You just took a urine pregnancy test and it's positive. What should you do now? I am an Internal Medicine Doctor that does quite a bit of women's health so many of my patients contact me before they've picked out an OB/GYN. This is an exciting time that sends people in to a panic about what they need to be taking, and what they should stop taking. Let's talk about some common issues in those first days:
- My urine test was positive do I need a blood test? No, not if your urine test was positive (and most of us do more than 1). I'll do it if a patient really wants it for confirmation but the urine tests are accurate enough to eliminate the need for a blood test.
- What should I start taking? You may have been taking iron and folic acid before you got pregnant so you will now replace that with a single prenatal vitamin. Prenatal vitamins are available over the counter (Whole Foods, Trader Joe's) but your primary care doctor can prescribe a prenatal vitamin that you can get at a pharmacy. These are prescription and may be "better" than what you get over the counter or at least the contents are more closely regulated.
- What should I not be taking? Any prescription medications you are taking should be discussed with your doctor. Here are some commonly used meds that are Category B (No evidence of risk in humans), so should be fine to continue with if needed: Claritin and Zyrtec for allergies, prevacid for heartburn and reflux disease and of course Tylenol. The new feeling about the SSRI antidepressants is that they should also be continued but that needs to be discussed on an individual basis. Non steroidal anti-inflammatory meds (Motrin, Advil, and ibuprofen) are NOT to be used during pregnancy and even TOPICAL retin-A creams/lotions must be discontinued immediately.
- Finding an OB/GYN: ask your doctor and friends for referrals, find someone whose office is close by, and think about where you want to deliver your baby and pick a doctor who has privileges at that hospital.
- When should I have my first prenatal visit? Your OB/GYN might not schedule your appointment until 8-10 weeks of pregnancy and this is in part because most miscarriages occur between 6 and 8 weeks and you don't want to do all of your screening during a prenatal visit until your pregnancy is more "certain".
- IF you have spotting associated with cramps before your OB/GYN visit you need to call your new doctor or primary care doctor right away. If you have mild spotting not associated with cramping monitor it and keep track of when it happens and if the spotting increases call your doc.
- Ugh the nausea: This peaks at 8 weeks and asking your friends what helped for them is beneficial: ginger, frequent small meals, more protein (eggs, chicken), sucking on lemon candies, cinnamon gum. I say whatever works. Give it all a try and keep telling yourself NAUSEA IS A GOOD SIGN and THIS TOO SHALL PASS!
- DO NOT BE SURPRISED ABOUT: Fatigue, breast tenderness, mood swings, low grade cramps, and nausea that isn't just in the morning.
- Enjoy this! If it's your first pregnancy start talking to your friends who have been through it, and ignore all those people who tell you your life is over and to see a movie every week because you will never see one again. Not true. This is a crazy ride but the prize at the end will carry you through.
"Like a ship that took me safely through the wildest storm"
Rainer Maria Rilke