- Talking to
doctors can be intimidating, but coming prepared with questions can help. - If you are pregnant, ask your OB-GYN if genetic testing or low-dose aspirin is right for you.
- If interested, you can also discuss telemedicine visits or using a midwife with your OB-GYN.
Every mother-to-be has probably, at some point, searched online for answers to common questions like, "Is that glass of wine safe?" and "Can I still have sex?"
But here's the thing: The internet, while useful, can't cater to everyone's individual needs and therefore offers up generic advice that may not be best for you. To top it off, no two pregnancies are the same.
That's why it's important to talk to your provider about what type of care is best for you and your baby.
"You need to clarify anything you find online with your providers," says Kate White, MD, MPH, the Vice-Chair of Academics in the Department of OBGYN at Boston Medical Center. "It's always good to do your own research, but the internet cannot tell you everything."
Here are seven questions you might not think to google the answers to that you should ask your OBGYN when pregnant:
1. Do you think I need genetic counseling?
"When it comes to things that might affect a
Medical term: Genetic counseling can help determine how genetic conditions, like sickle cell disease or Down syndrome, might affect you or your baby.
For example, if someone in your family has a history of blood clots, it may mean you have an inherited disorder called Factor V Leiden thrombophilia, which increases your risk of blood clots, miscarriage, and other pregnancy-related complications like preeclampsia.
That's why it's best to start this conversation with your gynecologist as soon as you become pregnant or even beforehand to catch any potential risks.
2. Can I do telemedicine visits?
Telemedicine visits during pregnancy are becoming more popular especially in rural communities where healthcare access is limited. They can also be a great option for working mothers or those in school who don't have time to travel to their doctors or sit in a waiting room, says White.
Most pregnant people, even those with gestational diabetes or blood pressure complications, should qualify for telemedicine visits, especially during their first and second trimesters. Ask your provider if you need special equipment at home like a scale or blood pressure cuff, says White. If you are unable to document blood pressures or weight gain accurately, you will likely not qualify for remote telemedicine visits in pregnancy.
Appointments that require ultrasounds, lab testing, or vaccinations will still need to be done in-office.
3. Should I be taking low-dose Aspirin?
New research indicates low-dose aspirin reduces the risk of preeclampsia, a potentially fatal complication that affects 2% to 8% of pregnancies. There is no known treatment except delivery, says White, which can be challenging if your baby is premature.
The American College of Obstetricians and Gynecologists now recommends low-dose aspirin (81 mg/day) beginning around the 12th week of pregnancy for people with:
- A history of preeclampsia
- Preterm delivery at less than 34 weeks of gestation
- High-risk factors like diabetes, renal disease, or chronic hypertension
- IF you are 35 years old with either your first pregnancy or a body mass index greater than 30
What the research says: A 2017 study of women at a high risk of developing preeclampsia found a significant decrease in the rate of preterm preeclampsia in those who took aspirin compared to the placebo group. They took low-dose aspirin daily starting at 11 to 14 weeks into pregnancy until 36 weeks gestation. Meanwhile, a 2007 review of 59 trials found a 17% relative reduction in preeclampsia with low-dose aspirin use.
Those who have a hypersensitivity to NSAIDs, asthma, or a history of stillbirth, ulcers, or gastrointestinal bleeding should not take aspirin during pregnancy.
4. Is it safe to see a midwife for my pregnancy?
If you want a more natural, low-intervention approach to pregnancy and don't have any serious chronic conditions or pregnancy complications, you may want to consider a midwife.
Midwives are certified healthcare professionals who provide prenatal and postpartum care as well as labor and delivery assistance.
Research indicates women cared for by midwives have:
- Lower rates of c-sections (10% compared to 32%)
- Higher rates of breastfeeding (79% compared to 51%)
- More prenatal education
- Increased sense of control during the birthing experience
Important: Midwives also have a higher risk of perinatal death and neonatal seizure. Therefore, look for midwifery groups or birthing centers that have established relationships with adjacent hospitals if complications occur, to reduce these risks.
If you are interested in using a midwife, bring this up early with your gynecologist, says White. You may be able to find a hospital or OB-GYN that works alongside midwives.
5. What is your cesarean delivery rate?
The United States has a cesarean delivery rate of 32%, which is significantly higher than the recommended 10% to 15%. While c-sections can prevent otherwise unavoidable maternal or newborn deaths, they also pose risks like:
- Infection
- Postpartum hemorrhage
- Blood clots
- Increased risks during a future pregnancy
Additionally, recovering from a C-section can take four to six weeks, making it difficult for a new mother to care for their baby, says White.
"I think talking to your provider at your first prenatal visit about their cesarean rate and how they approach C-sections is a good thing," says White. A safe and healthy delivery should be the ultimate goal, but understanding why and when your doctor would recommend a cesarean section is important to discuss.
6. What kind of postpartum care do you recommend?
The American College of Obstetricians and Gynecologists recommends all women follow-up with their provider within the first three weeks postpartum with ongoing care.
"Look for a doctor that wants to work with you on creating a comprehensive postpartum plan," says White.
Currently, 40% of women do not attend a postpartum visit which prevents:
- Proper screening for postpartum depression
- Management of chronic conditions like high blood pressure or diabetes
- Access to effective contraceptives
- Monitoring of C-section recovery
What the research says: A 2012 study of black and Latina mothers found just 15 minutes of postpartum guidance before hospital discharge along with a follow-up phone call two weeks later, reduced symptoms of depression and breastfed for longer through six months postpartum.
7. If you are black or American Indian, ask your doctor how you can work together to mitigate risks
Black, American Indian, and native Alaskan women are two to three times more likely to die from pregnancy-related causes than white women. This is not only due to
- Earlier onset of preeclampsia
- Fibroids, which increase the risk of postpartum hemorrhaging
- Pregnancy-induced hypertension
- Pulmonary embolism
It's important to discuss these statistics with your doctor so you can create a plan to mitigate risks. According to White, that plan may include more visits, blood pressure checks, or blood tests, which can monitor for anemia and platelet abnormalities - both of which can contribute to more significant problems with bleeding at the time of delivery.
"It's not that doctor's don't want all of their patients to be safe and healthy, but for patients who are particularly high risk - which really all black women in some sense should be considered high risk - they deserve to have a bit more attention paid to them when they're pregnant," says White.
Insider's takeaway
Talking with your OB-GYN early on about questions or concerns you have is essential for a healthy and successful pregnancy.
White recommends keeping a running list of questions on the notes app on your phone and printing research or other information you find online to run by your provider.
"Don't be afraid to ask questions. It's easy to feel intimidated, even if it's a doctor you love," says White. "But pregnancy is a special time and it can be a little scary for everybody."
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