Becoming pregnant with a new child, especially your first, is a very exciting time for expectant mothers. If you have never given birth, or you are new to the area, you may have a number of questions about what to expect when you deliver your baby. Dr. Jamie Rempe, an OB/GYN at The University of Kansas Health System St. Francis Campus, joins us to answer a few questions from expectant mothers.
1. When expectant mothers go to their first examination with their obstetrician, what should they expect?
They can expect to hear their baby’s heartbeat. If we are unable to hear it, we will get an ultrasound to see what is going on. Mothers should also expect the provider to review their medical history as well as their obstetric history if they have been pregnant in the past. Depending on any risk factors, the provider may talk about further testing or future interventions that may be expected in the pregnancy due to these risk factors. The provider will often discuss available testing in regard to genetics for the baby and the mother and offer testing or referral to another provider’s office for additional information.
There will typically be an exam, including a pelvic exam, but that is not always absolutely necessary depending on the gestational age and history. This is also a time when the patient should ask questions or express concerns they may have about this pregnancy.
2. What are the most important things expectant mothers should do while they carry their baby?
They should make sure that they get regular routine prenatal care as well as communicate well with their doctor’s office about concerns or issues they are having. It is important to try and be as healthy as possible during pregnancy. Start with a healthy diet and stay active unless directed otherwise by their doctor. Be sure to stay away from medications or environmental agents we know put moms and babies at risk.
I also tell my patients to decrease stress as much as possible. Life happens and is different for everyone, so I know there is only so much one can do to completely eliminate stress. Taking a prenatal vitamin is always a good idea unless the vitamins cause severe nausea and vomiting. If that happens, we will recommend waiting to take until that improves.
3. Of course the baby grows every day, certainly from one trimester to another. Which trimester is most important for the baby?
I don’t believe there is one trimester more important than the other. They are all very different and they are all essential to a healthy baby. The first trimester is often associated with nausea and vomiting, as well as significant fatigue. This is the time when the baby’s organs are forming, so exposure to certain medications, illnesses or other substances may play a key role in how these organs form and the growth of the baby.
In general, for most women the second trimester is the easiest one with regards to feeling well, having more energy and less pain.
The third trimester is when the baby and mother typically gain the most weight. There are certain illnesses or medications at this time (as well as the second trimester) that can affect the baby’s health. Moms start to feel more uncomfortable in the third trimester with low back pain, heartburn and difficulty sleeping. There is also increased swelling and greater feelings of fatigue by the end of the day. These are the most common symptoms for each trimester, though they can happen with any trimester.
4. Which trimester is most important (medically, emotionally, etc.) for the mother?
Again I don’t think you can really say. For some, the emotional importance is related to their obstetric history, so getting past a certain age seems to be very important to help with anxiety. For others, the hormone changes from the first trimester may significantly affect their mood. Others say the pain and fatigue at the end of the pregnancy play more of an issue on their emotions.
As I said, all trimesters are medically essential to the health of a baby. Still, the third trimester is the time when we often see increased medical conditions in mothers, such as gestational diabetes, gestational hypertension (high blood pressure), preeclampsia or cholestasis of pregnancy. That is why prenatal visits start to get closer together, going to every 2 weeks at 28 weeks and then weekly at 36 weeks. This helps healthcare providers monitor the expectant mothers for signs and symptoms of pregnancy complications.
5. Do you have any other tips/information that expecting mothers remember when they go to St. Francis Campus for the delivery?
I always tell expectant moms to trust their healthcare provider. They should believe that their obstetrician or midwife has the best possible intentions for them and their baby. If they don’t have trust, then they may not be seeing the right person. I also think it is completely understandable to have goals and desires of how they would like their delivery to go. Each mother is different in what is important to them and how to make their delivery experience a special and positive experience. Regardless, it is important to remember that no one can know for sure how the labor and delivery will go. Patients and providers need to be flexible and deal with what comes at us. The ultimate goal for any OB or midwife is to have a healthy mom and baby at the end of the day. Please listen to your provider and be open to suggestions, especially if your provider feels something has to change from the anticipated birth plan. We truly want every mom to have the experience they desire, but the health of mom and baby will be our top priority.
Dr. Rempe, along with our team of physicians and midwives at The University of Kansas Health System St. Francis Campus Women’s Center, offers a full range of gynecological and obstetric services for keeping you healthy through every stage of life.
Our experienced team is committed to providing personalized, quality care that you deserve. To learn more or to schedule an appointment, call 785-295-5330 or visit kutopeka.com/women.