Hello! For my first post I thought it would be good to go through the role of your GP during pregnancy, what to expect in your first appointment and a few important things that you need to know. I see a lot of women who aren’t quite sure what happens next so hopefully this helps to demystify things!
Seeing your GP is a good first step! I have listed below some things your GP may go through with you and things that you need to know.
How are you feeling?
Nausea, vomiting, piles, urine infections, vaginal thrush and indigestion are just some of the joys that us women get to enjoy (!) Nausea should generally settle around the 12 week mark although it can continue beyond this. Whilst many women will understandably be hesitant to take anything, if your symptoms are really debilitating then your GP can discuss medication options with you. If you have a urine infection or vaginal thrush then I would recommend treatment.
When was the first day of your last period?
This can give an estimated due date although a more accurate date can be given at the first scan. We do not routinely do a repeat pregnancy test unless there is any uncertainty. If you have done a test at home this is usually enough.
Are you taking any supplements?
The recommendations are that pregnant women should be taking 400mcg of folic acid and 400 units of vitamin D daily. If you are trying to conceive, you should be taking 400mcg of folic acid daily. This helps with development. These vitamins should continue until at least 12 weeks of pregnancy.
Are you taking any medications?
You may be taking some regular medications. If so, your GP can discuss whether they are safe to continue. If you are under a specialist team your GP will most likely involve them in the decision. In general it’s a risk/benefit balance.
Is this your first pregnancy? Have you had any previous complications?
You may need to be seen earlier by a medical team or have an earlier scan depending on any previous problems.
Are you aware of the dietary recommendations during pregnancy?
Bye bye Camembert..! Now that you’re pregnant there are some foods you have to avoid. E.g. no soft cheese, no raw eggs or undercooked meat, no raw fish. The NHS website has a full comprehensive list of these. One thing I want to highlight though is vitamin A. Vitamin A is bad news during pregnancy; large amounts may cause harm to the baby. You should not consume any supplements containing vitamin A or any foods with large amounts of vitamin A e.g. liver or liver pate. In addition, alcohol consumption and smoking is not advised during pregnancy.
Your GP will check your blood pressure and have a listen to your heart and chest. No urine test is required initially although be prepared for plenty of these at the later antenatal appointments! If you are due to have a smear test and have had previous abnormalities please tell your GP. Otherwise if things have been normal, your test can be done 3 months after giving birth.
What about exercise during pregnancy?
I think doing some form of exercise during pregnancy is a good idea. If you did regular exercise pre-pregnancy there’s no reason why you can’t continue. If you go to classes, let your instructor know so they can modify anything if needed. If you haven’t previously done much exercise but would like to do something, walking is a great (and free…!) place to start. Just make sure you have a decent pair of trainers and you’re good to go! Antenatal classes are also good e.g. pregnancy pilates, yoga or barre. I would advise against contact sports or anything that’s really extreme. Be sensible – pregnancy is not a time to run a marathon or go rock climbing!
Have you thought about where you want to have your baby?
You need to be referred to an antenatal team at your local hospital. You may have a few options. It’s a personal choice so there really is no right or wrong here. For me, I wanted somewhere that was close. Also I had some friends who had previously given birth in that hospital and had positive experiences.
You may even be considering a private unit/hospital. Most places will offer a complimentary meet and greet consultation with an Obstetrics consultant and a tour of the facilities. Things you may want to consider here are the on-site facilities. Is there a neonatal unit or adult high dependency unit? Some private units would have to transfer you elsewhere. NHS maternity hospitals all have these on-site as far as I know. I know it seems like a horrible thing to think about and hopefully it would never come to this but it’s important to think about.
When is the first scan?
The first NHS scan is at 12 weeks. You will be invited by the antenatal team. You will also see a midwife who will go through some questions (similar to what’s been covered here) and do some blood tests. (I’m going to cover specific blood tests and screening for genetic abnormalities in another post.) If you have had a previous miscarriage, you may be referred for an earlier scan. Some women are keen to have an early scan done privately. This can take place from 4-5 weeks.
Now that you are pregnant, NHS prescriptions and any NHS dental treatment are free! This lasts until one year after you have given birth. Your GP or midwife will give you a form to complete which is sent off and you receive a certificate in the post. It’s the size of a credit card so carry it in your wallet.
What vaccines do you need during pregnancy?
If you are pregnant during the flu season (September- March) you are entitled to a free flu jab! Your GP or midwife can give this to you. You should also have the Whooping Cough (Pertussis) vaccine from 16 weeks pregnancy. Both are safe to have!
What are concerning symptoms to look out for?
If you have any vaginal bleeding or increasing lower abdominal pain then please let your GP know and request an urgent appointment. Outside of opening hours, try to contact the local hospital early pregnancy unit (EPAU) or 111 or A&E if the pain is increasing.
What is my GP’s role during pregnancy?
We are here to support you throughout pregnancy. Anything goes really! We work alongside the midwifery team and can answer your questions, discuss symptoms you may have, prescribe medications and organise any referrals. In some areas you will see your GP for some of your antenatal checks. I personally love doing antenatal appointments! It’s a good chance to ask any questions so write them down before you go otherwise you inevitably forget to ask!
This is by no means everything but gives an overview of the important things to know! In my next posts I will delve into some of these areas in more depth. Be careful about where you look for information as well; I recommend the NHS website or Patient UK for accurate digestible information.