Since I’ve officially made it through the first trimester of pregnancy (this is my second child), I thought it would be a good time to talk about why there is no good reason that the typical healthy woman who is having no unusual symptoms must go to a doctor or midwife in the first trimester (unless she wants to).
I’m not a medical professional. Please do your own research and consult your practitioner on what is best for you. To be clear, I’m not telling you what to do, just giving another perspective. Please only do what you feel comfortable with. I’m not going to judge you either way. Please read the full post before commenting.
Why You Don’t Have to Have a First-Trimester Prenatal Appointment
Just like a lot of women, I was surprised that my midwives didn’t want to see me before 12 weeks. I thought that you basically rushed off to the doctors the minute you found out you were pregnant.
I think this view has become common because of the medicalization of pregnancy in the US. We treat pregnancy like an illness that needs to be managed instead of a natural biological process that our bodies usually know how to do on their own. Yes, there are times when women (including myself) need some medical help in pregnancy and thank goodness for its availability, but typically birth happens without all of that.
Not only that, but many interventions are potentially harmful to you or baby and should only be used when necessary and not routinely. Of course, if you are having unusual symptoms or not sure if your symptoms are unusual, (or if you just want to!) give your practitioner a call!
Bottom line: A woman who has no underlying health issues and is otherwise healthy (especially if she has had a previous pregnancy that was normal and healthy) may not need to go to a first-trimester prenatal appointment.
Should you call your doctor or midwife? Sure! Starting a connection with a midwife or doctor is a good idea so you can have someone to call for any reason or so you can have a phone consult if needed. I’m specifically talking about the standard first-trimester prenatal in-person appointment. I am NOT advising anyone not to call their doctor or midwife.
Why I WOULD Go to a First Trimester Appointment
There are a few reasons that I would go to an early first-trimester appointment.
If I could refuse any intervention I didn’t want (I can, legally), and my doctor or midwife would offer a thyroid test and a blood sugar test, I would consider having this appointment.
Thyroid Test
There is currently a debate among experts as to whether thyroid testing should be standard in early pregnancy Because of how a thyroid problem in pregnancy impacts the child later in life. From my research and my experience (having a diagnosis midway through my second pregnancy), I would ask for this test early in my first pregnancy.
Also, because I have a known thyroid condition I would need to see my PCP for an adjustment of my med in early pregnancy. This is not a penatal appointment!
Blood Sugar Test
New research suggests that an early first-trimester blood sugar test can catch gestational diabetes (GD) early which allows for more time to adjust diet for a healthier pregnancy.
At the time of this writing, these tests are not part of a standard first-trimester prenatal appointment. So while I would have a first-trimester appoint for these tests, many doctors won’t offer them, and may not even do them if you ask.
With this being said, the following is why a first-trimester prenatal appointment is not as important as you may think.
1. Home Pregnancy Tests are Just as Good as Doctors’ Urine Tests
There is no need to go to a doctor or midwife to confirm a pregnancy. Unless you are near menopause (which increases HCG levels and can cause a false positive) a positive test means you are pregnant.
A negative test means you are either not pregnant or have tested too early. Yes, you could go to the doctor and have a blood test, which is more sensitive and might provide a positive result, but I don’t recommend it.
The reason is that yes, a positive result means you’re pregnant BUT it doesn’t mean you will stay that way.
Early miscarriage is common and we have no way of knowing how common it is to miscarry before getting a positive HPT or missing a period. Many women would probably just think they didn’t conceive.
It’s enough of a loss to get your period when you are trying to conceive that I don’t see any benefit to knowing about a pregnancy before a urine test can confirm it and then face the huge chance of losing it.
Therefore, it makes sense to wait and test at home.
2. There’s Not Much to See or Hear
You typically can’t hear a heartbeat with a doppler until 12 weeks. In fact, you can barely feel the uterus at 12 weeks because it’s still way down in the pelvis. That means your doctor or midwife may not even bother measuring you at your 12-week appointment.
There will definitely not be anything to measure before that. Any appointment before 12 weeks will likely just be chatting and getting to know your practitioner which can be great but isn’t medically necessary (and can be done over the phone if needed).
3. Routine Ultrasounds are Unnecessary (and Potentially Harmful)
It is increasingly common for women to get routine ultrasounds in the first trimester, starting as early as 6 weeks. For a normal healthy woman (and I would argue for many others as well) there is no benefit to routine ultrasounds.
The American College of Obstetricians and Gynecologists discourage the use of ultrasound diagnostic without cause, arguing that, though there isn’t a proven connection between ultrasound use and ill effects on the mother or fetus at this time, there is a real possibility that it could be discovered in the future.
One study published in the New England Journal of Medicine concluded that the use of ultrasound scans did not improve fetal outcome. Even when the ultrasound discovered abnormalities the fetal survival rate was the same for the group who was given ultrasound scans and the group who was not.
Another study found similar results and concluded that there is no benefit to routine ultrasounds. In fact, some studies have found ultrasound to cause harm to the growing fetus.
Some doctors might argue that an ultrasound can accurately predict an estimated due date (EDD). Still, judging by last menstrual period is just as accurate (I like this online due date calculator for the most accurate dating).
Early Abnormalities?
Many readers have mentioned ectopic pregnancy and missed miscarriage. These are valid concerns as an ectopic pregnancy, though rare, can be very dangerous and a missed miscarriage carries the potential for infection (not to mention the emotional turmoil).
If I were someone with a history of ectopic pregnancies or was high risk for them (being a smoker or having pelvic inflammatory disease or endometriosis) I may want to have an early ultrasound to rule out ectopic pregnancy. I can also understand someone with this history wanting one to ease their mind after a previous ectopic pregnancy. Stress is terrible for a healthy pregnancy.
We all have to weigh the benefits and risks of our choices. I personally believe that for me the risks of early ultrasounds etc. are greater than the risk of a symptom-less ectopic pregnancy or missed miscarriage.
4. Routine Pelvic Exams are Unnecessary (and Potentially Harmful)
Unless there is a reason, symptoms of an infection, for example, pelvic exams are unnecessary and potentially harmful.
While researching for this post I had a really hard time finding what exactly these first trimester pelvic exams were looking for. To me, that seems like a red flag in and of itself.
