If you haven’t already done so, you’ll need to choose a prenatal health care provider and set up an appointment with him or her. But what kind of provider should you get?

According to a Wiser Pregnancy survey, most women choose to work with an obstetrician-gynecologist (ob/gyn), but other options include a family physician, nurse-midwife or high-risk specialist.

The survey found:

• 82% of women selected an ob/gyn as their primary health care practitioner during pregnancy
• 8% chose a certified nurse midwife
• 6% worked with a family practitioner
• 3% worked with a doctor specializing in high-risk pregnancies
• 1% chose a direct-entry midwife (not a nurse practitioner)

The three most important factors women considered when making their choice were insurance coverage, ability to handle specific risks and level of expertise, according to the survey.  To learn more about the different options and considerations when choosing your primary health care provider during pregnancy, click here.

If you haven’t had a baby before, your first appointment may be a bit of a mystery.  The appointment – usually eight weeks after your last period –will assess your overall health based on your medical history, identify potential risk factors and tell how far along you are.  Also, it’s a chance to start developing a relationship with your provider… or figure out if he or she isn’t the right person for you.

You can find more information about your first appointment – what to ask and what to expect – at the following sites:

• The American Pregnancy Association
• BabyCenter
• WebMD Women’s Health

What influenced your choice when you selected a health care provider for your pregnancy?  What was your first prenatal appointment like?

Related posts:

1. Prenatal Tests: Should You Get Them?

For our cheerful Wiser Pregnancy mom-to-be blogger, surging hormones in the early stages of pregnancy meant lots of uncharacteristic burping.  A home pregnancy test confirmed that a new baby was indeed on the way.

However, for many women, physical pregnancy symptoms aren’t the first clue.  According to a Wiser Pregnancy survey of more than 1,500 women, almost half (48.3%) of women first know they’re pregnant when they miss a period.  Another 28.9% of women first know they are pregnant when they take a home pregnancy test. Interestingly, a doctor’s visit alerts only about 5% of women that they are pregnant.

On the other hand, nearly 20% of women first know they’re pregnant based on physical pregnancy symptoms.  Potential clues include:

• Morning sickness (6.8%)
• Other pregnancy symptoms, such as burping (5.2%)
• Swollen, tender breasts (4.2%)
• Weight gain (1.3%)
• Frequent urination (0.7%)

How did you first know you were pregnant?  Did you experience any tell-tale physical symptoms?

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And the expenses begin during pregnancy.

That’s why many couples start planning early. About 35% of families begin financial planning for their bundle of joy before or during pregnancy, according to a Wiser Pregnancy survey of more than 1,500 women. Approximately 18% of couples financially plan during the first month of their pregnancy; 11% plan in month 2 and another 11% plan in month 3. 

It may seem difficult to meet the financial demands of having and raising a child, but remember: Thousands of others make it work, and so can you.  It just takes some advance planning and a few adjustments.

Not sure where to start? Here are some tips:

• Review your family’s jobs and income. Focus on both short-term baby costs and long-term opportunity costs, such as loss of promotions or retirement fund contributions if one or both parents take temporary or permanent leave.
• Review insurance coverage, including life, disability and health coverage.
• Plan your estate, including making a will and assigning a guardian.
• Evaluate and adjust your budget, taking extra monthly expenses and income changes across the short- and long-term into consideration.
• Begin to save for your child’s college education.
• Check out flexible spending accounts (FSAs) that may be available through your employer(s) for childcare or health care expenses.
• Get ready to take advantage of any and all tax breaks once the baby arrives; a good accountant can help you identify exemptions and tax credits you’re eligible for.
• Continue to plan for the long term. Having a baby requires some budget and lifestyle adjustments; however, the event should not disrupt your long-term financial goals, and a good financial planner can help you stay on track.

You’ll have more time to plan, save and cut back on expenses if you begin early.

However, planning at some point is better than not planning at all:  About 20% of women do their financial planning for pregnancy and post-delivery after the third month of pregnancy.

Did you plan financially for your pregnancy and having a baby?  What did you learn during or after the process that you wish you knew before?

