We all know that asking questions is the best way to gather information to make decisions… but what if you don’t know what questions to even ask???
Let’s explore questions you can be asking your provider during each trimester so you can be more informed in your prenatal care as you prepare for birth!
Asking questions is a great way to facilitate conversation with our birth team, so we can feel more confident in their care and trust our providers more! It may also be a good way to know if we need to find a new provider to support our birth!
First Trimester: 5 Questions to Ask
1) Will you do an ultrasound on baby?
This is a common question that people have, and it can be an exciting moment for many to see their baby for the first time.
This is more commonly done now because it gives them the most accurate due date when they do an ultrasound earlier compared to depending on the last menstrual period, and it’s becoming standard of care.
They don’t have to do the ultrasound if you are confident in your menstrual cycle and you do not want one.
2) What bloodwork and other labs will need to be drawn today?
Usually the labs that are done during the initial visit are a
Complete Blood Count (CBC): They are looking at the blood levels to be able to see if there is any issues and establish a baseline to be able to identify any future issues such as anemia, low platelets, or infection.
Blood type: One of the times of highest risk for most pregnant people needing a blood transfusion is pregnancy, so knowing you blood type can be important if this is needed.
Rh factor: Rh is a protein that can be found on the surface of you Red Blood Cells, if it is present you are positive, if its not present you are negative. If your negative they will advise to receive a Rhogam shot during pregnancy (usually at 28 weeks and after delivery) to present Rh iso-immunization from potentially happening if baby is Rh positive. This is when your body creates antibodies against the Rh factor. This usually will not affect the current pregnancy, but will affect future pregnancy. Can discuss this more with your provider if you are Rh negative.
Urinalysis & Urine Culture: This test is to see if there is any bacteria or blood cells in your urine which may be a sign of infection, or even if there is glucose or protein which would be a sign of some other complication in pregnancy.
Rubella: They are testing to see if your are immune for rubella, meaning you have the antibodies for it. Rubella is one of the diseases that if you have the infection during pregnancy it can cause birth defects for baby. So they test to see if this is a risk. If you are non-immune, they won’t give you the vaccine during pregnancy but will advise you receive it postpartum.
Hepatitis B & C: This is an infection of the liver that can be passed to baby in utero. So important to know if you have it during pregnancy for other tests and procedures to occur to hopefully minimize or prevent the transmission to baby.
HIV: Another infection/disease that can be passed to baby in-utero. Same applies here as Hep B/C.
STIs: Such as chlamydia, syphilis, and gonorrhea. If you have an STI or develop an STI during pregnancy, it’s important for it to be treated prior to birth to avoid complication for baby. It can be transmitted to baby during delivery and could cause developmental problems for baby in the womb.
Sometimes your provider may have other labs that they may want to test you for, such as thyroid tests!
3) Where do you deliver?
Some providers are there for all of their patients births unless they are out of town, and other clinics have rotating providers so you may have the provider you’re seeing during pregnancy or you may see another from the clinic at birth.
4) What is your birth philosophy?
Asking their thoughts on birth and pregnancy care can help decide if this is going to be a good fit for support during your pregnancy and birth.
You can also ask things like if they know their primary c-section rate for themselves or the hospital? Or what is your rate of episiotomies or vacuum/forcep use? etc.
This can help determine for you if you need to find a different provider.
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5) What routine tests will you recommend and when might we need to do other higher risk testing?
Some clinics and providers will offer or routinely do other tests than listed above, so asking what other tests to expect in the future can be helpful. They may be more blood tests or ultrasound test to detect for potential genetic abnormalities.
Or if you know you are higher risk or have a history of being higher risk, asking what tests they recommend. Sometimes HcG labs can be included if there’s history of miscarriage or suspicion of an ectopic pregnancy.
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Second Trimester: 5 Questions to Ask
1) What labs and bloodwork is done during this trimester?
Typically routine labs are CBCs and Urinalysis.
They will typically also offer lab work that can detect for markers of genetic defects or abnormalities with different tests.
Discussing which test they routine do and the risks and benefits of each can be helpful. The tests could be lab work (done between 16-18weeks) or done by ultrasound (18-20 weeks).
