Do I Need to See a Doctor the First Trimester?

QUESTION

Dear Midwife,
I am pregnant with my fourth child. My friends and I had a bit of an argument the other day because I had decided not to go and visit my doctor until I'm 3-4 months along. My reasons are that I have not had any complications before and it is such a hassle. They told me that I needed to think about the health of my baby. The doctor had told me before with other pregnancies that in the first trimester there wasn't much they could do to save the baby. Am I jeopardizing my baby's health by waiting for my first visit?

ANSWER

There is a long list of things that we do in the first trimester, some of which may not apply to you. We make sure you get on prenatal vitamins, and we check your blood to see if you need supplemental iron. We also check for infections that could interfere with the pregnancy. We make sure your dating is correct and that the baby is growing at a normal rate. We also help you with any other health issues specific to you personally that could make your pregnancy better (diet improvement, smoking cessation, counseling--I could make a long list here). I recently cared for a woman I had who transferred to my care at 31-weeks after only one visit with her family doctor because her first pregnancy had been so normal. The first visit was all "catch-up." By the second visit, when I had time to really look at her belly closely (33 weeks), she turned out to have twins! One wasn't growing properly and she had to be induced to save the baby. These things do happen. Then there's the practical issue -- which some providers just fill up!

-- Cynthia, CNM

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.