So you’ve used a pink dye home pregnancy (hopefully a FRER, because those actually work EARLY and won’t give you a horrific false positive). Let me guess: you’re here because it was as positive as Betty White! Are you already experiencing morning sickness or is that just sheer terror and butterflies? Time to make a plan, Jan. If anybody can overthink something, it’s me! So you’re in luck: here are 4 things you should do before the 8 week ultrasound.
First things first: call your provider.
Call a provider (OBGYN, GYN, or even your primary physician) and get the pregnancy confirmed in their office. Don’t overthink this one. Just get it done and worry about who your actual provider will be later. Switching is easy.
Why the rush? Well, this is sort of a buzzkill. If you have miscarriage problems at any point in the future, they won’t even start running tests until you’ve had at least two miscarriages documented. Some providers and insurance companies won’t cover testing until you’ve got three documented miscarriages. In order to document a miscarriage, you have to document the pregnancy. Since many miscarriages occur around weeks 5-6, it’s a good idea to go get the pregnancy confirmed immediately.
If you’re a bit of a Type A personality who might want to be proactive about your fertility in the future, cross this one off the ‘ole to-do list, stat.
Second: Inform the dude before the 8 week ultrasound.
This bit assumes two things about your current situation: 1) You know the baby’s daddy and 2) The deed was consensual. If so, tell that person now. They deserve a chance to participate in the 8 week ultrasound.
Your relationship with this cat is irrelevant. Perhaps this is your husband and high school sweetheart, and you plan to love them until your last breath. Conversely, you might have only met him once at a bumpin’ club (I’m not old at all – swear). Either way, this baby will have his DNA, and he deserves to know as soon as you do.
- The pregnancy was planned with your partner. In this case, you probably forgot to do something adorable and just ran out of the bathroom, half naked and waving a pee stick in the air. If so, go ahead and check this off your list.
- You and your loving partner weren’t expecting this right now or quite yet. If you and the man were not quite expecting this new friend, think deeply about how to break the news so that you don’t do something ridiculous like I did. With Turkey Burger, I waited four days for the perfect moment and then casually mentioned it at a restaurant, accidentally within earshot of his co-workers. With Chicken Nugget, I bumped into him in the hallway of our rent house crying and then clammed up until he JUST KNEW. It’s better if you plan out how to tell the poor schmuck! But plan quickly because he needs to know.
- You know the guy, but you’ve got regrets. Maybe you’re pretty sure he’ll be a lousy dad. He still needs to be given a chance. Perhaps you’re embarrassed to tell him? Better man up, sister. Maybe you’re kind of scared for your future because this guy is NOT what you were picturing when you imagined the father of your child(ren)? Well, I was once told that “Righteousness means doing the right thing at the right time for the right reason.” No matter how many goof ups you’ve had in the past, don’t get this part wrong. Tell the guy. And let it be.
Choose a provider that matches your birth philosophy – if possible, before the 8 week ultrasound.
Two things enter the equation when you’re choosing a provider: finances/insurance and birth philosophy.
It’s time to take a look at yourself and assess how you’re feeling about all this. There’s no wrong way to feel about pregnancy, labor and delivery, and postpartum. There’s a different right doctor or midwife for every pregnant gal. Just because you liked your gynecologist just fine doesn’t mean he or she needs to be your OB. Which one of these sounds most like you?
“I just want to be reasonably healthy at the end of all this and have a healthy baby, too. I’m totally comfortable in doctor’s offices and hospitals and will generally follow my doctor’s wishes without questioning things. I have preferences, but I would rather not dwell on them because birth is unpredictable.”
Rita needs to do a bit of research on the qualifications of her doctor and make sure she can trust him or her 100%, like any other type below. However, she might not require the same amount of research and stewing on it to be at peace with her decision. Assuming Rita is comfortable with her doctor’s qualifications and bedside manner, she will be happy following her provider’s lead peacefully. Occasionally, there’s a Rita who still craves information about childbirth and pregnancy. If so, the resources below are all fantastic!
“Women have been squatting in huts and jungles delivering babies since the beginning of time with nothing other than supportive family members present. My body was made for this and I want to do this without medical intervention.”
Natural Norma should look into assisted and unassisted homebirths and start watching unmedicated at-home and birth center deliveries on Youtube. She should consider reading Birthing from Within. She can listen to The Birthful Podcast and The Birth Hour podcast to get exposure to a wide variety of birth experiences in homes, hospitals and birth centers around the world. Norma needs lots of education to be sure she understands the risks and wide variety of outcomes.
She’ll want to carefully choose a midwife. She will probably need a CM (Certified Midwife) or a CPM (Certified Professional Midwife) to support her in the journey. A CNM (Certified Nurse Midwife) may not be naturally-minded enough for her, although there are exceptions to every rule.
Finally, some Natural Normas have unassisted births and do not have anyone credentialed helping them, which seems a bit like rolling the dice to me. There is a Facebook group called “Birthtube” and she may find some other freebirthers live streaming their unassisted homebirths there.
Think A Lot Thelma
“I like to do my research and decide what’s right for me. I value medical professionals and need to feel safe, but I tend to question the status quo when it’s such a big moment in my life. A healthy baby is the most important thing, but can I also have an empowering life experience?