The ultrasound is typically referred to as the anatomy ultrasound where they look at all of baby’s anatomical parts to determine if all is well. Gender is typically found at this ultrasound.
The most commonly known test in the second trimester is the Gestational Diabetes screening test. This is to be done between 24-28 week pregnant
2) What does the hospital consider viability of baby?
This can be particularly important for those who have a history of pre-term birth.
Some hospitals will consider baby’s viable at 23 weeks and others 24 weeks.
If baby is not considered viable, they may not offer interventions to help baby, but discussing the risks and benefits with your provider, especially a Neonatal provider, if this situation occurs for you is important!
3) Will you give me a referral to pelvic floor PT?
Especially if needed for any pelvic pain. This can be helpful if you start to have pelvic pain in the second trimester and want to see a pelvic floor PT.
Some providers are more hesitant to refer people to PFPT. If they aren’t willing during pregnancy, they may no be willing postpartum either.
4) What options do you offer for the gestational diabetes screening?
Is the only option the glucola drink or are they open to you using alternatives?
Alternatives could include:
- fresh test,
- eating a high carbohydrate meal,
- or monitoring your own blood sugar at home for 1-2 weeks.
This can help you also judge how open they are to alternative options in pregnancy and birth.
5) How do I contact you and where do I go for any concerns?
This can be helpful because in most places the location for concerns changes around 20 weeks from the clinic/ER to the actual labor and delivery triage unit.
So knowing where to go and the phone numbers to call is helpful. It can also help for non-urgent issues that aren’t labor related, where do you go?
Do you have to go to triage or can you be seen in person at the clinic or via virtual consult?
Third Trimester: 5 Questions to Ask
1) How to do kick count and when to start?
Kickcount is typically recommended starting at 28 weeks, which is beginning third trimester. It explained that at the same time everyday you sit down for 2 hours to count baby’s movement. Once you get 10 movements you’re done.
Research shows that potentially that is not the best method, learning baby’s normal movement patterns throughout the day is better. Baby’s are predictable in their movements because they typically are most active at the same time each day. So learn your babies active times and being aware when baby’s movement pattern has decreased from their normal.
Where do I go if baby’s movement is decreased?
Typically they will recommend go to Labor and Delivery to be assessed, but some clinics may do assessments for decreased fetal movement in their office.
2) When can I bring my birth plan in to go over what options I would like for my birth?
Some providers are making this part f the routine appointment at 36 weeks. Going over the birth plan with you provider before going into labor is beneficially because
- This can help you learn what is routine for the hospital and what options are available to you.
- Learn what is routine for your provider and hospital.
- Have a conversation about risks and benefits of different interventions to help you decide on birth options you may have.
Ex: Learning the risks and benefits of vacuum or forceps while not in labor and pushing can help you decide on if that’s something you would want while your mind is clear and not affected by labor! Can also be helpful to do the same with anesthesia about epidural/spinal and have true informed consent on this procedure.
3) What labs if any will be done this trimester?
Typically it is the CBC and urinalysis again along with GBS.
Asking if you can collect your own GBS test. GBS is typically done around 37 weeks pregnant. This is a normal flora that’s found in all our bodies, but during pregnancy can overgrow.
If GBS has overgrown it will come up as GBS positive on this test. They recommend antibiotics during labor for those that are positive. You have the right to decline, but discussing with your provider after finding out the result to weigh the risks and benefits can be helpful.
4) When do you start recommending induction of labor for low risk patients, medical need for GDMA, GHTN, etc.
What induction methods do you use and that I should expect if I have to be induced?
This can be helpful for your birth planning!
Also knowing what their routine methods are can help you know which ones to research. a bit more.
Not sure what to expect with an induction? Check out our labor induction mini-course to learn about your options!
5) When do you think about using pushing interventions? What are the risks and benefits of these interventions? How often do you use them? If I say no to them how does that change my birth? This can again help with that birth plan!
These questions can help you make the most of your prenatal visits but also create an open dialogue with your provider to make you an active participant in your care!