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According to a Wiser Pregnancy survey of more than 1,500 women in the U.S., nearly 6% of women are using fertility drugs.  About 3.5% of polled women conceived using IVF. 

Infertility can be devastating for a couple, but if you’re struggling to get pregnant, you’re not alone.  Approximately 10% of the U.S. population is affected by infertility.  However, since the late 1970s when IVF was first successfully performed in the U.S., thousands of couples with fertility problems have used the procedure – often combined with the use of fertility drugs – to have a child.

The success of IVF depends on a woman’s age and causes of the infertility.  Not every couple who uses IVF has success, and the older a woman is, the lower her chances of becoming pregnant. 

The CDC tracks data related to artificial reproductive technology (ART). In 2007, couples using IVF successfully got pregnant in more than 32% of all cycles.  Of all cycles (successful and unsuccessful), the live birth rate was 25.6% on average.  As ART methods advance and doctors become more experienced, these rates are increasing. 

However, IVF is not without its drawbacks, which can include: 

• High cost – Few states require insurance to cover IVF and there are many loopholes and limitations, such as a limit on the number of attempts that insurance will pay for.  Many couples end up paying thousands out of pocket.
• Increased risk of complications posed by the usage of fertility medication and invasive procedures used to retrieve and implant eggs
• Increased risk of conceiving multiples
• Increased risk of preterm birth or ectopic pregnancy

Have you conceived using IVF?  Would you do it over again?

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Back in June, the World Health Organization (WHO) declared that the spread of H1N1 had become a pandemic. Later this month, the WHO is meeting again to discuss whether the pandemic has peaked. 

However, even if the worst is over, the threat of the flu – H1N1 or seasonal – is still around.  According to the CDC, an estimated 41 million to 84 million people in the U.S. have been infected with the H1N1 flu, and it has resulted in up to 17,000 deaths in the U.S. to date.

So do you still need to be vaccinated? Public health officials and doctors alike have recommended the vaccine for pregnant women, who are at high risk of developing life-threatening complications such as pneumonia from the flu.  Yet only 45% of women in general got the flu shot, according to a Wiser Pregnancy survey.

Interestingly, even doctors who are also moms-to-be haven’t rushed out to get the H1N1 vaccine, according to a Wiser Pregnancy survey.  The majority (70%) of doctor-moms did get a shot for the seasonal flu shot, but only 19% received the H1N1 flu shot.

Of course, these numbers may have gone up as the vaccine became more widely available.

But why aren’t more pregnant women getting the flu shot?  Common reasons include the following: 

• Opposition to the vaccine (29%)
• Concern about the risk to the baby (15%)
• Doctor didn’t recommend it (12%)
• Other reasons (e.g., not available yet) (39%)

Did you get the H1N1 flu shot?  Why or why not?

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1. H1N1 and Pregnancy: Worrying for Two

And for many women, pregnancy can lead to more headaches.  More than 25% of women experience headaches during pregnancy, according to a Wiser Pregnancy survey.  About half of these moms-to-be did not get frequent headaches before pregnancy.

If your doctor is also a mom, she may know how you feel.  Nine percent of doctor-moms report getting “significant headaches” during pregnancy.

Interestingly, if you’re like many women, your doctor’s personal headache treatment approach may be substantially different from yours.  Most doctor-moms (90%) take over-the-counter medication to treat bad headaches, and nearly one-quarter also take prescription medication.  By comparison, 35% of pregnant women in general who get headaches do not take any medication at all.

Here’s a look at how treatment approaches vary between doctor-moms and pregnant women overall:

Deciding when and how to treat a headache or migraine during pregnancy is a personal choice.  Just remember to check with your doctor if you have any questions about which medications are safe.

Have you had headaches during pregnancy?  How have you treated them?

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3. How Do Doctor-Moms Manage Their Own Morning Sickness?

Group B strep is a common bacterium that naturally lives in the gastrointestinal and genital tract of about 40% of healthy adult women. It’s generally harmless in adults but can be life-threatening to newborns. 

