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Second Prenatal Appointment

I'm very happy to say that my second checkup went well. I got to see the fetus on the ultrasound (it's a fetus now at 10 weeks, not an embryo!) and it looked so much bigger than last time! I could see the head, and little arm buds, and then, the heartbeat, which my doctor said was good and strong. She also repeated the statistic that now I have a 5 percent chance of miscarriage.

"What chance will I have if things look good at week 12?" I asked her.

"Well...the same. I guess you could say that 10 weeks is the new 12 weeks," she said.

So, I'm thinking that she feels I'm over the first trimester hump in a way? I'm still waiting to tell everyone I'm pregnant until after the first genetic screen we're getting at 12 weeks, but it's nice to know that my obgyn feels I'm in a relatively "safe" place. Does that mean that normal pregnancies, once they reach the first trimester mark, continue to have a 5 percent chance of miscarriage until delivery? I'll have to ask my obgyn to clarify that.

One thing I did ask my obgyn at this appointment: Could she please check my thyroid function. No, I don't have a big reason to suspect that I have a thyroid disorder but at work, I recently met with the president of the American Association of Clinical Endocrinologists, a lovely and helpful doctor named Richard Hellman, and he mentioned how important it is to screen for thyroid abnormalities before pregnancy (a thyroid that isn't functioning properly during pregnancy can harm the fetus). So, after all the screenings I had made sure to get before conceiving (the blood screen for immunity to diseases, the Pap smear, the dental appointment, the vaccinations, etc.), I was never told (and had never read) to get my thyroid checked. Great. How did I miss that?

Well, apparently, according to Dr. Hellman, many doctors miss this and don't realize that thyroid function should be checked (thyroid disorders often go undiagnosed for a long time), and he was talking to magazine editors to get the word out about it. (You'll be able to read about this and more on preconception health in an upcoming Parenting magazine article I'm writing, by the way.)

So, I told Dr. Hellman that I was expecting and no one mentioned anything to me about thyroid function before or after I got pregnant. He was very nice, but suggested I call my doctor about it THAT DAY. I didn't panic when he told me this news. But I was concerned — and mad at my stupid doctors for never seeming to be on top of anything remotely current. What else are they going to miss next?!

Dr. Hellman followed up with me after our meeting with a very thoughtful e-mail about what I should tell my doctor, etc., and so I went to my obgyn armed with his e-mail just in case she thought I was paranoid to ask for a thyroid check.

"Well, it's not standard to do a thyroid panel screen before pregnancy or during, but we can do it," she said.

Why do there seem to be so many important things that AREN'T standard?! I thought. Each obgyn takes your blood when she feels like it (my doc didn't take it for some reason at my first prenatal appointment when all the pregnancy books said she would; instead she said she'd take it at my second visit); each obgyn sees you for the first time in your pregnancy when she feels like it (anywhere between 6 weeks and 10 weeks), each obgyn screens for different things it seems; and each obgyn wants to see you at different intervals and does ultrasounds on various schedules. Why aren't these things standardized so that we, the patients don't have to constantly keep making sure we're getting proper care?!

"Thank you," I said instead of what I was thinking. "I like to be screened for as many things as possible."

So, with that, the nurse drew my blood to check out the stuff they were going to screen anyway (I had to pump my doc for information about exactly what was being screened — it included Hepatitis, HIV, toxoplasmosis, Rh factor, blood type, and more), and to check my thyroid function. Phew.

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