First Trimester: Prenatal Testing
Your midwifery care will take you on a journey from the beginning stages of pregnancy all the way through those postpartum days. It provides you with an easy avenue for having all of your questions answered, for being granted peace of mind as you embark on this life-changing path, and for knowing that you and your baby are in experienced and capable hands. Gentle and professional midwifery care will be a comfort through this exciting, yet sometimes confusing and challenging time.
Pregnancy is a dance with the most powerful and rewarding finish. As your midwife, I will walk with you through each step along the way, and make sure you are maintaining your health and safety throughout with this holistic view.
We will walk through your body’s changes, your various moods, and the concerns and joys of pregnancy. Every step on your journey, every decision made, will be with you and your baby’s optimal health in mind. A small part of this picture are the various testing and screening options that we use and that are available to you. I am often asked by prospective clients if they will need to see a physician for bloodwork and testing. For all standard testing, the answer is NO! I can do it for you, in the comfort of your home (with the exception of ultrasound).
Everyone’s pregnancy is unique. The care that I as midwife provide includes all of the same screenings and tests offered in standard obstetric care, as well as unique care alternatives that are not always widely available amongst obstetric practices today. This allows me to better meet the care and needs of all individual clients. Many of the screenings available to you occur in the first trimester as you begin care. Suggestions will be made based on the findings of these tests and screenings in order to set you up for a normal, low-risk pregnancy.
With care for the unique needs of you as a client, your right to decline tests is respected. As your midwife (Orange County midwife), I aim to give you the resources and information you need to make the best educated decision for you, your family, and baby.
These standard tests and screenings include:
Physical exam.
This typically occurs at the first appointment (no matter when you are joining me in care). I will familiarize myself with what is normal for your body by discussing your health and obstetric history. Together we will also perform a brief physical exam. I will listen to your heart and lungs and go through other basic assessments of your physical well-being.
Pap test.
We will discuss current pap guidelines and can do this test if indicated and desired.
Bloodwork.
A basic blood panel and standard OB pregnancy panel will be drawn. These labs will screen you for infectious diseases that could be harmful to your pregnancy, determine your blood type and status, and rule out any major deficiencies.
Glucose screening
Our first line of defense in screening for gestational diabetes actually happens in the first trimester. We are able to determine how your body has been handling glucose during the first 3 months (including pre-pregnancy) which can be used to help establish your risks of developing gestational diabetes in the third trimester. This may influence the type of third-trimester glucose testing you choose or decline. This number will also help us determine any special diet and nutritional care that you may need. This is done with your initial bloodwork with a test called a Hemoglobin A1c.
Urine Analysis
A urinary analysis will be done at each of your prenatal appointments. If necessary, your urine will be sent to the lab for culturing for specific infections. Early detection of infection helps to ensure that you receive the necessary treatment to prevent complications for you and your baby.
Early ultrasound through local family-friendly practitioners
While not necessary in most cases, an early ultrasound is a special time where you and your family can connect with your baby, especially if you have experienced loss in the past. An early ultrasound may be recommended to confirm pregnancy and determine your due date if we are unsure of your last menstrual period and conception dates. First trimester ultrasounds show and measure the gestational sac, fetal pole, fetal tone, and yolk sac and can be used to detect many abnormalities or concerns.
Regular appointments.
Your care includes regular appointments which come more frequently the farther along you get into the pregnancy. These appointments include routine screenings and tests that will help me determine if your pregnancy is progressing normally. Expect to listen to your baby’s heartbeat at each appointment once the heartbeat is strong enough to be heard. Your appointments are also an opportunity to ask any questions you may have or share concerns. You can read more about prenatal visits in this blog post. These appointments make up the foundation of your midwifery (Orange County midwife) care and are essential to ensuring a safe and healthy pregnancy and delivery.
Fetal heart tones in the first trimester are detected via hand-held doppler or ultrasound.
Now widely available, many clients choose to undergo genetic screening during their pregnancy. We will discuss your options, risk factors, and the pros and cons of these testing options during your first first-trimester appointment.
Genetic screenings:
State PN genetic screening.
California department of public health provides screening for genetic disorders. The tests detect changes in the genes or chromosomes, bringing awareness if there is a possibility (this is just a screening and in no way is diagnostic) of common genetic or chromosomal disorders. This is done through a combination of maternal bloodwork and ultrasound.
Comprehensive genetic non-invasive prenatal testing (NIPT)
Non-invasive prenatal testing is a more comprehensive genetic screening than the state program and can screen for more than 113 genetic conditions. Blood samples are taken from mom and the results show whether there is a likelihood that the baby has a genetic disorder. This includes conditions that are common across ethnicities as well as rare conditions.
Carrier screening
With carrier screening, we test the parents to determine if they are a carrier of recessive genetic diseases. This screening arms the parents with knowledge, so they know if they are at risk, and the strength of that risk, and the risk of having a child with a genetic disease. This can be done with your NIPT. Abundant Blessings Midwifery uses NxGen MDx, the leader in NIPT for comprehensive NIPT and carrier screenings.
Early gender testing (as early as 8wks)
Instead of waiting until 18-20 weeks to find out your baby’s gender via ultrasound, we offer early gender testing. Through this simple test, the gender of your baby can be determined as early as 8 weeks. Early gender testing is over 99% accurate! This test is also a great option for those wanting to find out the gender through DNA testing, but do not wish to undergo complete NIPT screening. Abundant Blessings Midwifery uses Sneak Peak clinical test for early gender testing.
First Trimester Prenatal Testing for a Healthy Pregnancy
Again, I value and respect all clients. While I believe that prenatal testing is important for a healthy pregnancy and good fetal and maternal outcomes, I know that everyone is different and unique. I respect my client’s right to decline any testing that is offered.
IMPORTANT: This written material has been prepared based on the community standard of care and current practice guidelines and scope of midwifery care. Please discuss your care and testing options with your provider. I am not responsible for any medical, legal, or financial difficulty resulting from the use of any of these tests. I encourage you to educate yourself, question your provider on the risks and benefits of such testing, and make sure you have all of the information you need to make an informed decision.