Here is what I found the first-trimester exam is supposed to do:
Confirmation of pregnancy – I really don’t understand this one. How is a urine test not enough confirmation? Not to mention the lack of menstruation, constant peeing, sore breasts, etc. I’d really love to hear from some medical professionals on this one.
STD screening – If you’re in an exclusive relationship and have been tested in the past then you really don’t need to be tested again. Even if you are concerned about STDs, Chlamydia and Gonorrhea can now be tested for with urine. The point is: This shouldn’t be a routine procedure but should be utilized on a case by case basis.
Pap smear – If you’ve had a pap smear recently then you don’t need one in pregnancy. In fact, many practitioners won’t do one until after the birth. This is partly because any abnormalities wouldn’t be addressed until after the birth anyway.
Furthermore, though the doctor’s instruments are sterile, the vagina is not. An exam could push bacteria from the opening of the vagina back to the cervix, which then could cause infection. An Exam can also cause pain and bleeding. It’s one thing to agree to a procedure that is harmless just in case. A pelvic exam, though, is potentially harmful so shouldn’t be routine.
If the practitioner can’t gather any useful information why do some still bother seeing women in the first trimester?
We have to remember that the standard of care is put in place for the general public. That includes people who are uneducated/uninformed, addicted to drugs, don’t get healthcare regularly, and have unprotected sex with multiple partners. That doesn’t mean if you had this appointment you are any of these things! It simply means that the standards are set to address the needs of these people. Those standards happen to be unnecessary at best and harmful at worst for women who don’t fall into these categories.
Taking this into account it makes sense that an OB would want to see a pregnant woman in the first trimester to talk about nutrition and other health concerns such as drug use.
It also makes sense that they would want to check for STDs. Many STDs have no symptoms but can be very serious for your baby.
We also need to remember that a hospital is a business. I’m not saying that they are just out to get your insurance payments. I believe that most doctors and nurses truly care about giving the best medical attention they can.
I’m just saying that hospitals aren’t going to question whether those extra appointments are necessary. They’re getting paid for them and you are consenting to them and no harm is being done (depending on who you ask). So, they have no reason to question whether early appointments are necessary or not.
Many of the routine tests and procedures in obstetrics are not relevant to every woman or every pregnancy.
Becoming Informed and Confident
I have considered adding one more reason that you don’t have to go to the doctor in your first trimester. That would be – #5. Because you are in control of your body, life, and child! I think we sometimes forget this with doctors guilting, shaming, and otherwise emotionally manipulating us into doing what they want us to do. No, not every doctor! I believe many are great. But this has happened to me and has happened to many other women.
Does that mean I think women should put themselves or their babies in danger to assert their autonomy? No, of course not!
I’m not actually advising you not to have a prenatal appointment in the first trimester. Please read this sentence again before commenting please: I’m not advising you to skip a prenatal appointment in the first trimester.
If it makes you feel better to go and you can decline any procedure that is not harmless, then great. If you think the above interventions are good and necessary, do as you want.
Definitely make any necessary appointment if you have a thyroid issue or other underlying health problems. Call your midwife or doctor when you find out you are pregnant so they can get records transferred if necessary and know who you are in case you need an appointment for whatever reason.
I am simply offering information so that you don’t have to feel powerless in your pregnancy. If you have some information when you call to interview your doctor or midwife you are in a better position to choose someone who respects you and your wishes.
Ultimately we need to be our own advocates, do our own research, and choose a provider we trust. That way we can make informed decisions for ourselves and our families, right?
If you’re hoping to have a healthy pregnancy and birth based on evidence-based maternity care then I recommend a few resources:
Books!
Ina May Gaskin is amazing. I wanted to have a natural birth but was scared but reading Ina May’s Guide to Childbirth
A Natural Birth Class
Check out this natural birth class online. You’ll learn how to achieve the natural birth experience you desire. This class is run by my good friends and is an amazing resource for new moms, seasoned moms, VBAC moms, and anyone else hoping to achieve a natural childbirth.
A Midwife and/or Doula
Midwives follow an evidence-based model of care and are your best chance at a natural birth if you want one. If a midwife isn’t an option for you, a Doula is the next best thing. A Doula will stay by your side through your labor and delivery and can be your voice in a hospital birth setting.
What Do You Think?
Did you have a first-trimester prenatal appointment? Do you think they are important or not?
I completely agree with the pap smear. I refuse those at my prenatal appointments because I get them regularly and, I know that if a problem is discovered, doctors won’t really do much until after birth anyway (unless it is full-blown cancer, which might change things, I guess). I actually asked my doctor why those are done at initial prenatal visits and she said that basically it is the first/only time many women even see an OB/GYN, so they take advantage of that time to get routine screening done. I guess I tend to forget that there is a HUGE portion of the population who don’t have good, regular health care and that, for many women, prenatal care is the most “regular” care they get.
In general, I get that there isn’t much to see/do before 12 weeks and I suppose I may not be in the “normal, healthy women” population you refer to at the start of your post (though I certainly don’t think of myself as ill). but as someone who has had two missed miscarriages, there is something HUGE to be said for the reassurance and (temporary) anxiety relief that comes from knowing that a pregnancy is progressing normally, is in the right place, etc. Right now, that is far more important to me than the possibility that, at some future date, extra ultrasounds MIGHT be proven to be less-than-ideal. For now, any study that points to such an outcome is likely quite problematic because women who have more ultrasounds are likely ones who have had fertility issues or miscarriage problems, so of course the outcomes in that population will likely not be as good.
That’s a good point. Many women don’t go for regular screenings and therefore would be in need of such screenings during pregnancy. My point is that if you do go for screenings regularly then you don’t “have to” get it done again just because you are pregnant. A lot of women are just so nervous that they go along with whatever the doctor says without questioning whether it’s right for them.
And yes, someone who has fertility issues or a history of missed miscarriages would be in a different category as the benefits of early ultrasounds and exams might outweigh the risks in those cases.
Thanks for your comment!
The thing is, China just did a study on ultrasounds. They don’t have the ethics problem that we do with human studies, apparently, and they did find an issue with ultrasounds.
Interesting, I’d love to see that study.
I too would love to read that study!!
