You just found out you’re pregnant. You’re excited but also a little anxious as you aren’t sure what to do and where to go. While selecting baby names may be among your first thoughts, there are other important choices to make. Who do you want on your health care team for your pregnancy journey and beyond? And what are some of the key decisions you need to make in your first trimester?
Meghan Noonan, a certified nurse-midwife at VCU Health, will explain your care team options and guide you through some decisions to navigate your first trimester and pregnancy. Together with OB-GYN’s, nurses and you, certified nurse-midwives empower you to have the birth experience you want while preparing you to be a new parent.
Decisions You Make in the 1st Trimester of Pregnancy
Guest
: Meghan Noonan, CNM
From the Show: VCU Health System
Transcription:
Caitlin Whyte (Host): So you just found out you're pregnant, you're excited, but also a little anxious as you aren't sure what to do or where to go. While selecting baby names may be among your first thoughts, there's other important choices to make. So, to help us through these questions today is Meghan Noonan, a Certified Nurse Midwife at VCU Health.
Welcome to Healthy with VCU Health, where experts from VCU Health share their knowledge, cutting edge research and the latest innovations to help you achieve optimal health and wellness. Take control of your health. I'm your host, Caitlin Whyte. So, Meghan, to start us off, can you tell us about your specialty and what exactly a Certified Nurse Midwife does?
Meghan Noonan, CNM Guest): So as a Certified Nurse Midwife, we all have backgrounds in nursing and various experiences as Registered Nurses, and then have additional training at the Master's level to become nurse midwives. And we're able to provide full scope healthcare. So, starting in the teen years, as people get into adolescence through adulthood, obviously focusing on pregnancy and childbirth, but even beyond that through menopause care. So, really when people think of a midwife, often they think of birth and sometimes think of things like home birth, which is, can be true, but often midwives are practicing in all kinds of locations. And here at VCU, we practice primarily taking care of people who are having low risk pregnancies and are really looking for a low intervention approach to care. They're really just appreciating that that birth and pregnancy can be a normal, a normal thing that happens. You know, certainly there can be complications that arise, but often it is normal and, and letting normal be normal.
Host: Now choosing whether to deliver with a midwife or OB-GYN is a key decision you make in the first trimester, but are you locked into this decision or can you change your mind?
Meghan: You can absolutely change your mind. And I really encourage you to be an advocate for your own health. And really if you start care and, and don't feel like you're getting what you need from the practice or a provider, to really seek out other options. We are really fortunate, that as midwives we practice with a really great group of physicians - both generalists and high-risk groups. So, often people start with us, but sometimes complications do arise and we need to transfer care. And fortunately, those people are often right down the hallway so we can make it a really smooth transition. But there are many reasons why people might switch back and forth between seeing a midwife, and seeing an OB-GYN. It could be related to medical complications or it could just be personal choice.
You might be a low risk person who later on in your care decides that maybe you are really interested in this low intervention approach and want to come meet with one of the midwives and talk with us about what your options are.
Host: Well, that's good to know that there are always options. Now, what are some other decisions you make in the first trimester?
Meghan: Well, a lot of the focus of the first trimester is really just caring for yourself and sometimes just surviving the early pregnancy symptoms. But one of the biggest decisions is often related to genetic testing. So, thinking about genetic screening. Your provider will talk with you about the different options available and might talk about if you're at increased risk for any reason, whether related to age or family history. I think really, for a lot of people early in the pregnancy, once you get that positive pregnancy test, really taking a look at your own health and your own health decisions. Often, it's a time when many people decide, you know, what, I'm going to kick that smoking habit for good. Now that I have not just myself to think about, but this growing baby that I really want to care for. Focusing on making really good nutrition choices, lots of really great protein, lots of fruits and vegetables, which I think here in Virginia, we're really lucky that we do have a lot of produce out there and really looking at cutting out alcohol, cutting down on caffeine consumption. And I think really just the big picture of what does my health look like and how can I really maximize it right now?
Host: Well, talking about that, let's focus on stress. With COVID-19, stress levels are of course higher. And then you add pregnancy on top of that. What are some tips or advice you have to limit stress?
Meghan: I think, you know, pregnancy has always been a really stressful time because there's so much that's unknown. You're really trying to plan for the future. And you don't know when labor is going to happen, when the birth is going to happen, how, you know, what your baby's going to be like, are they going to breastfeed easily?
Is it going to take a lot of work? So it's always been a time of, of really heightened emotions and adding COVID on top of that has really just changed that unfortunately in ways that you just can't even imagine. But I think focusing again, on how to keep yourself safe and we really encourage everyone to get vaccinated, whether you're thinking about getting pregnant, whether you're already pregnant, if you've recently had a baby and think you might want more in the future, really the vaccine is safe at any point. And so that's one of the best things you can do to decrease the chance of potentially getting a more severe form of COVID or getting COVID at all during the pregnancy.
Host: So what can one expect at their first appointment? What do we learn here?
