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pre-conception appointment?

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Old 01-18-2011, 10:17 AM   #1
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Sorry I'm asking all these questions on here....no mom to ask, and no close female friends I can consult!

Before you all got pregnant, did you do a pre-conception appointment? I'm supposed to go tomorrow, but my insurance doesn't cover anything other than my actual "annual appointment," which comes up in April. We're wanting to start "trying" in March. Maybe I should just start taking a prenatal vitamin or folic acid supplement and skip the appointment? I mean...people get pregnant every single day without pre-conception appointments....
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Old 01-18-2011, 10:26 AM   #2
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I just went to see my PCP for a pre-conception appointment with my first (the second was a surprise, so no preparation there!). Honestly, looking back, I don't think it was necessary. I didn't have any special medical issues we needed to be concerned with, and she just told me to start taking my prenatal and try to stay as non-stressed as I could. I had that figured out on my own.

If you're taking a prenatal it should have at least the recommended amount of folic acid in it. Check the bottle before you buy a separate supplement. More isn't necessarily better, sometimes it's just more, you know?
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Old 01-18-2011, 10:31 AM   #3
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Right now I'm taking Centrum vitamins....400 mcg folic acid, which is what it says online to take before conception....

My thing with the appointment is, like I said...I'm having my annual in April and last year when my doctor and I discussed the possibility of me getting pregnant he already told me to be off BC for at least 2 months before "trying." We also discussed possible complications from my past LEEP procedure, but those won't become apparent until I'm actually pregnant. So discussing them again will do no good.
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Old 01-18-2011, 10:38 AM   #4
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I never have heard anything about being off the pill at least 2 months before getting pregnant. In fact many of my friends conceived pretty much the second they got off of the pill and they all had perfectly healthy and normal babies. In fact I heard that your body is ready to fire off those eggs the second you stop the pill, so that'd be a good time to conceive IMO.

If the pre-conception appointment is just going to be "go on pre-natal vitamins" then I wouldn't go if insurance isn't covering it and you are healthy. Women did it for hundreds of years without those appointments. So if money is tight or is an issue I'd either not go to the appointment or wait till you see your doctor in April.

How exciting! Congratulations to you and hubby and good luck TTC!
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Old 01-18-2011, 11:18 AM   #5
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I agree with the above. I never did have a pre-conception appt either. I just went to the doc after a positive pregnancy test. You can start taking prenatals though. I actually have a few friends that are not/cannot have children that take prenatals just because they are good for you. Good luck!
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Old 01-18-2011, 11:54 AM   #6
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I also agree with PP's that it's probably not necessary. I actually did have some extraneous problems that could come up when I went off of BC but even with that I knew I could keep them under control with a healthy diet and exercise so I just took prenatals and had no problems concieving and now have a healthy daughter (and another baby on the way).
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Old 01-23-2011, 10:04 AM   #7
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They want you off the BC pills so that your full cycle is natural. They want the full cycle to be natural because it makes it easier to figure out the time you conceived. They want to know that because it's important information in terms of evaluating the health of a baby: if you think you are almost 6 months pregnant but you are really 5 months pregnant, what looks like a normal sized baby might actually be a very big baby, suggesting possible diabetes or pre-eclampsia. In a dangerous pregnancy, they might decide to induce a baby at 30 weeks because it's far enough along and the danger to the mother is growing, but if the baby is 28 weeks they'd wait.

Two full months is long enough to know how long your natural cycle is, and that you probably ovulated in the middle of that cycle.

That said, it's not the end of the world if you don't wait two months. The 7-week ultrasound is also a pretty accurate way of estimating date of conception (the later ultrasounds are less accurate, as babies begin to vary more).
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Old 01-23-2011, 10:31 AM   #8
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A PC appointment is necessary if you have any family or medical history that you are concerned about (taking certain medications, genetic risk factors, history of disease or birth defects - both you and partner and your families)

If not, it's probably not necessary - but you can of course still go.

And yes! The best thing you could do is start taking your folic acid now!
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Old 01-23-2011, 12:41 PM   #9
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update - I did not go to the appointment, but have started prenatal vitamins.

Local family members are trying to convince me to change doctors before I become pregnant. My current doctor is 45 miles away, and is an OB/GYN who knows my history (with LEEP procedure, etc). The local doctors are family practitioners who also deliver babies in addition to everything else they do. I can see the benefit of having a baby, eventually, in a smaller local hospital. I will likely be the only woman giving birth at that time considering the size of the town, and will get one-on-one care. In the city were my doctor is, I will be one of dozens giving birth, will be kicked out the door as soon as possible, likely won't even have my doctor when the time comes and will be alone as I will be too far away for family to stop in and see me.

