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Patient Education



The earliest and most reliable sign of pregnancy, for women who have a regular monthly cycle, is a missed period. Sometimes women who are pregnant have a very light period, losing only a little blood. Other signs of pregnancy are listed below.

Feeling sick – you may feel sick, or even be sick, not necessarily in the morning, but at any time. If you are being sick all the time and can’t keep anything down, tell your doctor.

Changes in your breasts – often the breasts become larger and feel tender, rather as they may do before a period. They may tingle. The veins may show up more and the nipples may darken and stand out.

Needing to pass water more often. You may find that you have to get up in the night to do so.

Being constipated.

An increased vaginal discharge
without any soreness or irritation.

Feeling tired.

Having a strange taste in your mouth
– many women describe it as metallic.

‘Going off ’ certain things like tea or coffee, tobacco smoke or fatty food, for example.

Some women don’t even need these signs. They just ‘know’ that they are pregnant.


You may feel very happy or excited when you discover that you are pregnant, but you shouldn’t worry if you don’t. Even if
you have been looking forward to pregnancy, it is not unusual for your feelings to take you by surprise. And if your pregnancy was unplanned, then you may feel quite confused. Give yourself a little time to adjust to the idea of being pregnant. Even though you may feel rather anxious and uncertain now, this does not mean that you won’t come to enjoy your pregnancy or to welcome the idea of the baby. Discuss your feelings with your doctor who will help you to adjust to your pregnancy, you may want to share the news with family and friends immediately or wait a while until you’ve sorted out how you feel. Others in your family/extended family may have mixed feelings. You’ll need to talk about these feelings. But do begin to think about your
antenatal care (that is, the care you’ll receive leading up to the birth of your baby) and where you would like to have your baby. The earlier you begin to organize this, the more chance you will have of getting what you want.

Go ahead and make an appointment with your doctor when you discover that you’re pregnant. Typically, doctors will schedule you for your first appointment when you’re nine or ten weeks into your pregnancy. From that point on, you will probably see the doctor once a month until you reach 32–34 weeks at which point you will see the doctor every two weeks until you reach 37 weeks. After that, your appointments will likely be scheduled once a week.


As doctors, we determine the due date, or EDC (estimated date of confinement), calculated on approximately 40 weeks, beginning with the first day of the patient’s last menstrual period. Doctors have a pregnancy wheel that calculates this fairly easily. They can also use computer programs. An easy way for a patient to figure out her due date is to use Naegele’s Rule: take the first day of your last menstrual period, subtract three months, add seven days, and that should be your due date. We call it the poor man’s OB calculator. Interestingly, it comes up to 40 weeks pretty consistently. If you don’t know when your last period was (perhaps because you were breast feeding, on birth control pills, or had an irregular menstrual cycle), then the best way to determine the baby’s gestational age is to have an ultrasound. Sometimes, patients ask us why we use their last menstrual period, rather than the date they thought they conceived or had sex. It’s simple really. We’ve found that it’s easier for a woman to remember her last menstrual period than to know when she last had sex. Plus, fertilization doesn’t necessarily occur when the couple had sex.


The biggest “lie” of pregnancy is thinking that a baby’s gestation is nine months. Actually, the average pregnancy lasts 40 weeks; if it were nine months that would translate to 36 weeks.

Making Plans

OK, so you’re pregnant. Where do you go from here? Sit down—take a deep breath—and “veg” for a bit. Squelch the urge to panic. Give into the excitement and joy. Scream if you need to. But above all, give yourself a chance to assimilate the news. You have plenty of time for planning—the baby won’t be born for nine months or 40 weeks, give or take a few days or weeks. Right now—you, the mother, are the one who needs to be taken care of. If you feel like starting a list, here are some of the things you might put on it that are covered in subsequent chapters.

1. Choose a doctor
2. Choose a hospital.
3. Check insurance coverage (yours or your spouse’s).
4. Check into maternity leave (if you’re employed) or your spouse’s paternity leave (if he has it).

Choosing a doctor is probably one of the most critical factors of your pregnancy, but if you’re like me, it’s not an area that you want to address. It just feels too hard trying to figure out where to find a doctor and which one matches you. If you already have an OB/GYN, you’re the lucky one. If not, just how do you choose the doctor who is right for you?

There are many ways to find a doctor, but probably the best way is through word-ofmouth. Talk to your friends who have had babies and get recommendations from them. Did they like their doctor, was he or she easy or difficult to talk to, what are his/her credentials? However, remember that the same doctor who suits your friend may not be a match for you.

A Counseling Session with a Doctor

Here is a little known fact about doctors. They really wish that you would get in to see them and counsel with them before you get pregnant, rather than after. That way they can react to a medical problem you might have before the pregnancy, rather than afterwards when it might be too late. It’s particularly important with women who might have medical considerations factoring into their pregnancy. At this point, the doctor could tell you what your options for pregnancy are and whether or not you’re a high-risk patient. Factors that might be important to discuss with your doctor ahead of time are:

  • Current health and past medical history
  • Age of mother
  • Heart and/or lung problems
  • Drinking or smoking
  • Past pregnancy-related history

Choosing the Right Hospital

Many women have never been a patient in a hospital before the birth of their first baby, so they have absolutely no idea what to expect. The idea of even going to a hospital as a patient can be daunting. Fortunately, today’s hospitals try to make the experience as “painless” as possible by offering all the comforts of home, and then some.

So What Should Be Important to You

The most important thing is for you to feel comfortable with the staff and the environment of the hospital that you choose. Are the people friendly? Do you have confidence in their abilities? Some hospitals offer LDRP rooms, which translates to Labor Delivery Recovery Postpartum, meaning that you will be in the same room where you delivered until you go home. Other hospitals have a labor and delivery room, but then move you to a regular room on the maternity floor after you deliver. Do you want a private room (who doesn’t want one?) or a semi-private room? Does the hospital even offer semi-private rooms at reduced costs? Previously, maternity rooms looked like any other hospital rooms. Today’s maternity rooms often have carpeting and look more like luxury hotel rooms than anything remotely affiliated with a hospital. For example, all the oxygen outlets are hidden behind wooden cabinets. In fact, in some hospitals, the baby warmer in the mother’s room folds down from the wall like an old-fashioned ironing board. There is a lot of effort that goes into designing labor and delivery rooms these days. Many hospitals, in an effort to compete, will go to great extent to offer the most positive experience when you have your baby. The first step is to call the hospital and schedule an appointment or time to visit.

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