MrsSparkle10: I had my first appointment at 11w3d (I was certain, though). My appointment went down like so:
Lots of questions about your medical history: LMP, symptoms, genetic conditions on either side of the family, if you smoke/drink/wear a seatbelt, etc. I did get an ultrasound at my first appointment…I figured they’d just use the Doppler. They went for a transvaginal one (…the assistant could not, for the life of her, put in the correct dates, so the doctor thought I was only 7 – 8 weeks when she came in).
Even at the time, I was thinking, “I’m far enough along, WTF are you doing?” but just didn’t bother with saying anything. They did an abdominal too and ended up getting a much clearer image. The fact that I’m overweight probably also played a role in their decision to try the transvaginal first.
There was a very clear heartbeat for us. Honestly, if they couldn’t pick up the heartbeat on an ultrasound or a Doppler, or at least try to zoom in to see it, it would be a very bad sign (that is, of course, assuming you truly are 11 weeks).
They almost always do a pelvic exam, even if you’re up to date on your pap (as I was).
The suggestion of looking up episiotomy and c-section rates is also great. I didn’t bother at my first appointment because I knew I’d be switching from an OBGYN to a midwife in the practice on my next appointment, so I’ll be asking her. But I think it’s very valid to ask things like:
1. Under what circumstances would you usually perform an induction, membrane sweep, c-section or episiotomy?
2. If I start having bleeding or other symptoms, what should I do? Should I call the office, call you directly (this is usually addressed, but just in case)?
3. What is the appointment schedule like?
4. You will likely be scheduled for a nuchal translucency screening for your next appointment (usually done between 11 and 14 weeks). This involves an ultrasound and blood work. For each test that’s offered, ask: is this a screening test (which can give you your odds of having a child with a certain condition) or a diagnostic test (i.e., the results are definitive; it’s “Your baby has this” or “Your baby does not have this.”).
Ask about the risks involved for any sort of testing you are offered.
5. Ask about what sorts of pain methods and labor methods your OBGYN/midwife is open to. Some people will wait longer to ask this, but my philosophy is that I want to know ASAP if we’re compatible. If they’re the “you’re going to have your baby on your bed, likely flat on your back, usually with an epidural” type, it wouldn’t be for me.
I’d ask about the risks for some of that too — you also want to know right away if this is a doctor who’s going to tell you the truth or if he’s going to sugarcoat it. I.e., if a doctor didn’t tell me the risks with an epidural, but just reassured me, “Oh, it just takes away the pain, I give it to a lot of my patients,” I would be gone. That shows me that he’s only looking at one side of things, and that he isn’t giving me the full information I need to make an informed decision. Of course, I can look this up on my own as well, but I think it’s incredibly misleading — and you have a doctor for a reason.
6. Ask what you can do to prevent some of the biggest problems in pregnancy — gestational diabetes, preeclampsia and others being among them.