Pregnancy Series Part 3: Finding a Doctor

This is one of the most important things to do. Seriously! While many pregnancies and deliveries go well with no complications, many do not. When making the decision of which doctor to go to, remember that you are literally putting your life and your baby's life in the hands of your doctor (or midwife).

The easiest way to find a good doctor is to get recommendations from people you trust. If you are planning on waiting to announce the pregnancy until after you've seen a doctor, it can be awkward to ask for recommendations from friends because they get suspicious. Hopefully if they are good friends they will give you their recommendation and not ask any questions.

When you ask, don't just ask who is good, ask WHY they like their doctor. Even if you are best friends, you will probably like different things in a doctor. Some like to get in and get out, while others like a doctor to take their time, go over everything, give them a lot of reading materials, etc. My sister-in-law LOVES her doctor, and when she recommended him to a friend, her friend said, "I heard he was terrible!" So they got to discussing why some thought he was "terrible" and it was simply because he didn't allow doulas or legally binding birth plans (the kind that limits what a doctor can do in an emergency). My sister-in-law didn't want a doula or birth plan and he was an excellent doctor for her. But obviously, anyone wishing to have a doula or birth plan wouldn't like him. He wasn't a bad doctor, he just had different goals for delivery than some women. That's why it's important to ask WHY. (Remember when giving a review that it's best not to label as "good" or "bad" but just to explain what they did you liked and didn't like, including why you did or didn't. Sometimes you just don't click with a doctor but don't drive away potential patients).

My friend LOVED her doctor. And I mean she LOVED her!! She'd talk about her all the time. Due do scheduling conflicts she wasn't able to see her doctor for her 6 week check up  after the baby was born and she was so sad because it meant she wasn't going to be able to see her until her next pregnancy. Sounds like a glowing review, right?

So I went to her. She was a good doctor. She was nice. But I didn't love her quite like my friend did. I felt a little awkward asking her questions, though she never treated me poorly when I asked them. There was nothing wrong with her and I kept going to her. But then we moved for the summer and I started going to the OB/GYN I'd gone to for my premarital and 1 year check up (PAP smears and all the fun stuff that entails). I LOVED him! I felt so comfortable and at ease with him. I love the way he treated me, I felt like he truly cared about me and my baby. The way he talked, the way he dressed, the way he held himself... I can't say enough good things about him!

I can't pin point what exactly about these 2 doctors was so different. Part of it might have been the fact that one was male, one was female. I have only been to one female doctor in my life. (She was a dermotoligist who removed a mole off my back 5 years ago and the scar is still worse than my C-section scar from 7 months ago.) My pediatrician was male, my first OB/GYN was male... for some reason I feel more comfortable with male doctors. My friend on the other hand was rather uncomfortable when she delivered and the on call doctor was a male, not her female doctor. I didn't know she felt uncomfortable with men otherwise I would have taken her recommendation with a few grains of salt. (Can I change the expression like that?)

Most of what makes someone think they have a "good" doctor is personal preference. We all feel more comfortable around different types of people so it should make sense that we might prefer a different doctor.

Another note about listening to friend's suggestions: I had one friend who told me that a certain doctor did something during a friend's delivery that she wasn't supposed to. Well upon my own research, it really is ok for the doctor to do what she did, there are absolutely no complications with it (unless you're a cow. Like the animal. It's great being a vet school wife!) Remember that some procedures get emotionalized in the media and are put in a bad light when really it's not a problem. Check your sources. Ask a few doctors or nurses. Be careful with the internet though, anyone can put up anything and make it sound legitimate.

Another thing to do is call the hospitals and ask if they have a way to meet their doctors to make a better informed decision. Some may let you have a consultation but some may not. If you live in Utah, there is this AWESOME group called Intermountain Moms. The have a Facebook page (here) and YouTube channel (here). It's great because you can ask for recommendations, take virtual tours of hospitals and facilities, and even listen to some doctors talk about what they do what they do.

This is the OB/GYN who delivered my baby(click here). They have videos for lots of OB/GYNs and pediatricians. Take a minute to explore a few videos and explore their youtube channel. The have videos of nurses who answer commonly asked questions, it's great because I can search for a question and I don't have to call the doctor every time.

If you are not in Utah, call a few hospitals and ask if they have a Facebook page, YouTube channel, or Blog. Most of them will. They are great resources that are not used enough.

