First time pregnancy questions

At your first pregnancy appointment, your health care provider will confirm your pregnancy and then do an examination, much like your typical physical, to assess your general health. At your first visit, they will also go over your health history and your family’s medical history to determine if there are any risk factors that could affect your pregnancy. You’ll be answering a lot of questions during your first visit, but don’t forget that your provider is there to answer your questions as well. This first appointment is just the start of following your baby’s development through your pregnancy. As you probably know, pregnancy can be a roller coaster, and your body and mood are constantly changing. Our mission is to help you feel more informed, making your pregnant and new-mom life a little bit easier. The following "Questions and Answers" will help you better understand hypothyroidism and pregnancy. The key in dealing with your thyroid condition during pregnancy is close monitoring of your TSH and T3 and T4 levels and compliance with your treatment regimen.
Interestingly, if you call to schedule a first visit with an obstetrician, they often aren't that concerned about getting you in that early in the pregnancy, because they may not be particularly knowledgeable about hypothyroidism in pregnancy. My suggestion is that you try to make sure that you find out you are pregnant as early as possible, and get in for thyroid testing as soon as possible after finding out you are pregnant. I tested positive in a home pregnancy test 10 days post conception, had a blood test to confirm pregnancy at 3 weeks post conception, and was seen by a ob-gyn at a little less than 5 weeks.
I've just been surfing the Web reading about thyroid disease and pregnancy, and what I've read can be frightening -- fetal abnormalities, risk of low IQ, possible developmental problems, recurrent miscarriages, risk of stillbirth and premature labor. So, you may wish to consult with a cutting-edge endocrinologist or thyroid expert who is willing to monitor not only your TSH but your FT4 levels throughout your pregnancy. In terms of whether being pregnant is harder when you're hypothyroid, most people I've talked to who have autoimmune hypothyroidism say they've actually felt better while pregnant. In my case, when I called to schedule that first appointment, the nurse told me to start taking an over-the-counter prenatal vitamin with iron right away. This is a problem anytime, but particularly of concern during pregnancy, when you want to make extra sure you get enough thyroid hormone at all times.
I really want to have a drug-free pregnancy, and I'm suspicious of anything that might hurt the baby. When you’ve made up your mind to get pregnant, chances are you’re emotionally ready for the ride. Conditioning your body—basically, acting like you’re pregnant even before you know you are—can greatly reduce the chances of complication during this crucial time. Make sure you have full protection against infections that can complicate your pregnancy or be passed on to your child. Chronic conditions like asthma, diabetes, and high blood pressure can get in the way of getting pregnant, complicate pregnancy, or both. Some women are naturally predisposed to pregnancy complications, while others have sexually transmitted infections that make their pregnancies more delicate.