I’m really sorry, but those “China Studies” about ultrasound where there’s no “ethical considerations” are fake. I looked deeply into this and the guy who translated them made them up. In China, we get the same ultrasounds (every 4 weeks, then every 2 weeks, until about week 32, then every week), along with REALLY uncomfortable pap smears and there’s no evidence from here that they’re harmful to babies. Chinese hospitals are SO cautious when it comes to baby health because when you can’t have many kids, you are careful with them. They don’t randomly put babies at risk to do experiments and I find it disappointing that westerners are so ready to believe that. In fact, even getting medications for morning sickness is difficult here because they are worried it might harm the baby, whereas these are given out routinely in the US and Canada (I’ve been pregnant there, too).
Thank you for your comment. I’m going to look into this!
Cervical cancer is an extremely rare cancer any how. Also, having a pap during pregnancies can cause miscarriages, it is written right on the packet of the brush they use.
Cervical cancer still kills more women than breast cancer
In general, I’m 100% with you. BUT you haven’t spoken to the risks of ectopic pregnancy. Certainly relatively rare, but worth considering in these decisions.
Very true, which is why it’s important to be aware of symptoms of ectopic pregnancy (or any abnormality) so that you know when you are just experiencing regular pregnancy symptoms or whether something is wrong. I would call my doctor or midwife at any point in a pregnancy if I thought something didn’t seem right.
That was my concern when reading. I stopped reading but from what I read nothing was touched on or considering high risk patients who must be seen asap me regularly until the doctor and patient is sure baby and mommy are okay. I understand what you’re saying but reading the first part just sounded like an actual nurse or doctor who is tired of catering to the needs of anxious pregnant women. When it’s much easier said than done to just relax when you’ve been through a loss.
Great point! Having had an ectopic pregnancy and two other miscarriages before our perfect baby girl, I have to go for full blood work immediately upon having a positive pregnancy test and we do ultrasounds every couple weeks until 2nd trimester to confirm location. I’d much rather do that than have to do through everything I did with the ectopic again.
I agree Ashleigh, I rather have the scans earlier than have to go through all the pain I went through with my ectopic pregnancy.
I agree with you completely, but desperately want to see my baby’s heart beat. My first ultrasound is at 11weeks, but I would go earlier if they’d let me. I’m also seeing a birthing center full of midwives so they tend to agree with all of the sentiments expressed here. As an anxious new mom though, I just want to know all is well! Going on faith for 3 months is quite a long wait.
If you have had prev history of ectopics pls go to the doc for early scans! Also its not always easy differentiating pregnacy symptoms from ectopics pain so any first one sided pain needs a review by health professional.
Exactly. And some women don’t even really get that.
I just found out that I’m pregnant for the first time and I have irregular periods, so I am hoping they can tell me about how far along I am at my appointment on Friday (I’m guessing between 4-6 weeks). I’ve also been trying to find out what I’m supposed to be eating or not eating online, and there’s so much conflicting information that I prefer for someone to just give me a list of things I can and can’t eat. So that’s why I think my first appointment will be important.
A lot of women feel anxious and worried during the first 12 weeks of pregnancy, particularly if it’s there first . They may have little understanding and knowledge of what to expect , what symptoms are normal etc. Therefore a quick trip to your local doctor can reassure you and provide you with any information you may need on what care packages availability during pregnancy . It’s piece of mind and the first stage to planning a safe pregnancy . You shouldn’t be advising people not to go it their doctor if they are “healthy”- lots of other reasons to go .
I agree with what you said. Pelvic exams are still necessary because the relationship may be exclusive in one persons mind but it can sometimes not be the case with the other person. So it’s good to be safe than sorry. I agree with not necessarily needing the ultra sound until about 12 weeks because you can’t hear a heartbeat before that. It honestly sounds like the person that wrote it works or worked in a private practice or hospital and hated to work lol. I hear people talk like this all the time.
Also, urine tests can give false positives. It’s always good to double check and have a serum exams one to be 100% sure so that you start taking care of your body and quit any bad habits of you have any.
You can hear the heartbeat before 12 weeks actually. I heard my baby’s heartbeat when I was 8 weeks, and it was very clear. At 8 weeks the heartbeat can be heard on ultrasound.
Yes it can be but not always.
I heard my baby’s heart beat at 6 weeks
Same… I’ve always heard from my OB that a hearatbeat in a viable pregnancy should always be seen (on ultrasound) by 6 weeks.
For prenatal pills that’s why I would go and blood to be drawn you never know what you have
I typically have waited until the 2nd trimester before going to the doctor (just had our 5th child :-) ). But, after this last birth, the nurse informed me that if you don’t get prenatal care as soon as possible (I can’t remember how soon; it might vary by state), CPS will be called in to “talk” with the parents. Thankfully, CPS wasn’t called as I explained that I didn’t know I was pregnant until I was 2 months, or so, into it (you’d think I’d know by now! lol) and scheduled my dr. appointment as soon as I could (I’m busy and going to the dr. isn’t my idea of a “good time”). Anyway, I think that this new development with CPS has something to do with the “affordable care act”, since it had never been brought up before.
Just something else to think about. Like I said, I’m someone that prefers to stay away from drs., if I can help it. :-) But, at least my dr. is pretty good about letting me do things my way and only has one ultrasound during the pregnancy, unless there seems to be a problem.
Thanks for sharing that bit of information (which is extreme overreach in my opinion). I guess we could all just *ahem* not know until closer to the second trimester :)
I realize I’m jumping in a bit late, but I’ve only just come across your site and have been perusing. This information about CPS is not accurate. I worked for CPS for years and this is one of the most ridiculous “Thanks Obama” accusations that I’ve heard. CPS cannot open a case on an unborn child, period. If a newborn is born and there are some legitimate allegations, then prenatal care is a factor in assessing risk.
Oh good, I’m glad that’s not true. It does sound like the nurse was trying to scare her into certain exams though.
As someone with HG, I am so grateful I had established a relationship with my Doctor before I was a full 12 weeks with my first. I had no idea what I was going through wasn’t normal and had I not been going in for earlier appointments they wouldn’t have seen the weight differences and gotten me help. I totally agree with a more ‘hands-off’ approach when it comes to medical care during pregnancy/birth HOWEVER I would never encourage especially first time Moms to not to take advantage of early prenatal care. Also, you can hear a fetal heartbeat at 8 weeks with a Doppler, and there’s nothing like the comfort of that to ease any early pregnancy worries. You might want to add some sort of disclaimer to this post that you have no medical training…
After going through a miscarriage I completely agree with your thoughts. I actually went in 5 days before for spotting. The doctor did a quick ultrasound at 9 weeks and said heartbeat is good, no way you will have a miscarriage and sent us out the door. If you aren’t having an ectopic pregnancy or something crazy I feel like their isn’t much they can really do for you first trimester. So if you need peace of mind, or have great insurance by all means go. But with our crappy insurance I’m ok with skipping these $500 appointments and waiting a few weeks.