Things to keep in mind when choosing a doctor:

• Your health
• If you have some health problems, there are doctors that specialize in risky pregnancies. Find a doctor that is qualified and experienced in treating women with your health problems
• Doctor's Outlook
• You want to have the same opinion as your doctor on things like an episiotomy, medication, and emergency procedures. 
• Compatibility
• Like I mentioned before, do you get along and feel comfortable with the doctor?
• Man or Woman
• Some people have a preference and that is ok!
• Hospital Preference
• You might find a doctor that you love but not the hospital or vice versa
• Convenience
• How far do you have to go to see the doctor? How far away is the hospital?

Now I don't have a midwife, and the reasons my friends have explained to me for choosing to go with a midwife are all precisely the reasons I didn't have a midwife. Neither is wrong, it's up to you. It's your body, your baby, your pregnancy. Make sure you are happy, comfortable, and trust whoever is caring for you.

If you go to a doctor and you don't LOVE them, you can switch. Give it at least 2 or 3 appointments though, you never know what their day has been like. I can't stress enough, it is OK to switch. No one's feelings will be hurt, they want to make sure you're comfortable and taken care of. GOOD LUCK!

Any questions or other recommendations about choosing a doctor?

Pre Pregnancy Nutrition

I was just talking to a pregnant friend of mine. She hasn't told anyone else she's pregnant, she just needed some advice and since I'd been through it all and I live nowhere near anyone she knows (so I can't spill the beans) I was a good candidate. 

It can be scary and intimidating to be pregnant and you might not want to tell anyone yet but have no idea what you're supposed to do. And since those "Baby Your Baby" commercials don't play anymore, a lot of people don't know when to go to a doctor. Or what to expect at the doctor. Or even how to find a doctor. 

So I thought I'd go through basic "need to know" pregnancy tips. This post will cover pre-pregnancy nutrition. 

Pre-Pregnancy:

Nutrition
(I am not a doctor or a registered dietitian. Everything I have written here are general guidelines and may not apply to everyone. If you have special circumstances please talk to your doctor or a registered dietitian. You can find an RD here: http://www.eatright.org/programs/rdfinder/)

So you want to get pregnant. Congratulations! It's a scary decision, but so fun at the same time! First things first, if you want to get pregnant, you need to be healthy. Both of you. The absolute best way to get nutrition is through food. Yes you can and should take a multivitamin but please PLEASE eat a healthy diet. Here are some really easy guidelines of how to eat well:

60% of your calories should be carbohydrates. Yes, 60%, as in MORE THAN HALF. Carbs aren't bad, I'm not sure where they get their bad rap but carbs=energy and if you want a baby you need a LOT of it! Also, your brain runs off of glucose and guess what the easiest source of glucose is? You guessed it, carbohydrates. So a little more than half of everything you eat in a week should be carbs. Carbs are bread, pasta, cereal, and fruits even count because of their sugar content. Also candy is a carb. Eat up! 

My one stipulation to eating carbohydrates is you need to make half of the grains you eat whole. Oatmeal cookie anyone? If you do your own cooking, add half wheat to anything you would normally use white flour in. You can buy already ground wheat in the grocery store but keep it in the freezer because the oils will go rancid very quickly. If you grind your own, which is much more cost effective, freeze that too. (Wheat is cheap and you can get decent hand mills for a really good price. You can't really put a price on health, can you?) I've made German pancakes with half white and half wheat- tasted the same. I even thicken my soups and sauces with hand milled whole wheat instead of white. Buy whole wheat pasta, bread, and brown rice, if you like it. Don't buy anything you won't eat. But if you've never given it a chance, try it a few times. It takes children up to 12 times trying something before they like it. But if you've tried it and you just don't like it, fine. Don't eat it. I don't like brown rice. I eat lots and lots of white rice. But I eat whole wheat bread to make up for it. 

Some grains to enjoy: Amaranth, Barley, Bulgur wheat (cracked wheat), Corn, Durum wheat, Flaxseed, Fonio, Kamut, Millet, Oats, Popcorn, Rice, Rye, Semolina wheat, Sorghum, Spelt, Teff, Triticale, Wheat, Wild rice, Quinoa 

Please note that popcorn is a grain. That stuff is seriously SO good for you. I'll put up some delicious popcorn recipes. If you like popcorn, I recommend buying an air popper. I lived off this stuff while I was pregnant and teaching. Refer to this site for info on some of the unfamiliar grains: http://wholegrainscouncil.org/whole-grains-101/whole-grains-a-to-z

Nutrition is all about balance over time. It's ok if one meal or even one day is full of white flour, just be sure to balance it out throughout the week. 

