hi everyone it's week six in our 40 week journey through pregnancy
this week's topic we're going to talk all about how to choose your ob
provider and where you want to deliver your baby there's some different options
and so our goal for today is to talk about what those options are and some of
the related risks and benefits of each oh and it's week six which means we're
gonna get our very first chance to see our baby on ultrasound this week so in
case you haven't met us i'm sarah and i'm an ob gyn
i'm kurt and i'm a pediatrician and we are the doctors bjorkman
welcome back this week we are talking all about the sixth week of pregnancy
and a big part of that is starting to think about where and how
you want that little baby to be born and also starting to think about that first
ob visit so before we dive into that discussion
let's talk a little bit about baby it's week six and baby is already about
the size of a little sweet pea measuring about 2.5 millimeters in
length and it's the little arms and legs are
already starting to grow which if we're lucky we might be able to see on that
early first trimester ultrasound and speaking of that make sure you stick
around to the end of today's video to see sarah's first
ultrasound and our very first look at baby
to start our discussion about who you want to choose to be your medical
provider for your birth there are a couple things you need to
consider the first is do you have any health conditions
that might necessitate a higher level of specialized care and
later in your pregnancy this may be does your baby have any special
conditions that are going to necessitate immediate care after birth
it's also important to find out what is available in your area
are there multiple hospitals is there a birth center start to explore what those
options are and what are your plans to cope with
labor itself are you hoping for medication free birth or are you ready
for that epidural right now and finally what is your insurance cover
this may change some of your plans a little bit
so there are essentially three options available for where you can choose to
give birth at a hospital at home or at a birth
center at a hospital the providers that might
be available to you are an ob gyn an mfm a family physician or midwife and
we're going to talk more about what each of those means in a little bit
so 98 of women in the u.s choose to give birth in a hospital
and there are many benefits to in-hospital birth including
access to specialized medical care for mom and baby should an emergency arrives
as well as medicated pain relief during labor
another option for birth location would be the home so it is true that women
through all of known history have been giving birth to babies at home
and millions and millions have done so successfully in fact sarah and i both
have friends who welcomed their babies into the world at home
but before we begin the discussion about planned birth outside the hospital
we need to state that even the healthiest moms with the healthiest
pregnancies could have unexpected things happen
that could cause things to become life-threatening or significantly
dangerous to mom or baby with a little warning
yeah so and with this the american college of obstetrics and gynecology
continues to recommend even in the covet era that the safest place to give birth
is either at a hospital or an accredited birth center yep absolutely
in fact even now the american academy of pediatricians
and the american college of obstetrics and gynecology has statements addressing
the increased risk of death serious neurologic dysfunction and lower
apgar scores in infants who are born at home
so with all this if you're still considering birth at home
there's some extra things you should consider so it is critical
if you are planning to have a baby at home you should do so in the presence of
a certified nurse midwife or a midwife whose licensure and
education meet the standards of the international confederations of
midwives global standards for education with a little bit different view than
acog the american college of nurse midwife states
that international and u.s research results support the conclusion that a
planned home birth with an educated still skilled attendant
can be a safe satisfying cost-effective care option
for healthy low-risk women who want to give birth at
home so we fully support a woman's right to choose
where they give birth but need to stress the key points of this statement being
that mom and baby are at low risk and the home birth happens with an
educated skilled and licensed midwife and ideally this is all near a hospital
should additional care support be needed the third option for birth location is a
birth center if you are someone who doesn't have a
medical condition that necessitates an in-hospital birth
and you really desire limiting the medicalization of your birth process
an accredited birth center could provide a more home-like experience
as they're designed to be a bit more family centered than a traditional
hospital unit birth centers do have medical equipment
and other preparations for emergency situations
when a normal healthy pregnancy becomes a dangerous situation for mama or baby
the reason we spent so much time talking about where to give birth is that it's
really going to help inform your decision about
who is going to be your ob provider so if you are someone who is planning a
birth outside the hospital or a home birth again please please please make
sure your birth attendant is someone who has the appropriate training education
and licensure as we discussed previously if you're part of the vast majority of
women who will be giving birth in a hospital setting
your options for who your ob provider may be a bit more diverse
this is going to depend a little bit about where you live and what other
medical conditions are affecting your pregnancy
but could be anything from like an ob gyn
maternal fetal medicine specialist a family physician or even a midwife who's
certified to deliver babies in your hospital so if