Good point. I’ve heard from many women that insurance is a huge factor in whether they go to the doctor (pregnant or not).
I am 10 weeks and just had my first appointment yesterday. The OBGYN wanted to do a papsmear and check my cervix but I pushed it off till the next appointment (part 2 of the first prenatal appt. as they call it) because I get extremely uncomfortable during these tests (chills, shakes, cramp my legs etc.). After talking to my husband more and my mom they are saying to forego these tests so I will try to push them off because we all feel there is no reason to disturb things unless something is clearly not right. Any thoughts?
They did do an ultrasound and she checked the uterus with fingers and said it felt normal.
I had a papsmear and the cervix exam last year in October when I was expecting for that very first time and results were normal, however, I miscarried later in the fourth month due to spotting which I feel they had no real input on other than “you could’ve done nothing different” and it appeared to be due to an earlier hemmorage to the placenta. This time I am taking the time to avoid any procedures that could potentially do more harm than good. Thank you for your article and the info, glad to see we are not alone.
I feel the same way as you. I went for my annual pap and little did Inknow I was already pregnant. I did not find out until a couple of weeks later (I had gone for the pap at approx 3 weeks preggo) funny thing was the doctor could not tell,probably too early. Any ways once I foundnout she sent me all these pills,ultrasounds and exams because I was low on pregesterone. I finally ended up loosing the baby at week 14. There is a part of me that beleives that nature would have made things final or that all that stuff had something to do with my miscarriage. I am considering not going to see a doctor (god willingly) next time I get pregnant until at least week 12. But with the antecedent of a miscarriage it makes me wonder as well.
Interesting post. I do agree with you that most prenatal appointments are essentially useless in those first few months. With that said, though it is good to see your doctor so that they have it on record that you are pregnant and they can get your baseline blood pressure, weight (on their scale), and a complete blood count requisitioned for blood work. Knowing if you are low in iron is important as our iron reserves are burned through quite quickly in pregnancy and we need all those byproducts of iron handy before delivery.
Pelvic exams can confirm a pregnancy, but it is a pretty needless exercise.
To be fair, I found out I was pregnant as soon as I was 5 days late, and I literally went to the doctor, who referred me to a midwife, who then sent me a letter to have my first booking appointment at 9 weeks. So I think in my case, that’s the only reasons you need to go in the first tri, but other than that I agree really.
This post concerns me. Had I read this several years back before I got pregnant, I might not have been inclined to call the dr right after having the BFP at home. However, I was not given this advice and so I did. I called my primary care. (I didn’t yet have an established OBGYN) They did a blood test to confirm pregnancy and then refered me on to another Dr. When I called to schedule my first appt, they scheduled it for 6 weeks. Seemed early based on things I had read, but sounded good to me. They took another blood test at that appt and determined that my progesterone level was too low. I was immediately put on supplements through week 10 and my pregnancy continued on and I had a healthy baby. What would have happened if I had not had those early blood draws? I am 6 weeks pregnant again and now have a known history of low progesterone, so it was a no brainier to get a blood test right away. Sure enough, low again. I am back on supplements and hoping and praying this baby sticks just like my first did. I know that early screenings and procedures are not always necessary, but there is nothing wrong with getting baseline readings of hormones. And some problems (like mine) don’t come with symptoms. I was/am healthy and do not have a history of known miscarriages. I am thankful I got in early. It might have saved the lives of my babies!
Thanks for sharing. We have to weigh the benefits vs. risks of everything we do. But many people believe that there is no risk and only benefit to seeing a doctor or doing tests or having interventions, which is simply not true. Glad everything worked out well for you!
I agree that blood work early can allow for simple corrections that otherwise could lead to miscarriage or complications. There is no risk to baby or mom to have blood work done. Hormones (progesterone or thyroid hormone, etc) are proven safe for use during pregnancy, no risks.
My second child was a home water birth. I had no ultrasound, no Pap smear, no early appointments. I only remember agreeing to the glucose screening for the only bloodwork the entire pregnancy. He was a healthy 9.5 lb boy and I didn’t tear and healed well. The third baby was a stark comparison because somewhere between the two I had developed a severe cardiomyopathy (weak heart) and I was medicated, developed severe gestational diabetes, and had altogether probably 20 ultrasounds because of the beta blockers and insulin I was taking. Now I am three months pregnant with my fourth and because of my condition, I have already seen high risk doctors 3 times, the regular OB twice, had so much bloodwork I don’t even know, a PAP (that was 6 months overdue), and 2 ultrasounds. As a student preparing to become a nurse midwife in the next 5 years, and a Birthing From Within mentor, the last pregnancy was certainly difficult for me to accept all the invasive aspects. However I was still able to give 100% un-medicated and natural birth, albeit in a hospital with monitors and restrictions.
What I’m getting at is there is balance. I took my first two normal and completely healthy pregnancies for granted, and wished I would have been educated enough to have had the first baby at home, because a midwife would never accept my request for home birth now unless I lied to her. A healthy pregnancy is an enormous gift and certainly shouldn’t be wasted on digging deeper to try to find some tiny worry or anomaly. Unless you have underlying health conditions like me, won’t go looking for them!
I completely disagree with so much of what is said here – it’s just flat out dangerous. Your doctor should immediately give you blood tests once you know you are pregnant to check for things like progesterone and thyroid levels. If your thyroid is/becomes hypo your baby can get brain damage and it occurs mostly in first trimester when the baby’s brain is forming. This is so common they are talking about making it compulsory in Australia. Stop being so arrogant that you think your body ‘tells you’ when somethings wrong. Babies’ mortality rates have dramatically decreased with modern medicine and we should all be grateful for that. If your regular GP isn’t giving you these tests, get a new one.
