older now and don't need a babysitter.In previous pregnancies, I was ok taking them with me to appointments that didn't require internals and finding childcare for the few that did require internals wasn't too hard because we had plenty of time to plan. 

[MeaganS]

I went to them all, even when it was 3 hours away (a few months with my 2nd). I also always brought all my kids. It was very rare that they didn't come with me. Dh was working and I didn't have a choice. I'd just set them on the chair with an iPad. ☺ï¸

[maize]

I'm totally fine with stretching out the time between visits and usually do.

[Heather in OK]

As a midwife, I sometimes am fine stretching out a client's appointments to every 5 weeks before 28 weeks and every 3 weeks between 28-36 weeks.  However, I'm pretty picky about those last few weeks being weekly appointments.  There is so much than can creep up during that time which makes those frequent visits so important.

[medawyn]

Early pregnancy I don't mind stretching 5-6 weeks. My doctor actually just scheduled my last appt for 6 weeks to accommodate the anatomy scan.

 

After 35 weeks, I always go weekly. I know too many people who have had issues with things like preeclampsia to fool around. My last doctor was over an hour away, and dragging two toddlers was not awesome, but we did it. I'm glad to have found a doctor I like in town for this pregnancy, even if cramming three kids into the patient rooms makes it feel like I've brought a horde of monkeys.

[My4arrows]

I actually just talked to my doctor about this today and she said since all has been well in this and my previous pregnancies there's no need to come as often. So as of now she's ok with stretching appointments out...yea! No appointments every two weeks! And that helps since I hate having to find child care for my other 4 and she said if anything feels wrong or I want to come more often she can get me in that day and well reassess. For my others I did go regularly as told, but I will say my doctors then were less willing to work with me and my wants/needs.

[eternalsummer]

I weigh myself, take my blood pressure, ask myself how I'm feeling, ask myself if the baby is still moving okay, and skip pretty much half my appointments.

[QueenCat]

You don't know that everything is fine unless you keep up with regular appointments. Thank goodness I did....

[scholarly]

With my first I went according to schedule because I could take the time off work and it didn't count against me. When choosing between going to work or sitting in a waiting room reading a book, it was a no-brainer for me. With my last two I had homebirths and the midwife came to my house for all appointments. I had all appointments as recommended, even though I had no complications whatsoever. I enjoyed my midwife appointments so much! Childcare was not a problem, since I just sent the kids to another room to watch a movie while the midwife was there.

[happypamama]

My CNMs with my first two did the standard schedule. After my second, my SIL had all the standard care, ultrasounds, all the OB appointments, and her baby was an unexpected stillbirth at 35 weeks due to a cord accident. I had been wanting a less structured approach anyway, and that pushed me over the edge. I took a more variable schedule with my last four. I did appointments when I felt they were necessary. With number five, I saw the midwife shortly before term specifically to confirm that he was head down. He was. And then he flipped before birth, little adventurer, and he and I were totally fine.

 

For number six, I saw the MW at 10 weeks, 19 weeks, and then 23 weeks when the 22 week ultrasound looked disconcerting. I also had my primary doctor running labwork and scheduling ultrasounds in there too because my insurance didn't work with my midwife (same midwife as number five). More appointments wouldn't have told us anything helpful. He measured close enough to target at all the early ultrasounds, and at 19 weeks, my BP was good, and my uterus was measuring ahead. Nothing short of a lot of ultrasounds, if that, would have told us before 20 weeks that his fluid was low and his growth behind. And even if we'd known, there wasn't anything we could have done. There wasn't anything anyone could do at 24 weeks when the MFM diagnosed oligohydramnios and serious IUGR. At that point, my BP was still just fine. When it spiked a week later, the MFM caught it and got me set up for the preeclampsia workup. Had I stayed with my midwife, it's possible that my high BP might not have been caught in time, and I might well have had a stroke and/or a stillborn baby. (My BP hit 200/something the night before I ended up delivering, and I was still asymptomatic of the preeclampsia hallmarks.) However, going with the standard OB care and visits at 20, 24, and 28 weeks, the BP spike, which happened at 26 weeks, wouldn't have been caught either. It is only by the grace of God and a super strong impression He put in my heart that Something Was Not Right that when I went from the lowest of low risk to highest of high risk, I was seeing the right people. Sooooo, all that to say, the standard schedule is fine and all, but things can go south at any point, and your intuition counts for way more than you think.

 

Now, I hear that next time, it'll be biweekly appointments and ultrasounds starting early and very possibly multiple appointments each week toward the end. And if I get that far, someone can smack me for complaining about so many appointments. ;)

[kroe1]

For the oldest one, I had no money. I went to the local health department when I could get there. For the last child, I had no prenatal care except what I did on my own while working in the hospital. For example, I could take my blood pressure. I did have an ultrasound with each pregnancy. Both of my children were preemies. I am not sure how prenatal care would have prevented that in their case.

 

Nonetheless, there are many reasons to get good, on-time, prenatal care. When a problem is discovered early, such as gestational diabetes, treatment can help prevent complications.