you are someone who has complex medical issues yourself or you
discover that your baby has a complex medical issue or fetal anomaly
you will likely be referred to a higher level of care
with a maternal fetal medicine specialist so these are ob gyns who have
done three additional years of training in all
things related to pregnancy and high risk obstetrics
and family physicians also deliver babies so they classically see patients
of all ages and are primary care for all sorts of medical conditions including
labor and birth so if you live in a rural
area a family physician may be the only physician option you have available but
even if you live in a highly populated area
some of the benefits of going to a family physician is that you may already
be seeing them for your medical care and they could continue to care for you
and your baby after birth so the next option is an ob gyn obgyns
are physicians that have done four additional years of
specialized training in all things obstetrics and gynecology
so they are specialists in all things related to labor
birth and postpartum they are often the most experienced baby catchers in the
hospital and are trained in emergency procedures and a c-section
if that's something that arises during your birth process
and then also midwives could be the person to be your ob provider
they classically provide holistic care for pregnancy
birth and the postpartum periods if practicing in a hospital they're usually
supervised by an ob gyn and may be a good midway choice for
those of you who are looking to have less medical intervention with your
birth process but still want the safety of delivering
in a hospital even if you do choose the midwife root
you could still get an epidural could still have ultrasounds or even
continuous monitoring throughout that birth process
if that's desired or needed so with all of these options in front of you
at the end of the day you just need to pick what feels right for you
and one of the best ways to do that is to talk to women in your area who have
recently given birth talk to your friends
ask them what group they saw ask how they felt about their providers ask what
their experience at the hospital was like
because they have recently done it and have a lot of insider information
absolutely and some specific questions you might want to consider
are you know is this a group of providers is it a solo provider
or if it is a group does this group also have midwives if it's a group practice
you're going to want to find out if you're going to see the same provider at
all of your prenatal visits or if they rotate so that you meet all the
different providers in the group and if it's a solo provider which is
pretty rare nowadays uh you'd want to know who would be
delivering your baby if that person was unavailable
you're going to want to find out which hospital that this group or provider
delivers at and then it's also really good to find
out for this specific provider or group how do they feel about things like birth
plans episiotomies epidurals vbacs etc and these topics
we're all going to be covering in the upcoming months as we think about our
own plans and hopes for birth and please please remember that if the
first provider group you meet doesn't feel like a good fit if
you can keep exploring because it's really important that you
have a good therapeutic relationship with your provider
and at the end of the day all this planning well great
may have to go out the window as in things with medicine things can change
and you may have to have some acute changes to your plans and so
with that if you are on your sixth week of
pregnancy it is time to start thinking about making that appointment for a
confirmation of pregnancy ultrasound where a sonographer will use
a transvaginal ultrasound to look and make sure that that little
embryo is in your uterus hey everybody i am here at the doctor's
office about to go in for my early ob scans gonna make sure this
little embryo is in the uterus i'm about six
weeks and three days and so should see a heartbeat today
i'm here by myself this is pregnancy karen
kovid got my mask ready to go i'm gonna make sure the stenographer
prints me lots of pictures to take home to kurt
wish me luck oh kurt's gonna love this
oh wow look at the arms those are arms oh
this is awesome head is to the right tail is to the left
so today sarah went for her six week confirmation of pregnancy visit with
transvaginal ultrasound a little disappointed i didn't get to go
with covid and partner restrictions etc etc
but she did at least bring back some really cool pictures for me the first
here you can see they actually take a measurement
of baby's length this is to verify dates uh and from what we know of
sarah's lnp these both match up uh saying that she's six and a half
weeks along so far they also do an m mode through baby's
heart we get to see baby's heart beating for the very first time
this is especially exciting to me as pediatric cardiologist
and i'm sure it will be exciting to all of you to get to see your baby's heart
beating already and then finally baby's first message to
dad don't know if you can read this or not
but it says hi daddy uh of course this was typed in by the sonographer but i'll
take it uh so excited to get to watch this
little baby grow over the next 30 plus weeks
that is it for us this week please leave any comments or questions you have below
about choosing a provider or choosing where to give birth
and if you've done this recently let us know how it went let us know how you
chose a provider we're really thrilled to be getting
advice from you all and the comments section can be a great place
for all of you expecting parents to be supportive for one another so please
leave a comment click subscribe and come back and see us next week for
week seven of pregnancy see you guys
we're doctors but not your doctors anything we've said in this video is for
education or entertainment purposes only it is not medical advice any specific
medical questions you have should be directed to your provider