Once upon a time, group B strep was the leading cause of infant death in the U.S. But it’s now a public success story: Nearly 85% of women get screened for group B strep, up from lessthan 50% in the late 1990’s.  Fewer babies die from group B strep disease as a result.

That’s why your doctor will likely suggest screening for group B strep in the third trimester.  The test involves swabbing the vagina and rectum for samples, which are then tested in the lab.

According to a Wiser Pregnancy survey, 7% of women tested positive for group B strep during pregnancy. 

If you test positive for group B strep at some point during pregnancy, your doctor will likely recommend antibiotics during delivery to keep your baby free from group B strep.  Most women (87%) decide to take antibiotics. 

Learn more about group B strep here.

Have you or someone you know had group B strep while pregnant? What course of action did you take?

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According to a WiserPregnancy survey, 27% of doctor-moms attend a birth preparation course.  Most (82%) doctor-moms attend a general class offered by a hospital. Their next favorite options are Lamaze (28%) and BirthWorks (20%).

By comparison, just under half of women overall attend classes prior to labor and delivery. 

So why do these physicians who’ve seen it all also attend birthing classes? Turns out it’s for the same reason as other women.

Most classes cover labor, delivery, recovery and new baby care.  They also focus on different methods to help you relax, stay calm and manage pain during delivery.  Classes also help many women establish a support network of other pregnant women and their partners – something all the medical knowledge in the world can’t give you.

In addition, if you take an on-site hospital course, you can check out the facility where you’ll be giving birth and become more familiar with the surroundings and staff. 

Of course, that still means that half of all pregnant women don’t take a birthing class. Common reasons for opting out include: not seeing a point to the classes, not having time, having attended a class during a previous pregnancy, class costs being too high or lack of class availability.   

If you attended a birthing class, what part of the course was most helpful?  If you didn’t attend a class, was there a particular reason why not?

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1. Birthing Class Doesn’t Impact Epidural Use
2. Birthing Class Philosophy: Not So Important to Women
3. How Do Doctor-Moms Manage Their Own Morning Sickness?

The question is, how much bleeding is normal and when should you see your doctor?

Light vaginal bleeding during the first trimester is not uncommon. In fact, a Wiser Pregnancy survey finds that 11% of women experience vaginal bleeding during pregnancy.  Almost all women (97%) seek their doctor’s advice, and the majority receives reassuring news.

Vaginal bleeding can occur for a variety of reasons.  Here’s what might be causing the bleeding, based on responses to the Wiser Pregnancy survey:

• 65% were not diagnosed with any specific problem
• 14% were diagnosed with a miscarriage
• 9% were diagnosed with a problem with the placenta (placenta previa or placental abruption)
• 4% were diagnosed with a urinary tract infection
• 3% were diagnosed with preterm labor
• 6% were diagnosed with another condition (e.g., ectopic pregnancy, molar pregnancy) that caused the bleeding

Of course, if you’re at all concerned, don’t hesitate to consult with your doctor. Most likely, you’ll be sent home reassured that nothing is wrong.

However, if your doctor suspects a complication, he or she may recommend an ultrasound or other tests to diagnose the problem. Depending on the cause, your doctor will recommend appropriate treatment. 

Did you experience vaginal bleeding? What was your reaction and how did your doctor care for you?

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According to a Wiser Pregnancy survey, 40% of women seek a doctor’s advice for morning sickness remedies, yet the advice isn’t always helpful. 

Which begs the question: What do pregnant doctors do for their own morning sickness?

About 35% of doctor-moms (pregnant OB/GYNs, internists and general practitioners) report having “significant nausea” during pregnancy.  Interestingly, these women’s approach to treating morning sickness differs quite a bit from their patients’.

One of the most noteworthy differences is that pregnant doctors are more likely to take prescription medication to alleviate nausea – 49% use it, compared to 20% of other women.

Also, a higher percentage of doctor-moms try common morning sickness remedies than other moms-to-be. 

Take a look:

Would you be more willing to seek morning sickness advice from your doctor if she knew exactly what you’re going through, or is it more trial-and-error?  What’s worked for you?

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1. Top Remedy for Morning Sickness? There Is None
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