Let's talk about seeing a GP in the lead up to getting pregnant. I'm not talking about when you ARE pregnant - I'm talking about the potential benefits of being proactive and seeing them BEFORE you conceive.
Why see a GP before getting pregnant?
The FitRight Women’s Health GP’s tell me that so often women make their first appointment to see them when they are already pregnant, and they silently wish that they had thought to come before conception as there are so many things that could and should have been implemented earlier.
It may be perceived that a preconception consult would only be necessary for those who have identified health issues - but actually it’s valuable for anyone planning a pregnancy to ensure the best possible start for both the parents and the future child.
Some couples may think that this is the realm of an obstetrician - and this can definitely be the case, you can see an obstetrician before getting pregnant. But it’s important to know that another, perhaps more easily accessible,option is to see a GP who specialises in Women’s Health and Perinatal Health - like the GP’s at FitRight HQ.
It’s recommended to book a Preconception Consult at least 6 months before you plan to get pregnant - but it’s never too late!
What would the GP cover in a ‘Preconception Consult’?
Here's what a Women's Health GP consult would entail for a patient who would like to fall pregnant in the near future:
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Reviewing medical history and making sure that everything is optimised before falling pregnant, including making sure that medications are pregnancy-safe
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Identifying any risk factors that might make conception, pregnancy, delivery or the post-partum period more complicated and making a plan to address these
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Checking vaccination history and immunity to certain diseases, such as Rubella, which can cause pregnancy complications
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Discussing and organising preconception genetic carrier screening
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Ensuring that the appropriate pre-conception supplements are being taken, taking into account that woman's unique medical history and risk factors
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Recommendations in pregnancy around diet, exercise and things to avoid
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Discussing what can be done to improve the odds of conceiving and when to come in for a review if you're not falling pregnant.
Why see a GP in early pregnancy?
What about seeing a GP in those first weeks where you know you're pregnant, but you haven't told any/many people yet?
Women can be really symptomatic for common issues like nausea and constipation and keen for some advice. There are likely to be lots of questions, and women are obviously very keen to do the best things possible for their health. But a first appointment with an Obstetrician or midwife often doesn’t occur until closer to 12-16 weeks, and this is where a GP appointment with a practitioner who really knows about prenatal health can be extremely helpful.
What would the GP cover in an ‘Early Pregnancy Consult’?
During an appointment with a GP in the early weeks of pregnancy, they would run through medical screening questions, any relevant examinations and ordering tests, and they would also discuss some useful extras such as sharing tips, resources and local knowledge.
Here’s what a consult might include:
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Discussing dating: the first day of your last period and usual cycle length is helpful here
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Management of any symptoms experienced: nausea, vomiting, constipation, tiredness, pain, bleeding
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Exploring medical history: previous cervical screening results and pregnancies including any complications and birthing experience/preferences for the future
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Checking current medications: safety and discussing supplements
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Social history: getting to known you and your situation, for example FIFO work or partners, support network, exercise preferences
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Discussing family history (eg. cystic fibrosis/spina bifida) and genetic screening test options
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Physical examinations: abdominal exam, breast check if appropriate, listening to heart and lungs
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Investigations - blood tests, urine samples, timing of dating scan if previous early pregnancy loss, counseling regarding NIPT(Harmony)/ second trimester screening
The Women’s Health GP can then help to navigate pregnancy pathways, such as private obstetricians, public hospitals, birthing centres and private midwives. In Perth, we are lucky to have all of these different options so it's useful to take time to discuss these and make sure women know what's available.
Over the course of the next few appointments through pregnancy it can be useful to talk about birthing and feeding resources to prepare for the next chapter.
Why are the GP’s at FitRight HQ so perfect for these consults?
At Fitright HQ we have the benefit of longer appointment times (45 minutes is the norm for initial appointments), which means the GP’s have enough time to discuss these areas in depth, they have more time to answer questions, and they have more time to really personalise care.
The FitRight GP’s love being able to empower women to walk out of their appointments having answered questions that they were uncertain about, and to support them through their journey.
Another benefit is that they have the rest of the multidisciplinary team to refer these patients to. Many women in the preconception or early pregnancy phase could benefit from input from a Women’s Health Physio, a Musculoskeletal Physio, a Sexologist or a Remedial Massage Therapist.
For example, here's what a Women's Health Physio consult in the preconception or early pregnancy period might entail:
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Screening for bladder and bowel health, and teaching optimal fluid, fibre, and toileting habits
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Screening for sexual dysfunction and helping with any muscle-related issues that might make conception harder, such as vaginismus or overactive pelvic floor muscles.
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Pelvic floor muscle assessment and diagnosing any weakness, overactivity or other issues that require the implementation of a regular pelvic floor exercise routine
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Review of general exercise routine and early discussion about how and why this could be altered to be 'pregnancy friendly', and/or how it could meet the WHO guidelines for pregnancy health.
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'Core muscle' assessment and reviewing 'pressure management' technique for common abs exercises
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Review of any current or past musculoskeletal injuries or pain that may impact on pregnancy, and that could potentially be helped before conception.