Meghan: The first appointment is usually in a longer sort of time slot because it is a lot of talking. We really want to get to know you. We want to get to know about your past history. Have you had medical problems in the past? Have you had surgeries in the past? Are you taking any medications? We'll talk about your family. Are there any known genetic conditions that run in your family that perhaps we can screen for? We might also start that discussion of what are you looking for? You know, some people come in and want to see a midwife or I really know I want to work with this provider.
But for a lot of people that first pregnancy test, that's sort of the open door and you don't even know what's out there. So, we might talk a little bit about what the options even are and what might be the best route. Or of all the options that are available. If you're someone who's really low risk. We also will recommend doing some routine tests. There's kind of a standard panel of some blood work and urine tests. Looking for infection, checking for things like anemia and checking your blood type, which can sometimes affect some of the recommendations in pregnancy. There may also be an ultrasound, or an ultrasound may be recommended later, depending on if we need to find out how far along you are.
And then we'll talk about the plan going forward. There is standard schedule for prenatal care, but some people, you know, may need more than that. Again, if there is anything else going on, so we start to make that plan. So you have an idea of what to expect for the next eight to nine months, depending on when you start care.
Host: Absolutely. And as we wrap up here, Meghan, can you tell us where your clinics are located?
Meghan: We are very excited that we're expanding our care options and locations. So we're currently located downtown for a little while longer at the Nelson Clinic. And then we'll be moving into the brand-new Adult Pavilion this December, which we're very excited about. It should have a lot more space and more parking options because parking downtown in the city is always a challenge. And we also last year moved to a new building in Stony Point. And then we will be, I think, early next year, expanding into the Short Pump Area. So kind of reaching people on the Western side of Richmond, a little more easily.
Host: Wonderful. Well, Meghan, is there anything else you want soon to be moms to know in this exciting, but nerve-wracking time?
Meghan: I think come with questions. I would say every day I have someone tell me this is probably a dumb question, but truly there are no dumb questions. If you've thought of it, someone else, and probably dozens, if not, hundreds of people have thought that same question, and wondered that same thing.
So many changes are happening both to your family, but also to your body. And it can be really scary and unknown and can be a little bit of a mystery as to what's normal and what's not normal. So, finding a provider, where you feel comfortable and feel like you can really ask those questions, whether they feel silly or not. And if you don't find what you're looking for, feeling empowered to look for a different provider, and really advocating for yourself and what you need during this time.
Host: Well, thank you so much for this guidance. I hope we put some moms at ease today. That was Meghan Noonan, a Certified Nurse Midwife at VCU Health. Thank you for listening to Healthy with VCU Health. To learn more about pregnancy care at VCU Health, or to make an appointment, please call 804-628-1263, that's 804-628-1263. Or visit vcuhealth.org/birth. I'm Caitlin Whyte. We'll see you next time.
Caitlin Whyte (Host): So you just found out you're pregnant, you're excited, but also a little anxious as you aren't sure what to do or where to go. While selecting baby names may be among your first thoughts, there's other important choices to make. So, to help us through these questions today is Meghan Noonan, a Certified Nurse Midwife at VCU Health.
Welcome to Healthy with VCU Health, where experts from VCU Health share their knowledge, cutting edge research and the latest innovations to help you achieve optimal health and wellness. Take control of your health. I'm your host, Caitlin Whyte. So, Meghan, to start us off, can you tell us about your specialty and what exactly a Certified Nurse Midwife does?
Meghan Noonan, CNM Guest): So as a Certified Nurse Midwife, we all have backgrounds in nursing and various experiences as Registered Nurses, and then have additional training at the Master's level to become nurse midwives. And we're able to provide full scope healthcare. So, starting in the teen years, as people get into adolescence through adulthood, obviously focusing on pregnancy and childbirth, but even beyond that through menopause care. So, really when people think of a midwife, often they think of birth and sometimes think of things like home birth, which is, can be true, but often midwives are practicing in all kinds of locations. And here at VCU, we practice primarily taking care of people who are having low risk pregnancies and are really looking for a low intervention approach to care. They're really just appreciating that that birth and pregnancy can be a normal, a normal thing that happens. You know, certainly there can be complications that arise, but often it is normal and, and letting normal be normal.
Host: Now choosing whether to deliver with a midwife or OB-GYN is a key decision you make in the first trimester, but are you locked into this decision or can you change your mind?
Meghan: You can absolutely change your mind. And I really encourage you to be an advocate for your own health. And really if you start care and, and don't feel like you're getting what you need from the practice or a provider, to really seek out other options. We are really fortunate, that as midwives we practice with a really great group of physicians - both generalists and high-risk groups. So, often people start with us, but sometimes complications do arise and we need to transfer care. And fortunately, those people are often right down the hallway so we can make it a really smooth transition. But there are many reasons why people might switch back and forth between seeing a midwife, and seeing an OB-GYN. It could be related to medical complications or it could just be personal choice.