If you’re a first time mom-to-be, you’ll likely be filled of both questions and excitement.
With a caring, experienced health care provider who can answer your questions and provide support along the way, it’s the start of a nine-month (more or less) experience that you’ll look back on for the rest of your life!
Being pregnant with my first child later in life (I recently turned 38) has been a fantastic departure from that pattern.
Whether this is your first child or fifth, whether conception took you many years or a few months, pregnancy is a marvelous, awe-inspiring time in a woman's life. You are your baby's only source of source of thyroid hormones at this point - your baby's thyroid gland isn't fully functional until after 12 weeks of pregnancy. According to research presented at the June 2000 Endocrine Society conference ("Maternal Thyroid Function During Early Pregnancy and Neurodevelopment of the Offspring," June 21, 2000, Clinical Symposium: Impact of Maternal Thyroid Function on the Fetus and Neonate) there is increasing evidence that even normal FT4 levels that fall into the lowest tenth percentile during the early stages of pregnancy can be associated with poor infant development. More weight gain that I'd have liked, and a borderline blood sugar problem that the doctor said wasn't gestational diabetes, but was close to it, late in the pregnancy. What the nurse didn't tell me then, or the doctor didn't mention at any point during my pregnancy, is something few obstetricians or even endocrinologists will tell you about prenatal vitamins.
Eating a high-fiber diet and taking antacids are two activities more common during pregnancy. Your instincts are good, as most drugs -- prescription or over-the-counter -- are not recommended during pregnancy. That means by the time most couples find out they’re expecting, the baby will have been around for at least two weeks. Bring these up with your doctor at least a few weeks before trying to conceive, so that you’ll have time to get them under control. Your doctor may prescribe prenatal vitamins early on to ensure proper development of the neural tube (which will become the spinal cord and brain) during the first month.
Even minor factors like the time you go to sleep and how you get to work can affect your chances of pregnancy, so be as detailed as possible when talking to your doctor. Always consult your physician or other qualified health care provider as soon as possible about any medical or health-related question and do not wait for a response from our experts before such consultation.
I’ve had dozens women to turn to with my questions, including friends and my younger sister who has two beautiful kids of her own. This was tough during the first trimester before my husband and I publically shared the news, so it felt like I was carrying a secret. So if it’s early in your first pregnancy and you’re feeling overwhelmed by all of the strange things going on in your body and your life, find someone who you trust and talk about it. Your hypothyroidism -- an underactive thyroid -- doesn't change that, although it may make your pregnancy slightly more complicated than someone without a thyroid disorder. Yes, it's true, for example, that babies born to mothers with untreated hypothyroidism are almost four times more likely to have lower IQs and learning difficulties, according to a study reported on in the New England Journal of Medicine in 1999.
Naturally, I had the typical tiredness most pregnant women experience, but it was a different feeling, not the bone-numbing fatigue and brain fog I'd had with untreated hypothyroidism, but more of a sleepiness that was relieved by naps and nighttime sleep. Both activities, however, can have an impact on absorption of thyroid medication, and thus, affect thyroid function and levels during pregnancy.

Many couples, especially first-time parents, overestimate the value of pre-pregnancy planning. It’s around this time that a baby’s vital organs start developing, so it’s a rather delicate period. Common problems include ectopic pregnancies (when the egg is implanted outside the uterus) and miscarriages. It’s a good time for you and your partner to quit smoking, drinking, and any other unhealthy habits. It’s a good idea to meet with your provider regularly throughout your pregnancy, and it’s best if your first appointment takes place soon after you suspect you’re pregnant or take an at-home pregnancy test.
I chose to confide in my sister and one friend who was farther along in her pregnancy as soon as I found out that we were expecting, which kept me from feeing isolated in those early days when I was just getting used to the idea of being pregnant. It's heartening to note, however, that most women with thyroid disease are able to have an uneventful pregnancy and healthy baby. I was tested again a second time at around 9 weeks, and again, my TSH had risen, and a dosage adjustment was required. Pre-existing nodules and goiters, for example, don't tend to create any additional concern, and treated hypothyroidism adds only a slight risk during pregnancy.
I think that hypothyroidism's tendency to give some people an exaggerated insulin response and near diabetic blood sugar levels may make some pregnant women with hypothyroidism more susceptible to borderline or full-blown gestational diabetes. What you do before you get pregnant can have lasting effects on your pregnancy and your baby’s health, so knowing what you’re up against is vital. If you’re overweight or underweight, start working towards your ideal body mass index before trying to get pregnant.
Everyday factors that could affect your pregnancy, such as high blood pressure or infections, should be identified right away and addressed immediately. I've heard doctors speculate that some women with autoimmune diseases have immune systems that function almost perfectly during pregnancy, and I seemed to be one of them. Thyroid hormone, in proper doses, is replacing something your body needs in order to maintain a healthy pregnancy. After several fluctuations and dosage adjustments the first trimester, I had my thyroid tested every two months or so, and it varied no more than a few tenths of a point, requiring no adjustment in my medication throughout the entire pregnancy. Think about your questions before your appointment and don’t be afraid to ask them; this appointment is the first of many with your provider throughout your pregnancy, and it’s the one that providers expect to be the longest. Thyroid hormone is one of the few drugs in pharmaceutical category "A" (Low Risk) for pregnant women. Studies in pregnant women show that when taken in the proper dosage, there are no adverse effects on the fetus.

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