I agree that thyroid levels should be tested (I had undiagnosed hypothyroidism with both pregnancies) but it’s not a routine test in America and is in fact, being pushed by ACOG as an unnecessary screening. Why, I don’t know. I don’t know for a fact, but I’m guessing that many doctors would give a lot of resistance to a woman wanting this screening since the ACOG actually recommends against it. The point is, you’re right, it’s an important screening, but you don’t get it at those early appts (at least in the U.S.). I would recommend finding a doctor who will order the test without subjecting you to the other parts of the first trimester appt that make you uncomfortable.
Oh and, no name calling please.
Whoever wrote this article should take it offline now. And probably has never had a ectopic pregnancy. You do not bleed until complications are about to arise such as a tube or an ovary bursting. Then your in the hospital having emergency surgery like I was at 9 weeks and almost died.
Couldn’t agree more!
It’s people like you that make women feel stupid or as if they do not even deserve the right to be pregnant when they find out they are.
I’m sorry you had such a terrible experience, I hope you find emotional healing.
You’re so right!!!!! These kind of posts are what make me feel like an idiot when I have questions! I first had a faint positive at home… it’s my first pregnancy after an ectopic… WHICH IS VERY EMOTIONALLY AND PHYSCIALLY DRAINING FOR ANYONE WHO HAS NOT HAD ONE OR DOESNT HAVE THE EMPATHY OR CARE FOR ANYONE WHO HAS DUE TO LACK OF UNDERSTANDING. . I tried to just stick to… I’m pregnant. Yay. Fake excitement because I had no knowledge that everything was okay. Last time I got a faint positive and a couple days later I was bleeding and a few weeks later… diagnosed with ectopic. Keep in mind these or other factors don’t always come with warnings or symptoms. I went to the ER because after a couple days I couldn’t handle the anxiety. At all. I was very panicky. All I wanted was a test and blood draw to check numbers. My doctor was closed when I got off work. Well at the ER the pregnancy test was negative. The nurses their treated me so unfairly I think. Like seriously you came here for this and you’re not even pregnant. I was so embarrassed I didn’t even want my blood checked. Well the very next morning I took an HPT and it was very positive. I called my doctors office that morning and the nurse told me I needed to come have my blood taken. As of now my HCG levels are rising beautifully. We now know I have a history of low progesterone as well. So I’m being treated for progesterone. Something that could’ve caused me to lose my baby without early care. I just didn’t like the gist of the post. I understand what you were getting at though. What this message portrays does nothing but make most women feel like complete idiots for being concerned with their body and child.
I’m sorry you feel that way. My intention is the opposite, to tell women who are concerned with their health and the health of their baby (and choose not to go the standard route for that reason) are in good company and supported here. I believe I’ve made it clear that each woman should do what’s best for her, but I’ll say it one more time: If you aren’t comfortable waiting for an appointment, DON’T. I’m not judging you, just offering another point of view that is evidence based.
I agree with this post 100%. I am on my 3rd child with the same partner & the dr tries to make me come in every 3 wks. I dont get free healthcare, & ive never had any problems in the past with my pregnancies. I told them today that i am not coming in just to talk to the dr, that i will wait until my glucose test is due. They want me in 2 times before that for nothing! It has definitely been made like an illness, & i refuse when im not having problems. They got mad acting like i am a horrible person, but i have went for the “required” tests. Im not going in & paying them hundreds of dollars to tell me i am healthy & have a good day. It truly is ridiculous!
I hear you!
I think this is so wrong. I just had my 9 week ultrasound, we saw a fetus measuring almost 9 weeks with no heartbeat. It died few days ago. I still have all my pregnancy symptoms, I am not spotting or cramping. I asked if they are sure that there is no heartbeat, they said yes, they said at this stage it’s easy to see a heartbeat. If i waited three more weeks for an ultrasound who knows what would have happened, plus three weeks is a lot of time to think you are pregnant, you have hopes, you make plans. It is better to know as soon as possible. I am healthy, no medical conditions.
well this is terrifying. I am 2.5 weeks pregnant and haven’t seen a dr. I have been away for vacation and a week back i had a one day spotting. All posts here are controversial. I guess i should be calling in for an appointment asap since I was diagonalized with unknown infertility and took pills to get pregnant.
It sounds like your pregnancy may require a closer watch. I don’t have any experience with fertility treatments etc so I can’t help much but say congrats and I’m sure everything is fine :)
Totally agree! With my first pregnancy I went for an 8 week dating ultrasound, a million blood tests, and two appointments with my GP, only to find out at my nuchal testing ultrasound at 12 weeks that I had a missed miscarriage. I hadn’t even seen the OB yet and the way he handled my MMC was really frustrating so I cancelled my follow up. This was a couple months ago. Now I’m 7 weeks pregnant again but decided to go with a midwife. I was so happy when I called them and they just made an appt for week 12 – no ultrasounds, appointments, blood tests … it seemed like none of that made a difference last time as it’s not like a doctor could have “saved” the embryo, so what’s the point of going to all those appointments? It seems to be such a different process with the midwife than a doctor, so this article was very reassuring. Thanks!
I’m glad that this article was helpful. So sorry for your loss, and congratulations on your current pregnancy!
Hi, I’ve had three miscarriages, but they hall happened after I got my cervix checked for some reason…. when I found out the third time that I was pregnant and also had a cervix checked which I regret so much ! A day later I had a miscarriage if I do get pregnant I don’t want to make any appointment and my doctor is really no help at all my second pregnancy ( I didn’t know I was pregnant ) I was almost three months ! :( now I know I will not let anything touch or go in me until my baby is born.
I’m so sorry for your losses. It’s hard to say for sure what the cause was but it can’t hurt to skip the exams.
Hi, I feel a bit foolish to have permitted the doctor to do an internal ultrasound in my first visit at 5 weeks. It caught me off guard since they just confirmed my pregnancy and performed a Pap smear that was past due. I hope I did not affect my baby. I feel more informed now and I want to wait til 20 or 24 weeks for my next ultrasound. What do you suggest? Any good books on positive natural childbirth?
Actually, a friend of mine is about to come out with a book for natural pregnancy and birth You can find it here: http://amzn.to/2nqSxuy.