On the other hand, my current doctor knows my history and specializes in this type of thing. He has cared for women with complications from LEEP procedures before, and the local doctors (who are not long out of medical school) may or may not have.

So that's another decision to make...
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Old 01-23-2011, 12:57 PM   #10
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I don't think you can predict the quality of care at a hospital based on things like hospital size. Some huge hospitals offer amazingly specialized care, and some small hospitals are pits. For one thing, large hospitals are competing against other large hospitals. But some large hospitals are like factories and some small hospitals are cozy and intimate and up to date.

Personally, I think people get better at things when they do them all day every day, so I would tend toward the specialist route. I would also find a big hospital more comforting because if there were a problem, they'd be able to treat it right there.
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Old 01-23-2011, 12:59 PM   #11
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45 minutes is a long way to go when you are in labour or when you are just worried about something. When you concieve why don't you just ask him what he thinks. In canada it is the norm for a gp to handle your pregnancy and if there is some issue you are sent to a gyn. Maybe you can see a gp near you and if there are any concerns follow them up with the ob/gyn?
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Old 01-23-2011, 01:16 PM   #12
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I have always been told that the second I go off birth control I better be ready to get pregnant. I think it is more convenient for the doctor to have you wait in order to calculate due date, but that's it. I did conceive the first cycle after bc, but it was a chemical. Also, your cycles could snap back to normal right away, but I've had several friends have totally out of whack cycles for several months (most get an initial cycle and then nothing for months). I had 90-100 day cycles before going on the pill and resumed a 50-60 day cycle after going off. But that's me. Just like everyone responds to the pill differently, everyone also responds to going off the pill differently. I don't think there's a medical reason to wait though. I'm actually a baby that was conceived the first cycle after my mom quit the pill when her doctor told her it would be a year (that was 1982, though). I know lots of babies that are right-after-the-pill babies. The rule of thumb (and not very helpful I might add) is that while it could take up to a year for your cycles to resume to normal, you could get pregnant immediately.

As far as the pre-con appt, I don't think it's necessary unless you have issues that you need to address with the doctor. I personally needed to do it because I have PCOS and a family history of endometriosis. I expected to face infertility and wanted a documented "start date". Otherwise, I think a prenatal and folic acid is a fine way to go.

I also again want to suggest "Taking Charge of Your Fertility" by Toni Weschler. I don't have a lot of women in my life to discuss this stuff with and the book is so informative!! I became so in tune to my body after reading it. You don't have to chart or temp, but it helps you understand your cycles and possible ovulation signs much better. With PCOS, my doctors just assume I don't ovulate naturally, but I do. I wouldn't believe it unless I had read the book and charted, though. I was totally clueless before reading it and it was like a lightbub went off.

But really, going off the pill is just a big game of "wait and see". Be patient, relax, be knowledgeable and baby dance a lot
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Old 01-23-2011, 06:48 PM   #13
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My birth center is 45 minutes to an hour away depending on traffic - not really a big deal. I've had two children there, and have yet to not make it on time Honestly, I'd stick with the doctor who knows your history - usually with women who've had LEEP (especially fairly extensive ones) they like to monitor the length of your cervix throughout pregnancy and some women require a cerclage to prevent miscarriage/preterm labor. If you happened to become 'high risk' because of it I'd want the best doctors and facilities around me, not newer doctors at a small town hospital. Best of luck with your decision, but this is my third time around making the 45 minute trip for all my appointments and the birth; it's worth it to me because I love where I go and I'm 100% comfortable with the practice I go to.
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Old 01-23-2011, 07:13 PM   #14
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Do you know the doctor that will deliver your baby? Most doctors will meet with you free of charge if you want to "interview" them.

If I was planning to conceive I would stop alcohol completely and of course, cigs if you smoke. Beyond that, I would make sure I was eating very balanced whole foods and taking my good vitamins. It may sound over the top, but I would also ask my husband to do these things. IMHO, not over the top at all.

You are a doll and I can hardly wait to read your good news. LOL, backward cowgirl did the trick for us. LOL! OMG..cannot believe I just wrote that except that most guys won't be in this thread.
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Old 01-24-2011, 07:43 AM   #15
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Thanks for all the advice, y'all! My cycles are apparently going to be out of whack. Before I got on the pill about 10 years ago I had 2 periods a month....today is the first day mine is due since I've been off the pill for a month. Nothing. No PMS, no normal headache. So we will see. May be a while, but who knows? Right now I'm taking the stance of "Don't think about it, let whatever happens happen." I'll worry months from now if I'm still all out of whack and there's no baby yet....
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