Pregnancy: Making Choices

Finding out you’re pregnant is a life-changing event. You find yourself faced with many new questions and situations you’ve never had to deal with before. There are many decisions you’ll need to make. It can be hard to know what to do.

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Here are some of the questions you’ll face during pregnancy, and some information to help you make decisions.

Will I have the baby?

The first decision you need to make when you find out you’re pregnant is whether you are going to have the baby. This can be a difficult decision. There is a lot to think about. You have to make the decision that is right for you. Consider your personal situation and your beliefs. You have several options:

  • You can continue the pregnancy and raise the baby.
  • You can continue the pregnancy and create an adoption plan to allow someone else to raise the baby.
  • You can end the pregnancy.

If you’re not sure what to do, talk to someone you trust. This could be your baby’s father, a family member, a friend, your doctor, or a minister or rabbi. Learn about all of your options. Getting more information can help you make your decision. It can also help you feel more confident about your decision.

What doctor will I use?

If you decide to continue your pregnancy, the first thing you need to do is find a doctor. There are several types of doctors who can take care of you when you’re pregnant. These include:

  • Family doctor. Family doctors provide care for the whole family. Some will provide care for pregnant women, while others may refer pregnant patients to an OB/GYN.
  • Obstetrician-gynecologist (OB/GYN). OB/GYNs are medical doctors specially trained to take care of pregnant women and women’s reproductive health.
  • Certified nurse midwife. Midwives are trained and licensed professionals who provide comprehensive, family-centered maternity care. They are registered nurses who work with obstetricians.

What kind of doctor you choose may depend on how much risk you have in your pregnancy. If you are at low risk for complications, a family doctor or midwife might be right for you. However, if you have a high-risk pregnancy, you will probably need to see an OB/GYN or other specialist. Problems in high-risk pregnancies include high blood pressure, diabetes, a history of previous pregnancy complications, or being older than 35.

Where will I give birth?

Early on in your pregnancy, you’ll want to start thinking about where you want to deliver your baby. A large majority of women deliver their babies in a hospital. This is the safest place to deliver. But you can also deliver at a birthing center or at home. Several factors will influence where you decide to have your baby. These include:

  • Where your doctor delivers. Many women choose their provider and then deliver their baby wherever that doctor practices.
  • What your insurance covers. Some insurance policies may not cover a birthing center or a home delivery.
  • If your pregnancy is high-risk. Women with high-risk pregnancies should deliver at a hospital. This ensures there will be back-up services and medical interventions available if something goes wrong.
  • Where you live. Some states are “friendlier” to birthing center or home births than others. Check your state regulations before you decide where to deliver. You may also be limited based on what hospitals or birthing centers are nearby.

Where you want to give birth may also determine who your doctor will be. For example, if you want to use a birthing center or your home to give birth, you’ll need to find a doctor willing to deliver there.

Will I go to all my prenatal appointments?

The best thing you can do for yourself and your baby when you are pregnant is to go to all your prenatal doctor appointments. At these visits, your doctor will check your weight, your blood pressure, and your urine. He or she will listen to the baby’s heartbeat and measure the baby’s growth. These appointments give your doctor the chance to find out early if there is anything wrong that could endanger you or your pregnancy. It is very important that you go to all of your scheduled visits.

Will I have prenatal screenings or prenatal diagnosis tests done?

Prenatal screenings and diagnostic tests are tests your doctor performs while you are pregnant. They are done to check for any health problems with the baby before it is born. Problems could include birth defects, genetic disorders such as Down syndrome, or diseases such as cystic fibrosis. Screenings are usually done early in the pregnancy with blood tests or ultrasound. They detect risks for or signs of a possible health problem. Diagnostic tests can confirm or rule out specific health problems in you or your baby. They are usually done through:

  • Chorionic villus sampling (CVS). The doctor collects a sample of tissue from your placenta.
  • Amniocentesis. The doctor collects a sample of your amniotic fluid.

Screenings and diagnostic tests can be helpful to let you know if your baby might have problems when it is born. But sometimes they can cause added worry or concern. Some can increase your chance of miscarriage or other problems. It is up to you if you want to get these tests done. Talk to your doctor about the risks and benefits of the tests.

What will I eat while I’m pregnant?

It is important to make healthy choices when you’re pregnant. What you put in your body directly affects your growing baby. You should eat a balanced diet with plenty of lean protein, fruits, vegetables, whole grains, and low-fat dairy. This will ensure that your baby is getting the nutrients it needs to grow. You should also take a prenatal vitamin that contains folic acid. This will help supplement nutrients you may be missing. There are also certain foods you should avoid when you’re pregnant. These include raw fish, raw eggs, unpasteurized milk or soft cheeses, and lunch meat.

It is important that you eat the right number of calories. Too few calories could result in low birth weight and have a negative impact on your baby’s development. Too many calories could result in high birth weight and a more complicated delivery for the baby and you. Talk to your doctor about how many calories you should have each day and how much weight you should gain during your pregnancy.