Hi Deva, my doctor gave me an ultrasound when i was just two weeks. It terrifies me now that I read more and more that ultrasounds can be harmful. Please tell me how everything worked out for you and your baby? I read you had ultrasound at early stage too…
I loved finding this article. I am newly pregnant and while researching prenatal care and what goes on during early visits, I decided to wait until the 2nd trimester. The first time I sat with my midwife, I asked her how she felt about this and she said as long as I feel good and am not having any bleeding or feel that I am at risk for miscarriage, she agreed with that completely. I think the bottom line (and you did mention this several times) is that if you already take care yourself, generally feel good physically aside from normal ‘pregnancy stuff’, and do not have pre-existing health problems, you really don’t need to start care in the 1st tri. I’ve also read about the risks associated with ultrasounds (Dr. Ben Kim wrote a great one) and would not want one so early if at all. If you really want to hear that heartbeat (and I totally get that), you can purchase the same Doppler that the nurses use on brand new on Ebay for less than $40…I definitely plan to : ) Love to all the mommas, and thank you for this article.
Thank you!
I will have to say I like the article but if you live in the state of Florida you are not given any choices. You are forced to do as they say or they threaten you with DCF. I called every doctor around and they all said that I have to allow them to do whatever they want to me. They made me do a pelvic exam and I have had nothing but problems since. They told me I don’t have a choice even though I consider myself to be intelligent and told them I know the health risks and do not want it done. They fully disrespected me and when I went to the appointment my husband had to carry me out of the hospital because I could hardly walk and was holding my stomach. I recently made another appointment and the person told me “you will see who you see not your doctor”. Like excuse me but last I knew I am not an animal nor am I a crimal, I am a human being and should have a say in who I want to see. I am almost due and still, no one has gone over my ultrasound. It is obsurd.
Oh my goodness, that is terrible! I’m so sorry for the way you are being treated. I don’t believe that is legal. If I were you I’d consider talking to a lawyer.
I found out I was pregnant 4 days before I was supposed to miss my period. The pregnancy test came back very positive. I immediately called my Doctor to make an appointment and they did not want to see me until I reached the 12 or 13 week mark…
This was my first pregnancy but I was a bit disappointed. He said, unless anything is going wrong there is no need to see you. Even once I had my appointment he said he would not do a ultrasound until I am 20 weeks.
But, I felt like at 13 weeks I couldn’t wait. I insisted and got an unltrasound that day. There I saw heartbeats and discovered I was having twins. :)
Thanks for sharing :)
Good on you for putting this out there! Everything you said made sense.
When I found out I was pregnant I went for bloodwork just to confirm pregnancy. I wasn’t planning on getting it done because it is really expensive, but after doing some research I read that ovarian cysts can give misleading results on a urine test, even checked the Clear Blue test packet and it said the same.
I’ve been batteling with a very big ovarian cyst (not the dangerous kind) on my right side, once it measured 7.4cm about three years ago, I had surgery to drain the fluid but guess what? It started growing again…
About a month before I found out I was pregnant I had an appointment with my OB and it was already back to 7.2cm.
Anyway, my OB won’t see me for my first prenatal before 12 weeks unless I have concerns before that so totally adds up to what you said.
People can be so quick to make it clear how they disagree with what you said but most of time they don’t read the whole article and you clearly said this is your opinion and at the end of the day everyone can decide for themselves.
Thank you for your kind comment!
Great post! I was under midwife care for my first and will be for my 2nd. And they do the same…first appointment around 10-12 weeks. And as you made crystal clear in your post, If you have underlying conditions or need piece of mind…by all means see someone! Pregnancy isn’t a medical event in a low risk mama.
Thanks!
I’ll be 16 weeks Sunday and have yet to see a doctor. My family has been pushing for me to go to the doctor even though I don’t trust them. They also don’t understand that I’m not automatically covered by insurance because pregnant (I live I a different state than they do). I found out I was pregnant the day before I missed my period,I took 2 test that both came back positive and from there I slowly started having pregnancy symptoms. Even though I haven’t been to the doctor I’ve done my own research and found out how to feel for my uterus and I can always tell when the baby moves because it leaves a much firmer spot in my uterus. When I’m ready to go to the doctor I will, but I don’t want to go and be told I have to have certain tests done that can be dangerous to my baby, all I want is them to check how my pregnancy is progressing. I don’t want to worry unnecessarily out things that may or may not happen and are completely out of my control. Even though this is my first pregnancy I do have an idea as to what is right for my child and my body. I have no health issue unless you count anxiety that only comes about when I go to the doctor.
I did find some relief in reading your article and when. I finally do see a medical professional I’m going to try finding a midwife to see me through my pregnancy.
I’m glad it was helpful! Being your own advocate is so important. You just have to remember that everything is optional, whether they make it seem that way or not. I certainly don’t want you to avoid going at all out of fear of being forced into something. Congrats!
Hi Mindy,
Thank you for writing this article–it is refreshing to hear someone’s POV where it does not center around western medicine. I was so excited when I found out I was pregnant–I thought I was at least 8 weeks, but when I went to the hospital, I found out I was only 5 weeks. The doctor wanted me to come back in 2-3 weeks to do another ultra sound–the baby should be more developed by then. However, when I saw the bill for our first visit (more than $700), I was so shocked. $700 to see a doctor and for her to show me the gestational sack and yolk?! I am not ready to shell out another $700 in the coming weeks.
This article helped me to realize that if I am a healthy person and I don’t see any complications so far, I can wait until my second trimester. I’m not saying I am against seeing doctors, but I really don’t think it is necessary to see one every month (as many websites I’ve looked into advertise). The hospital world is a money- making business and they will gladly schedule you in knowing that you will pay $700 to have some face to face time w/ a doctor.
I am hoping to have a healthy baby, and I want to do everything right in order to make sure my baby will be healthy, but I think some things can be quite excessive. Thank you Mindy for writing this article, and don’t listen to all those people who have been bashing your article.
Heidi
Thanks Heidi!
Again, I know this is a bit late, but I wanted to say some things.
Thank you for keeping this post up, despite getting negative feedback concerning safety risks. Without going into statistics, those situations/conditions are rare. Those are the same people that will criticize home birth because of a random unlikely scenario that they personally encountered.