You might be a low risk person who later on in your care decides that maybe you are really interested in this low intervention approach and want to come meet with one of the midwives and talk with us about what your options are.
Host: Well, that's good to know that there are always options. Now, what are some other decisions you make in the first trimester?
Meghan: Well, a lot of the focus of the first trimester is really just caring for yourself and sometimes just surviving the early pregnancy symptoms. But one of the biggest decisions is often related to genetic testing. So, thinking about genetic screening. Your provider will talk with you about the different options available and might talk about if you're at increased risk for any reason, whether related to age or family history. I think really, for a lot of people early in the pregnancy, once you get that positive pregnancy test, really taking a look at your own health and your own health decisions. Often, it's a time when many people decide, you know, what, I'm going to kick that smoking habit for good. Now that I have not just myself to think about, but this growing baby that I really want to care for. Focusing on making really good nutrition choices, lots of really great protein, lots of fruits and vegetables, which I think here in Virginia, we're really lucky that we do have a lot of produce out there and really looking at cutting out alcohol, cutting down on caffeine consumption. And I think really just the big picture of what does my health look like and how can I really maximize it right now?
Host: Well, talking about that, let's focus on stress. With COVID-19, stress levels are of course higher. And then you add pregnancy on top of that. What are some tips or advice you have to limit stress?
Meghan: I think, you know, pregnancy has always been a really stressful time because there's so much that's unknown. You're really trying to plan for the future. And you don't know when labor is going to happen, when the birth is going to happen, how, you know, what your baby's going to be like, are they going to breastfeed easily?
Is it going to take a lot of work? So it's always been a time of, of really heightened emotions and adding COVID on top of that has really just changed that unfortunately in ways that you just can't even imagine. But I think focusing again, on how to keep yourself safe and we really encourage everyone to get vaccinated, whether you're thinking about getting pregnant, whether you're already pregnant, if you've recently had a baby and think you might want more in the future, really the vaccine is safe at any point. And so that's one of the best things you can do to decrease the chance of potentially getting a more severe form of COVID or getting COVID at all during the pregnancy.
Host: So what can one expect at their first appointment? What do we learn here?
Meghan: The first appointment is usually in a longer sort of time slot because it is a lot of talking. We really want to get to know you. We want to get to know about your past history. Have you had medical problems in the past? Have you had surgeries in the past? Are you taking any medications? We'll talk about your family. Are there any known genetic conditions that run in your family that perhaps we can screen for? We might also start that discussion of what are you looking for? You know, some people come in and want to see a midwife or I really know I want to work with this provider.
But for a lot of people that first pregnancy test, that's sort of the open door and you don't even know what's out there. So, we might talk a little bit about what the options even are and what might be the best route. Or of all the options that are available. If you're someone who's really low risk. We also will recommend doing some routine tests. There's kind of a standard panel of some blood work and urine tests. Looking for infection, checking for things like anemia and checking your blood type, which can sometimes affect some of the recommendations in pregnancy. There may also be an ultrasound, or an ultrasound may be recommended later, depending on if we need to find out how far along you are.
And then we'll talk about the plan going forward. There is standard schedule for prenatal care, but some people, you know, may need more than that. Again, if there is anything else going on, so we start to make that plan. So you have an idea of what to expect for the next eight to nine months, depending on when you start care.
Host: Absolutely. And as we wrap up here, Meghan, can you tell us where your clinics are located?
Meghan: We are very excited that we're expanding our care options and locations. So we're currently located downtown for a little while longer at the Nelson Clinic. And then we'll be moving into the brand-new Adult Pavilion this December, which we're very excited about. It should have a lot more space and more parking options because parking downtown in the city is always a challenge. And we also last year moved to a new building in Stony Point. And then we will be, I think, early next year, expanding into the Short Pump Area. So kind of reaching people on the Western side of Richmond, a little more easily.
Host: Wonderful. Well, Meghan, is there anything else you want soon to be moms to know in this exciting, but nerve-wracking time?
Meghan: I think come with questions. I would say every day I have someone tell me this is probably a dumb question, but truly there are no dumb questions. If you've thought of it, someone else, and probably dozens, if not, hundreds of people have thought that same question, and wondered that same thing.
So many changes are happening both to your family, but also to your body. And it can be really scary and unknown and can be a little bit of a mystery as to what's normal and what's not normal. So, finding a provider, where you feel comfortable and feel like you can really ask those questions, whether they feel silly or not. And if you don't find what you're looking for, feeling empowered to look for a different provider, and really advocating for yourself and what you need during this time.
Host: Well, thank you so much for this guidance. I hope we put some moms at ease today. That was Meghan Noonan, a Certified Nurse Midwife at VCU Health. Thank you for listening to Healthy with VCU Health. To learn more about pregnancy care at VCU Health, or to make an appointment, please call 804-628-1263, that's 804-628-1263. Or visit vcuhealth.org/birth. I'm Caitlin Whyte. We'll see you next time.