Next up, fruits and vegetables. Half your plate should be filled with these! If the only way you can stand broccoli is covered in cheese sauce, PERFECT! Cover it in cheese sauce! Nutrition doesn't cancel out. You still get the benefits of broccoli. And eating broccoli with cheese sauce is better for you than not eating it all. My favorite way to eat most vegetables is steamed or blanched (put in boiling water until almost cooked) then sauteed in canola oil and Real Salt or Vegetable salt (regular salt is fine too, I just prefer the flavor of the others). Obviously fresh fruits and vegetables are best. But frozen, canned, and dried are still wonderful!! Really, there is so much flavor in a well prepared fruit/vegetable, it's sad that so many people don't like a lot of them. If you want tips on how to prepare certain foods, comment and I'll put up a post for you!!

Next up, dairy!! Milk, cheese, yogurt, and ice cream. No really, ice cream. In high school I compared the nutrition facts of a Sweet and Salty Peanut Butter granola bar to those of an ice cream sandwich. They were almost exactly identical. Did I eat another granola bar after that? You better believe I didn't! Ice cream is great. Make a milk shake: frozen strawberries, some ice cream, and some milk.... a wonderful, delicious, and nutritious snack! Dairy is SO important!!! Girls, your baby steals your calcium before your bones even get a look at it. It's not uncommon for women's teeth to fall out during pregnancy if they are deficient in calcium. Because of a variety of other factors, women are more prone to osteoporosis (break down of bone). I won't get into that right now, but trust me, you need calcium! But dairy is so much more than calcium. You get a lot of protein and good fats from it. There is nothing wrong with drinking 2% by the way. 

A good rule of thumb is to drink a glass of milk at each meal and drink water throughout the day. If you can't stand the flavor of milk go ahead and add chocolate or strawberry syrup. 

Meats and beans! More protein! More fiber! More iron! I don't have a soap box for this group, but eat them! Beans can be substituted in baked goods for the oil. Seriously, I make a mean black bean cupcake! When choosing meats, choose a lean cut and try to vary your meats: ground beef, chicken, pork, etc. Don't forget your fish too! Some fantastic oils are in those!

Multivitamins:
Alright.... here we go. Men, you need to be healthy to create healthy sperm. You really should get your nutrients from a healthy diet, but if you are finding that hard, a simple multivitamin will be fine. Unless you are seriously deficient in a particular substance and your doctor has tested and told you this, stay away from single nutrient vitamins. This can lead to toxicities. There IS such thing as too much of a good thing. Talk to your doctor if you have questions or concerns. 

Women: there are a billion multivitamins. What's the difference between a prenatal and regular multi? It depends on the brand, but I'm seeing a trend in prenatals to be lacking in a lot of nutrients, probably to avoid toxicities for you and the baby. To be honest it doesn't really matter what you choose. There are 2 things you want to look for: Folate (or folic acid) and Vitamin A (from beta carotene). You want to make sure you are getting enough folate. And if the scene from Baby Mama where she has to swallow a folate pill the size of a cookie scares you, just realize that most people don't take a separate folate pill. It's in most multis and at the point in her pregnancy in the movie it wouldn't have been effective. You need folate before you even know you are pregnant. Luckily for us, most cereals are fortified with it. If you don't have enough folate your baby is far more likely to have spina bifida. That is a birth defect where the backbone and spinal canal do not close before birth. Scary. But don't be scared, just eat your grains and take your vitamin with it. Next, it doesn't matter what type of multivitamin you take but make sure the vitamin A comes from beta carotene.  This is an inactive form of the vitamin. If your body needs it, it activates it and uses it. If it doesn't need it, it gets rid of it. If the vitamin is coming from retinol, it's already activated and you can have vitamin A toxicity. It can cause serious birth defects. Any vitamin A you get from food will only be used if needed.  

Something you may notice about a prenatal is that it's high in iron but low in calcium. That's because calcium actually blocks the absorption of iron. It's best to take the multi with a meal or snack that is low in calcium. However, if you have a bowl of cereal every morning and can't remember to take your vitamin another part of the day, take it with your cereal, you will be fine.

A word about iron: you need it. Lots of it, and so does your baby. Here is a list of iron rich foods. Obviously red meat is a good source but I know that can be hard to stomach during pregnancy. 

• Beef
• Lamb
• Ham
• Turkey
• Chicken
• Veal
• Pork
• Eggs (any style)
• Spinach
• Sweet potatoes
• Peas
• Broccoli
• String beans
• Beet greens
• Collards
• Kale
• Chard

So basically, meats and dark leafy green vegetables. A spinach salad with chopped chicken topped with berries and your favorite dressing... delicious!

What nutrition questions do you have? When you're pregnant your nutritional needs do change but I will cover that in another post.