Pregnancy is, in and of itself, a calculated risk. We all have to weigh the pros and cons and decide what is best for us. You clearly stated, I’d argue painstakingly, that early medical care is necessary for a lot of people and that people need to make their own judgement calls. You’re presenting information that most people don’t have- so few women even consider questioning their doctor’s standard protocol. They don’t realize that it’s an option. Thank you for giving them permission to do so.
I wish I’d had more information like this prior to my first birth. It was the bad experience that I had with that one that prompted me to do more research before my second pregnancy. The information that I obtained allowed me to have a more successful outcome the second time around.
Thank you!
A very good article. Very refreshing at times when “finding a heart beat” early during pregnancy became a must. I am a doctor and I myself do not trust my colleagues who are trained to find pathology even when there is none. How many times the heart beat was not found in perfectly normal foetus because the scan was performed too early? And how many D&Cs were performed on healthy pregnancies only because the sonographer did not find the heart beat (again because it was too early)? I am scared to think… The author is right. Pregnancy is not an illness. Leave it alone and do not interfere unless it’s absolutely necessary.
Thank you :)
I went to the gynecologist when we were still deciding if we wanted a baby. We both had blood tests made, pap smear, everything. Also, she prescribed vitamins and folic acid three months before trying for both of us. All tests came out perfect… we took the vitamins, and I’m taking a blood test to know if I’m pregnant one whole week after my period is missed, so in case it is positive, I guess there is no reason to go back to the doctor before 12 weeks, right? It might be the advantage of careful planning and preparation.
Planning is always good! Sounds like you don’t need to go until 12 weeks but that’s your decision :)
I’d consult with my doctor or midwife on this question.
This makes me feel a little at ease. I’m a healthy 29 year old with my first pregnancy and I can’t be seen by a doctor till my 13th week cause of insurance complications. I have been stressing about this but trying to listen to other moms saying as long as I have no vaginal bleeding or anything like that I’ll be fine. Which thank God I haven’t. So thank you for this article.
I’m so glad to have eased your mind a bit. And congrats!
You are handling these angry people very well. I found then post helpful.
Thanks :)
That’s a lot of BS! I had a blighted ovum and only miscarried at 12 weeks! It was so traumatic and painful. The horrendous physical and emotional pain could had been avoided had I learn that I was no longer pregnant at 7 weeks or so.
This time round I’ve had regular ultrasounds to keep monitoring this second pregnancy and no harm or whatsoever has been done!
You should stop publishing shit like these.
Everyone is different. I had a miscarriage and refuse to see a doctor until 14 weeks to save on heartache, pain, and money of going week after week to end in another miscarry. Here, I can be at peace at home and miscarriage is low after 14 weeks.
Thanks for sharing :)
Thank you. I can’t find the date this was written so I’m sure I’m late in this thread but I just wanted to say that this is great information and thanks for sharing it with others. I’m 15 weeks pregnant today and haven’t seen anyone, no dr or midwife. I have contacted a midwife who I intend to meet in the next two weeks. I was born at home, along with all 3 of my healthy siblings without any prenatal care, and only the family was at our births. My dad delivered all his children. I come from a long line/family of home births and the use of ultrasounds are very rare in my inner circle. As much as I want one for peace of mind I haven’t brought myself to do it based on many research papers and the information I’ve gathered. The safety of US is very controversial, although most people believe them to be safe. I would suggest that you look into this further if it interests you at all. (Also the use of a Doppler).
Your body was made to do this. I know how scary it can be though! I’ve had quite a bit of anxiety as well, with this being my first pregnancy and all! But this is the work I do (I’m a doula), and I’ve studied this subject my entire life and been to many births…it’s a beautiful and natural process and I don’t trust doctors one bit, especially with the care of my fetus or newborn. Most of them have never even witnessed a real birth without intervention.
Here’s just one of so many links on this subject of ultrasounds. I’m not here to judge or make anyone feel more anxious. I just believe it’s good to research all things, especially when it comes to the most important thing you’ll ever create…a beautiful human life!!
https://chriskresser.com/natural-childbirth-iib-ultrasound-not-as-safe-as-commonly-thought/
I appreciate this post so much. It has validated everything I’ve been thinking. Im 10wks pregnant with my first child. I haven’t went to the doctor yet because I want to wait to the beginning of my first trimester. My fiance and I disagrees with this. He says I need to go see if the babies is fine and he would like to see that I’m pregnant on paper. Even though he has witness all symptoms and body changes. I told him I feel good…in spite of the symptoms. The discomfort is normal. Although the symptoms can be very uncomfortable…i rejoice because it’s normal. However he becomes scared and doubtful. I don’t feed into because he’s a man and no matter how much I try to explain the changes, he will never know because of that fact. Then I get very emotional. All I want him to do is listen.. rub my back…and be patient. I t’s him even when I see the doctor in 12wks he/she will confirm the due date, heartbeat. Because of how I feel..im not concerned; I BELIEVE our baby is fine. Back in the day there weren’t any of what we have today to aid and assist, and the babies were fine. Thank you Mindy. This post by far was the best post I’ve read and only post I replied too. Thanks again and God Bless.
I meant to say..go to the doctor beginning my second trimester
Thanks for your kind words!
(At 2.5 weeks pregnant, spotting is likely implantation. You won’t even get a positive pregnancy test yet for a few more days…unless you’re counting weeks differently. When the egg & sperm meet, that is “2 weeks.”)
I disagree. One must establish the efficacy of papsmears to prove that “taking advantage” of women during their routine prenatal care doesn’t cause harm.
Pap smears are not relevant to pregnancy, so they should not be done.
Also the “peace” of ultrasounding is a circular argument – pregnancy tests and ultrasounds cause women to want to Know the status of their pregnancy. But since it is a small snapshot, you have no idea if your baby will live beyond that tiny window of observation. But if you never believed you had the opportunity to “see” your baby, you would have a stronger emotional resolve. In this way, you would just not need reassurance.
Besides, if you tend to worry, it’s like being a smoker – stopping smoking can cause a health crisis that could endanger a pregnancy (gradual changes are better I think), and similarly, if you tend to worry, you should not worry about worrying affecting your pregnancy. Women who are NOT trying to get pregnant and DO are more likely to experience negative affects of worrying due to pregnancy than women who are accustomed to worrying. I fell into this category with my first pregnancy, which ended at six weeks though I was planning to keep it, stopped drinking caffeine, and was taking prenatl vitamins. I felt like I was so rocked (rocked my world) and stressed even though I was for it, but not expecting it, that my body got whacked out.
