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Pregnant? Your first visit to the obstetrician
Dr Roopa Nishi Viswanathan
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February 05, 2007

Your home pregnancy test was positive.

What is the logical next step? Should you visit the doctor right away? Should you start popping those supplement pills? Should you wait a few weeks to confirm if you are indeed pregnant?

The right answer: Make an appointment with your obstetrician if your home pregnancy test is positive.

How to choose your obstetrician

Not all obstetricians are created equal. Here are a few tips to choose the right one for you. Make sure you answer the following questions about your obstetrician before you decide on one. Do not hesitate to ask your doctor or their assistant some of these questions. You have the right to know.

~ What are your doctor's qualifications?

~ How many years of experience does she/he have?

~ Which hospital/maternity home are they affiliated to? Is it well equipped and hygienic?

~ What is the doctor's policy on the number of people in the delivery room with you?

~ What are the chances the delivery will not be conducted by your obstetrician, but her assistant doctor or another doctor from her network?

~ Are you permitted to call your obstetrician's cell phone in case of emergencies?

~ How is the doctor's bedside manner? Do you feel comfortable with her?

~ Does she patiently respond to all your questions? Does she try to end the visit quickly so she can see the next patient?

~ Does she seem well informed and up to date in her thinking?

~ How much time does it generally take for you to see her if you have an appointment?

~ Does he/she accept your company's insurance?

There are obviously no "Yes" or "No" answers to these questions. There is no such thing as "the perfect obstetrician". Every woman finds that there are certain things that matter more to her than others when choosing an obstetrician. Try to set your priorities early in the pregnancy, so you can find the perfect doctor for you.

Your best bet might be to talk to a friend/acquaintance who was treated by the same obstetrician. When you are in the sitting room, try and have conversations with fellow patients to get more information about the doctor. This might sound trite, but even in today's world; word of mouth is still one of the most resourceful ways to choose a doctor.

Changing your doctor

What if you choose a famous obstetrician and after a few visits, find that you do not really like her?

Many women think that once they have chosen a doctor, they are stuck with her/him for the duration of their pregnancy. This is not necessarily so. If your doctor's personality, her bedside manner or her treatment philosophies (for instance, prescribing drugs for every minor condition) do not suit you, feel free to look for another obstetrician. Again, try and glean from your friends' experiences.

Mekhala Reddy, a 28-year old marketing executive from Hyderabad realised in her second trimester that she did not feel too comfortable with her obstetrician.

Mekhala says, "I had the feeling she had too many patients and was not giving me enough attention. She used to keep me waiting for hours before I could finally see her. And when I finally got to see her, she was constantly taking calls on her cell phone. I was not even sure if she would be present for my delivery. Even though, it was a little late to do so, I decided to switch doctors and now I am happy with my obstetrician. She patiently answers all my questions and I think she genuinely cares about her patients."

What to expect during your first visit to the doctor

On the day of your first visit, your obstetrician will do the following things.

~ Determine your due date.

~ Ask you several health related questions to assess your general health

~ Ask you about any genetic conditions associated with you or your family.

~ Find out if there are any pregnancy risk factors based on your age, health and/or personal and family history. If there are any genetic diseases (like sickle cell anemia, thalassemia) that run in your family, you might be counseled for genetic screening.

~ She will assess your weight, check your blood pressure and do a general physical examination.

~ A pelvic exam will be done to assess the size of your uterus and pelvis.

~ Order blood tests and urinalysis to rule out the presence of any other health issues.

~ Prescribe prenatal vitamins, especially folic acid.

~ Schedule your next visit.

Your doctor might also:

~ Check for your baby's heartbeat using a fetal heart monitor (usually the heartbeat is audible after 10-12 weeks of pregnancy).

~ Have an ultrasound performed to verify your due date and check the baby's heartbeat.

Questions to ask the doctor

Here are some examples of questions to ask your obstetrician:

~ Do I need to take any other medications?

~ What medications should I totally avoid?

~ Are all my symptoms normal for this stage of pregnancy?

~ What should I do in case my morning sickness becomes severe?

~ Are there any guidelines regarding weight gain, nutrition and exercise?

~ What activities and foods should I avoid?

~ Do you consider my pregnancy "high-risk"? What does that mean?

~ Can I sleep on my side/stomach?

~ What medicine should I take for flatulence?

~ For what symptoms should I call you?

Dr Anjali Rajurkar, a gynaecologist from Mumbai says, "Most women who come to me are very excited and apprehensive at their first visit. I usually encourage patients to ask me every single question they might have. When it comes to the health of your baby, no question is a dumb question. When in doubt, ask".

Next week: We answer common questions about pregnancy

-- Dr Roopa Nishi Viswanathan has an MBBS from KEM Hospital, Mumbai, with a Masters in Nutrition from the University of Texas at Austin.

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