Healthy Woman: The 12 Months of Pregnancy

When should a woman meet with a health-care provider about pregnancy? I would suggest that if a woman is considering pregnancy she seek health-care advice before she goes off birth control or at least three months prior to actively trying to be pregnant. Then you're truly making informed decisions about what kind of provider might be best for you and what choices you might need to think about in terms of genetic testing or early prenatal testing, or maybe earlier access into health care because you have medical risks that put your pregnancy in a higher category.

What kinds of providers are available to women? We have many health-care providers in the women's health field and maternity care that could help women preconceptually. All the way from maternal fetal medicine specialists who take care of the most-ill women to reproductive infertility specialists who help women who have reproductive problems conceive. OB/GYNs, family practice physicians, certified nurse midwives, women's health nurse practitioners, physician's assistants, Planned Parenthood and health departments are other providers.

What should women be looking for when trying to choose a provider? I think what's important is thinking about what kind of pregnancy and birth experience they're looking for. They also need to consider their choices based on their insurance and where they live.

There's variation in the philosophy of care among different providers. A certified nurse midwife's expertise is in caring for healthy pregnant women, which is about 80 percent to 85 percent of all pregnancies. Their foundation of care is based on health promotion and disease prevention and seeing pregnancy as a healthy, natural function. In medical communities, there may be more of a slant on seeing pregnancy as a potential disease and perhaps being more interventionist.

I encourage women to think of pregnancy and childbirth as something that is truly a life-changing event and to try to take the time to think about how this can be an emotionally positive experience that's shared by all the people she wants to share it with. And I encourage women to invest in a provider that will give her that experience.

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