Don’t drink alcohol, or use tobacco or drugs while you are pregnant. Even minor use carries risks for health issues in your baby. These include miscarriage, preterm birth, low birth weight, birth defects, and brain damage. No amount of these substances is safe during pregnancy.

Will I exercise while I’m pregnant?

Exercise is important when you are pregnant. It promotes a healthy lifestyle and can ease some of the discomforts that come with pregnancy. Some women say exercising while you are pregnant makes labor and delivery easier. It does not increase your risk of miscarriage or of delivering your baby early.

Try to get at least 30 minutes of exercise every day. If you were not active before getting pregnant, talk to your doctor before you start. When you do start, start slowly. Drink plenty of water. Avoid playing sports or any exercise that could cause you to fall, such as skiing or rock climbing.

Will I take birthing classes?

Taking birthing classes is an important part of preparing for the birth of your baby. They help you develop a birth plan. They can ease your anxiety about the unknowns of labor and delivery. They cover many topics, including the different methods of delivery, how to know if you are in labor, strategies for pain management, breastfeeding basics, and how to care for your newborn at home. Attending these classes is a great way for you and your partner to gain more confidence going into childbirth. Ask your doctor or midwife about classes in your area.

How will I manage my pain during labor?

Pain is often part of the labor and childbirth process. How you want to deal with this pain is an important decision.

You can deal with childbirth pain in a natural way or by using medicine. Most women use a mixture of both. Natural methods of managing your pain include activities such as breathing exercises, relaxation, massage, and forms of distraction. There are also popular methods such as Lamaze and the Bradley method that can help you deal with your pain without medicine.

Many women who choose to use medicine to help manage their pain get an epidural block. It is the most common form of medicine used in childbirth. It helps numb the lower half of your body so that you don’t feel the strong pain of labor or delivery. There are other forms of pain medicine that can be given in some situations, as well.

Talk with your doctor and create a pain management plan with them early on. This will help you be prepared and know what to expect. But remember that a plan is what you want to happen in a best-case scenario. Sometimes different factors can change the plan. For example, if your labor is progressing rapidly, you might not have time to get the pain medicine you had planned on.

Do I want to breastfeed?

Breastfeeding is a natural process that has many benefits for your baby. It is rich in nutrients. It has antibodies that help protect your baby against infections. It can help prevent sudden infant death syndrome (SIDS). And babies who are breastfed are less likely to have allergies, asthma, diabetes, or become overweight. Breastfeeding also benefits you. It can help you lost weight faster. It can delay the return of your periods. And women who breastfeed have lower risk of type 2 diabetes, breast cancer, ovarian cancer, high blood pressure, and heart disease. Breastfeeding is often the best thing you can do for yourself and your baby.

Do I want my baby boy to be circumcised?

During a circumcision, the foreskin (skin that covers the tip of the penis) is removed. It is usually done 1 to 2 days after birth. Deciding whether to have your newborn son circumcised may be difficult. You will need to consider the benefits and the risks of circumcision. Factors such as your culture, religion, and personal preference may also affect your decision. It is a good idea to decide before your son is born whether you want him to be circumcised. The Orenschools (AAFP) recommends that parents talk to their family doctor about the potential benefits and risks when making their decision. The American Academy of Pediatrics (AAP) says the health benefits of circumcision outweigh the risks, but not enough to recommend the procedure in all male newborns.

Will I bank my newborn’s cord blood?

One choice that can be confusing in pregnancy is whether you should save your baby’s umbilical cord blood. Researchers have found that the blood in your baby’s umbilical cord is rich in blood-forming cells. These can be used as treatment for people with life-threatening illnesses such as leukemia, lymphoma, or some inherited metabolic or immune system disorders. So instead of throwing that cord blood away, parents can choose to:

  • Donate it to a public cord blood bank. This option can help someone you don’t know. Your baby’s cord blood will be stored and listed on a public donation registry. It doesn’t cost anything and can help save lives.
  • Save it for a family member who needs it. This is for people who have family members with a disease that may be treated with a cord blood transplant. It is called directed donation. It is usually offered at little to no cost to eligible families.
  • Store it in a private bank. This option is like an insurance policy. If your child or any other family member gets sick and needs those cells, you have them stored and available. There are collection and yearly storage fees involved.

Talk with your doctor early on in your pregnancy about saving your baby’s cord blood. There are some steps you’ll need to go through ahead of time if you choose to do it.

Things to consider

You have many decisions to make when you are pregnant. Some of them are relatively simple. Others are more complicated and are harder to make. That is why it is important to know all of your options. Do research to make sure you know the pros and cons of each choice. There are many pregnancy books and websites available that can help you learn about your options. It can also help to have a support network. Surround yourself with friends and family members who will support you no matter what you decide. And of course, always talk to your doctor if you have questions or you are unsure about what to do.

Questions to ask your doctor

  • I have so many questions. Who can I turn to for help?
  • Can you recommend any books or websites that might answer some of my questions?
  • Can I call your office if I have a question?
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