When should women go to the doctor once they find out they're pregnant?
Can you say what the benefit is to going and what the harm is if they don't?
So I'm actually going to back up a bit and recommend that its best to get into the doctor when you are thinking about becoming pregnant. There are a lot of lifestyle things and medications that can be very harmful to the fetus; many times, before women even know they are pregnant. Its best to get in before your pregnant so you can talk to your doctor about medication and supplements you may be taking and if they are safe for pregnancy. If they are not, the doctor can help wean you off of them or switch to more pregnant friendly drugs. Before becoming pregnant its also important to quit smoking, reduce drinking alcohol and caffeine and be taking a multivitamin. Preferable a prenatal with DHA and folic acid in it. A healthy diet and exercise will also make pregnancy much more enjoyable. Having these things as habits before becoming pregnant helps the rest of pregnancy go much smoother.
Important vitamins and supplements to take while trying to get pregnant or are pregnant:
Prenatal vitamin- This provides a good balance of vitamins and minerals that are important to help the fetus grow. Taking the supplement will ensure that you have enough vitamins and minerals in your diet and don't become deficient. The baby is really good at taking what it needs to grow. We don't want the moms to have vitamin deficiencies resulting in complications.
Folic acid- Most prenatal vitamins now have folic acid in them, but if yours doesn't make sure to supplement. Folic acid is very important to the neural tube in the fetus which develops into the brain and spinal cord of the baby. These develop very early on in pregnancy, usually from fertilization to week 4.
DHA- Is an omega-3 fatty acid that is the primary structural component in the brain. Once again a lot of prenatal vitamins now how this in them but if not make sure to supplement. This helps the fetus brain develop correctly.
It is best to get in to see the doctor as soon as you know or think you may be pregnant. It is important to start prenatal care in the first trimester. Usually around week 8 or 9. This allows the provider to be able to get baseline weight, blood pressure, and labs on the mother that they can compare to as pregnancy progresses. Having a complete history and physical is also important early on. This will make the provider aware of any possible health issues that may come up and cause complications during pregnancy and delivery. Getting in and starting prenatal care early is important for screening tests for both mom and fetus. Mom should be up to date on her immunizations (flu, varicella, tetanus), and tested for disease and/or infections that can pass through to the baby. These include genetic and inheritable conditions but also infections that can lead to preterm labor, miscarriage or illness during delivery. This also includes chronic conditions that mom may have or develop during pregnancy like high blood pressure, thyroid disease, and diabetes. Having an ultrasound early on in pregnancy is also beneficial. It allows more accurate dating of how far along you are and when the due date is, can show early abnormalities with the fetus, can ensure that the egg implanted correctly and that the placenta is not over the cervix, as well as the amount of fluid around the fetus. Prenatal care is also important to help with information. It allows you to ask your questions on why you are feeling the way you are and get advice on what to expect. Everything from morning sickness, frequency of urination, pelvic discomfort, feeling bloated, breast tenderness, what to expect with labor, and medications that are safe if you develop a cold or illness. Prenatal care usually starts with being seen about 1 time a month early on in pregnancy and progresses to more frequent visits the closer to delivery. Getting these frequent checks helps to ensure that the fetus is growing and developing appropriately and if any problems arise it can be addressed appropriately.
Not getting in for regularly scheduled prenatal visits can lead to a lot of complications. If there are medical conditions like diabetes, hypertension and genetic conditions they will not be treated appropriately. Continuing to take medication that is not appropriate, smoking or drinking alcohol could lead to birth defects, preterm labor or miscarriage. Without prenatal care, babies are 5 times more likely to die for complications with pregnancy or in infancy.
What things should they stop doing that could harm the baby?
Things that can cause harm to the baby:
Smoking- Smoking during pregnancy reduces the amount of oxygen the fetus receives. This results in structural changes in the placenta, therefore the fetus is not getting the correct nutrients leading to altered development. The increased carbon monoxide due to smoking attaches to the red blood cells stronger than oxygen. This means all tissues in the fetus are not getting the oxygen they need to develop. The nicotine also directly impairs lung development. All of these factors contribute to low birth weight babies, preterm labor and a higher incidence of sudden infant death syndrome (SIDS)
Drinking alcohol- alcohol is a teratogen (known agent to cause malformations of the embryo). Fetal alcohol syndrome and fetal alcohol spectrum disorder are both used to describe the complications a baby suffers due to the mother drinking. It impacts fetal growth and development at all stages of pregnancy. Resulting in birth defects and developmental disabilities. Everything from low birth weight and preterm labor to disabilities and dysfunction in motor skills, behavior, and IQ.
Illicit drugs- Marijuana, cocaine, heroin, hallucinogens, meth, inhalants- many people doing any of these drugs are not properly nourished leading to the fetus not getting proper nutrient for development. The majority of these babies after delivery go through withdrawal. These drugs can also pass through breast milk. The effects on the baby are dependent on the drugs that the mom is doing. In general, all of these can lead to abruption placentae (placenta detaches- can cause death to baby and mom), intra-amniotic infection (infection in the fluid around baby), preeclampsia (elevated blood pressure and seizures in mom), preterm labor, premature rupture of membranes, miscarriage, postpartum hemorrhage, septic thrombophlebitis (infected blood clot in mom), heart disease and death.
Medications- Opioids or pain medication cause a lot of the same problems as heroin. The babies go through withdrawal after delivery resulting in seizures and brain dysfunction. Benzodiazepines (Xanax, Ativan, Klonopin, etc) fetal exposure to these drugs cause an increase in oral cleft deformities, spontaneous abortion, low or high muscle tone, tremor (shaking), poor feeding and preterm labor. These drugs are all listed as possible teratogenicity.
There are medications that need to be taken during pregnancy for some conditions. It is important to discuss risks vs. benefits with a provider and which medications are the safest. Whenever possible it is best to avoid fetal drug exposure, especially during the first trimester. Please discuss starting or stopping any medication or supplement with provider beforehand.
Food- Avoid unpasteurized cheeses or milk. These foods can carry the bacteria Listeria. This bacterium can cause severe stomach symptoms including vomiting and diarrhea. Occasionally this bacterium can affect the tissues surrounding the brain and spinal cord and cause meningitis and meningoencephalitis. This can lead to fetal death, premature birth or infected newborns.
Avoid eating uncooked fish. There may be parasites and bacteria. Avoid fish with high mercury levels. Examples include marlin, shark, swordfish, and bigeye tuna. Eating these fish in large quantities can lead to fetal mercury toxicity and damage to the central nervous system (brain and spinal cord).
Avoiding under-cooked or cured meat products is recommended. These foods can carry a parasite called Toxoplasmosis. This parasite can be transferred to the fetus; it invades the brain and muscle tissues. Maternal infection is usually not symptomatic or nonspecific symptoms including- fever, headaches, chills, muscle aches. Cats can also carry toxoplasmosis so it is not recommended that pregnant women change litter boxes.
Hot tubs and Saunas- Avoid during pregnancy but especially during the first trimester. The heat exposure from these causes the mother's body temperature to rise which can cause defects with the neural tube (turns into the brain and spinal cord).
This is not an extensive list. Please talk to your OB/GYN or other health care provider about other chemicals or hazards you may be exposed to during pregnancy.
Ginger Todd PA-C
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