Your hormones get used to yOUR normal even if your normal is not ideal. The next pregnancy after my miscarriage, I decided I wouldn’t worry about anything come what may (drank caffeine, ate lots of black pepper, scrapped the vitamins, etc.) and I had a successful pregnancy. I basically just did MY normal and made gradual changes as my pregnancy continued.
Women who WANT care and have anxiety reduced by receiving care are not the only women who exist. Prenatal appointments can increase anxiety for many normal women. Just like many women walk away from hospital births with PTSD.
It is irresponsible to say all women SHOULD receive care early when the majority of women should not.
If it is your first pregnancy and you WANT care, you will get a lot of counseling that can be a good idea, unless you don’t believe in what you’re being taught. You’re at your most vulnerable and least informed the first time you get pregnant.
Also, if you don’t know intuitively your health status, you may benefit by establishing a baseline of understanding your health status.
Women who have gone through prenatal care several times (I have four times) and have no significant changes to their health status probably need NO prenatal care or can do their own monitoring and pick and choose certain tests and ultrasounds.
But most first time mom’s probably will seek standard care models and go from there, though that doesn’t mean they won’t have bad experiences with it. The ones who do usually go on to learn more and change their approach to care, can you blame them?
I disagree with you on so many levels. During my second pregnancy (I was completely healthy and my first pregnancy was perfect) I found out at 6 week ultrasound that I have a hemmorage and should be on pelvic rest, rest a lot, and take it easy in general. And then I had a missed miscarriage. My baby died and I had no idea for whole 2 weeks. I possibly would go more, because my body still had full blown symptoms of pregnancy and didn’t know how to naturally misscary. If I did not go to the doctor before 12 weeks a) I would never find out about my complications b) I could potentially be walking around with a baby who died for a whole month.
You haven’t had complications or miscarriage, so you can’t judge. I want to tell you, that seeing your doctor early is important and in my opinion crucial.
I am on my third pregnancy and being seen by doctor since week 4 weekly. They are doing everything they can to save my baby.
I hope you never go through any complications and never understand this pain.
I actually have had complications. Miscarriages (many, probably due to my Hashimoto’s) and preeclampsia with my first pregnancy. I still believe in evidence-based care, not “just in case” care. I’m sorry for the ordeal you went through, and congrats on your pregnancy!
Hashimoto’s should not increase chances of miscarriage at all unless you are not seeing your endocrinologist or OB/Gyn who can treat thyroid disease early in pregnancy. The fact that even you, the “educated”, believe this, and in the same breath are encouraging women to avoid early pregnancy medical treatment that should completely ameliorate this particular risk of miscarriage, should be an eye-opener that the advice to avoid a doctor or midwife in the first trimester is not sound.
I’ve been meaning to update this post to address this so I’m doing that now. But quickly, Hashimoto’s shouldn’t cause miscarriages when it’s properly managed, not just when you regularly see a doctor/endo for it. It’s the part about getting it managed properly that is tricky and can take time and money to figure out.
This is good advice for women in their second pregnancies with no known complications in their first that would require early intervention, particularly if they plan to see the same OB/Gyn. Many women, even those who are “educated” or presume themselves to be “educated”, do not know much about the physiology of pregnancy, because they’re not medical professionals. Alternatively, there are plenty of “uneducated” women who know lots about pregnancy from working in women’s communities. This part of the post came off as quite elitist, like education can somehow insulate somebody from pregnancy complications, or those with lower levels of education can’t learn about pregnancy on their own.
Many women have health issues that surface in early pregnancy, or are exacerbated by it, and don’t necessarily know what’s happening amidst all the hormonal changes. Not everybody gets good OB/Gyn care, particularly the huge number of women who receive in in America at clinics with no continuity of care. It’s very important that women at the very least call their OB/Gyn to report their pregnancy, get phone counseling by a nurse to ensure they don’t have risk factors, and are educated on prenatal vitamins, things to avoid, etc… It’s also important for them to start the transfer of all medical records from any clinics or other providers to their OB/Gyn as soon as possible.
As a doctor and researcher, I completely agree about avoiding ultrasounds whenever possible, and waiting until heartbeats can be heard on the doppler if there are no signs of complication. I’m generally against-intervention, but this post is dangerous in steering women away from early pregnancy counseling by professionals who have access to their medical record.
Thanks for your comment. I will update to make it more clear that I wouldn’t avoid talking with my midwife or doctor. Also, I’m not sure where I wrote anything about being educated (in a comment maybe?) but when I talk about being educated I really mean “informed” as I don’t believe knowledge or education need to necessarily come from a formal schooling situation (obviously to be a doctor you have to have certain formal training).
I am so glad you brought this up. I went in to see the Obgyn because I had found out I was pregnant, and was having what I thought were symptoms of an UTI. I allowed the doctors to do 3 ultrasound in the spam of 2 weeks. I feel quite stupid admitting to this of course. I knew in my heart it was hurting me and my child. I also know that, that last ultrasound was the cause of my miscarriage. After that experience my husband and I decided to stay far away from doctors office until 12 weeks along.
As someone who has experienced missed miscarriage, and carried around the dead baby for several weeks at least (came out naturally at 11 weeks but size was obviously much smaller), I still did not go in until second trimester for my next pregnancy, nor plan to for any others , God willing. I would prefer to pass the baby naturally than to go in and have a procedure, with them possibly keeping my fetus’ remains. No thank you.
I took responsibility for my own care – My husband who is a healthcare professional weighed me, took my blood pressure, we tested my blood sugar levels, I put myself on a whole food prenatal. I don’t have thyroid issues so it wasn’t a factor, and overall I keep myself in good health through diet and exercise.
Also would like to add, even if you are not up to date on pap smears, it is still your right to decline. Your Body, your choice.
I respect this article very much. Thank you for pointing these aspects out. I believe we depend on doctors far more than we need to. My next pregnancy will be addressed more conservatively so it’s nice reading articles such as these. Starting a homestead has made our family more in touch with nature and God. We need to trust the process we were made for. Some will argue till they’re blue in the face that this information is harmful but it comes down to letting others make their own informed decisions. Ignorance is not bliss.
Thank you for your comment!