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I would make the appointment with your primary care doctor first to make sure the "plumbing" is in good working order, but may start looking for a midwife so you know who you will be going with when the time comes.
Depending on the amount of testing you feel comfortable with or the amount of testing you can afford, my OB/GYN gave me one test at my yearly exam and then recommended I come back when we were ready to start (which might not be for a while now), but he said we could do the rest of the testing later. As an aside, the testing he ran was to see if I was a carrier for a particular disease which looks at your genes. Any kind of genetic testing like this can get pricey, so if that is a concern, you should ask ahead of time about the cost.
I'm not TTC, but at my annual exam, my ob/gyn gave me the speech about getting in shape for having children. She went over the medications that I take & reviewed which might cause concerns if I got pregnant. She also mentioned some blood tests I could get to test for certain nutrient deficiencies and offered me a prescription for pre-natal vitamins. If nothing else, it might be worth it to go to your doc so you can get a script to start taking the vitamins.
I went to my current ob/gyn even though I will probably have to switch doctors when I'm pregnant because of insurance stuff. I got some genetic testing done for diseases that my background makes me susceptible to. Otherwise, it was mostly a regular annual exam. He recommended just taking over the counter prenatals about 2 months before we start trying.
I would say go to your current doctor for now, then start with the midwife once you're actually pregnant.
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We are planning to start ttc in May/June. So I'm thinking it would be a good idea to have a pre-conception visit with my doctor in the next few months, to make sure all systems are go. Two questions for y'all:
1 - My current primary care doctor is a gyn, but does not provide maternity services. I'm planning on using a midwife for care during my pregnancy (still part of the same health center and coverage). Should I use my primary care dr or the midwife I hope to use once pregnant for this visit?
2 - Any particular questions or topics that you think are really important to cover, or tests to have done? I've been doing lots of research, but there's still so much out there! I take a lot of supplements now, and I know I need to go over the list with someone for what's safe before ttc.
Any advice is much appreciated!