Thelma might struggle between two worlds of wanting the fewest possible medical interventions but within the safety net of a hospital or birth center attached to a hospital. She knows that birth is unpredictable and wants top notch professionals to be at her side. However, she also concerned or worried about being treated as an individual, and she wants to maintain some autonomy over her body and feel in control of her choices. She’s the type that can’t chill out unless she knows ALL THE THINGS. Thelma needs to watch The Business of Being Born and read Ina May’s Guide to Childbirth to satisfy an itch for information about physiological childbirth. She should also listen to The Birth Hour. The Birth Hour is especially good about telling all kinds of birth stories, and plenty of them are hospital births where the woman still got the birth experience she wanted.
Then, Thelma should tentatively choose a provider after doing some research about the more natural-minded doctors and midwives with hospital privileges. This will be much easier to find in larger cities. Often, local doulas are an excellent resource when it comes to learning about different provider philosophies. She needs to know it’s always okay to switch her doctor or midwife, but if the decision is made too far along in the pregnancy, she may have difficulty finding a provider who will take her on as a new patient.
PS – I’m Thelma. It’s nice to meet you.
Freaked Out Fanny
“Um, I don’t understand how an 8 pound fetus is escaping my body without a scalpel and I don’t wanna know, either. I do not appreciate the unpredictability of spontaneous labor and delivery. I would like to put d-day on my calendar, take a deep sleep, and wake up not pregnant. Give me ALL the interventions, Doc!”
There’s such a thing as a “C Section by Maternal Request” in the medical community. I’m using the term interchangeably with “elective c-section” although I believe doctors make a distinction between the two. C-sections by maternal request only occur in 2.5% of births in the United States. I read an interesting article here about a woman who was terrified of vaginal delivery, and she chose a c-section instead. She felt empowered by her doctor’s willingness to let her have autonomy over her body.
Fanny needs an OB that makes her feel more comfortable with the pregnancy and her body. Not all doctors will happily support an elective c-section, so it’s important to gauge the doctor’s attitude on or before the 8 week ultrasound. There are some insurance plans that won’t pay on a c-section by maternal request, either. Still, she has options, and there are good OBGYNs out there who will happily treat Fanny and honor her wishes for the birth experience she desires. Fanny knows what she wants (good for her!) and she just needs an OBGYN who will be a good listener and be understanding.
Here’s an article from the ACOG (American College of Obstetrics and Gynecology) that addresses elective c-sections.
“I’ve been through a lot. It’s not that I distrust doctors, but I just don’t like strange hands on my body. The vulnerability of pregnancy, labor and delivery is really hard for me to fathom. I hate going to even routine OBGYN appointments because it brings back terrible memories. I’m afraid that a normal doctor won’t respect my wishes or understand me at all.”
Survivor Sally needs to ask around her community about OBs and midwives that specialize in trauma-informed labor and delivery. Her best bet will be to consult with a local well-respected, experienced doula, because these helpers often have seen a wide range of doctors and midwives in action. She might have recommendations for what providers to avoid and which ones might be a great fit.
There are some modifications that can be made to the standard practice of care to make the end of pregnancy and early labor less emotionally painful for Survivor Sally, and that will help her feel more in control of what’s happening to her body. I think this article might be helpful.
Think about the upcoming testing decisions.
At the 8 week ultrasound, your doctor is going to give you the option to find out (A) the gender of your baby and (B) a whole host of genetic information in the next few weeks. Now is the time to decide how much information you want.
We chose not to find out the gender of our second two babies. For our first, we wanted to know the gender because everything else in our life felt up in the air and unpredictable and scary.
If I were to have a fourth baby (which…NO), I would again have a surprise baby. There’s something so precious about hearing the dude I love announce our tiny baby’s gender while I’m lying in the bed, sweaty and shaking on some crazy birth high.
Conversely, when we found out the gender at the 20 week ultrasound with baby #1 – before early blood tests were a big thing – it felt kind of anticlimactic, like “Well duh, there was a 50% chance it would be a girl and there she is.”
Genetic Profile and Risk Factors
We chose to skip these tests at 11 weeks all three times, and our three different providers were very supportive. The decision is highly personal and very dependent on the family’s belief system around termination. We decided that if the test revealed major chromosomal abnormalities, we wouldn’t terminate the pregnancy anyway. Therefore, we’d be faced with an incredible burden to bear without any course of action to take other than wait and grieve or worry. It was more information than we wanted.
However, for women who can imagine themselves terminating the pregnancy when confronted with the truly scary reality of delivering a baby who won’t survive, this testing makes a lot of sense. There are plenty of other reasons a woman would choose to undergo testing, too.
So just spend some time thinking about how much information you’d like to have before confronted with the decision at the doctor’s office.
I’d Say That About Covers It
So there you have it! Not much happens before the 8 week ultrasound, and for those of us who are a bit (ahem) Type A, it’s a super time to let your mind run wild.
What’s your birth philosophy? Are you a Rita, Norma, Thelma, Fanny, or Sally? It takes all kinds to make the world go-round! Much love, mamas.