4 Appointments to Keep During COVID-19

With all the changes to our healthcare during this global crisis, there have been so many questions about cancelled appointments! Millions of women all over the world are being told that their prenatals are being cancelled and this has left so many folks feeling unsure and scared about how to have a baby in this pandemic. I’ve talked to so many women who have been left scratching their head with what to do next.

I may not have the answer of what to do next, but I do have some pointers on the doctor appointments that are worth keeping even among this pandemic. You can expect that your doctor will probably request you come in for these. And, if they don’t, but you think they should, you have the right to ask about that, too. Just because times are crazy, doesn’t mean you don’t get to advocate for yourself. Now is the time more than ever to use your voice and make it heard to receive the care you deserve.

Pregnancy Confirmation 

This can be a tricky one because pre-pandemic, many women might be seen at 6 or 8 weeks pregnant, to ‘confirm.’ It’s always more of a confirmation (duh) of what you were already expecting (or maybe not) or it was a delightful surprise and a sigh of relief. BUT, that is no longer the case amongst this global health crisis. We are seeing pregnancy confirmation appointments be pushed out to 10, even 12 weeks. Not only does this leave thousands of women with lots of questions and nowhere to turn to for answers, but it also leaves a huge gap in care. It creates this limbo type space for women who are pregnant and have questions, but not pregnant enough to get care during a pandemic.

Even if your provider is still seeing patients or providing telehealth appointments, you are probably left with tons of questions and nowhere to turn to for answers. The Birth Lounge has a community for exactly this. You can ask women all over the country what their experiences have been like, what their options are where they live, and what their providers are telling them! Join us in The Birth Lounge.

Genetic testing

It is so unlikely that your provider cancels this appointment, but should they, you can definitely ask why and request the test be done anyway. This is such an emotional test that can feel dreadful for days leading up to it. There are so many questions that this testing can bring up and your provider isn’t too busy to give you the compassionate care required for this part of pregnancy. If they are, change doctors. There’s genetic in the first (blood work and ultrasound) and second trimester The first trimester looks at the risk of Down Syndrome, Trisomy 18, Trisomy 13, and complication with the 23rd chromosome (sex chromosome). The second trimester is going to be made up of blood work around 16-18 weeks and an ultrasound at week 20 (anatomy scan) to check for cleft palate kidney conditions, and heart complications.

Gestational Diabetes Test

Just because you shouldn’t skip it, doesn’t mean you are forced to be in the hospital for extended periods of time. While the traditional way to test a pregnant person’s is what everyone is used to, this study shows that eating 28 jelly beans is an acceptable alternative to the glucose drink. It is important to note that studies show treating gestational diabetes does improve maternal and fetal outcomes. There are multiple other alternatives that women have shared such as fruit juice, pancakes and maple syrup, a soda, some fruit, and a bowl of milk and cereal or a two week food diary.. The American College of Obstetrics and Gynecology (ACOG) states, “should not be construed as dictating an exclusive course of treatment or procedure. Variations in practice may be warranted based on the needs of the individual patient, resources, and limitations unique to the institution or type of practice.” One of my favorite Physician & Midwives, Aviva Romm shares why the traditional glucose drink may actually be harmful to your thyroid.

Non-Stress Test

This is done usually after 28 weeks gestation and it measures your baby's heart rate. Sometimes your baby will be asleep and that’s totally okay! It’s not indicative of your baby’s health! They need sleep just like you do. Your nurse or tech may try to wake your baby up with noise or physically touching and pressing on your belly. You are hoping for a “reactive” response. Things like maternal prescriptions and poor oxygenation can also cause non (or less) responsive results. This will call for further testing to double check everything is okay. This often looks like staying hooked up to the fetal monitors for additional time in 20 minute increments. ACOG defines a responsive result as “two or more accelerations peak at 15 bpm or more above baseline, each lasting 15 seconds or more, and all occurring within 20 minutes of beginning the test.”

This pandemic has definitely changed things, but it hasn't taken away your control. In Boston, we have the option of free standing ultrasound centers. With a quick google search, you can find out if there’s one near you. Knowing how to minimize your time in the hospital, but also advocate for the care you want and deserve.

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