What to do after a positive pregnancy test
When I experienced my positive pregnancy test, I was so excited! However, aside from booking an appointment with my family doctor, I didn’t really know what my next steps were. So, after two pregnancies (and two babies), here’s what you need to know once you see that positive.
Confirm with beta-hCG
This may seem obvious. A urine pregnancy test is great to confirm a pregnancy if you notice that your period is late. But, testing via serum is important especially to see that number. When you go to the lab, they will assess your beta-hCG levels (which is the pregnancy hormone). This number will give us a confirmation (hopefully), and a baseline.
In most cases (where there is a viable pregnancy) beta-hCG doesn’t need to be re-checked. However, if the number starts off low - there may be a subsequent test done to determine how it is rising.
You may also notice that many vials of blood are being taken during that appointment, because a lot of screening needs to be done in the first trimester.
Choose a care provider
In Ontario, you can choose between a few options for prenatal care. These include:
Family Physician Obstetricians: Some family doctors have obstetrical training. Women’s College Hospital has a team that you can self refer to (or have your family doctor refer to them).
Obstetrician-Gynecologist (OB/GYN): In my experience, my family doctor asked if I wanted a referral to a particular OB or hospital. However, I didn’t choose this route. Talking to friends and clients though, if you do not have a high-risk pregnancy, you may not see your OB until your 20th week of pregnancy. Your family doctor will manage your pregnancy until that point.
Midwives: I chose Midwives for my pregnancies, and I loved their care. If you are even considering Midwifery care, then it’s best to book an appointment with them ASAP. Midwives are incredibly popular (at least here in Toronto), and that first appointment will give you an idea of how they can support you during your pregnancy and see if they are a good fit for you. This may happen around 9-11 weeks pregnant in my experience. I’ve written an extensive post about this, but you can still give birth at a hospital and have an epidural if you choose midwifery care. If you have your pick of midwifery clinics, then you may want to choose which hospital you’d like to deliver at (even if you choose to have a home birth - things might change) and go from there. Usually you cannot choose your midwife. In a subsequent birth, you might get the same team!
Review your supplements
When I see clients early in the first trimester, we go over their supplements and determine if they’re still safe to take or if we need to adjust dosages. This type of appointment is helpful for people who were doing IVF treatments and have been taking quite a number of supplements. Similar to those with PCOS who sometimes have a laundry list of supplements.
There are certain supplements that could be helpful, particularly if you have a history of deficiencies (ex. iron, vitamin D, etc.) or are vegan/vegetarian.
Cut out alcohol & more
Another obvious one, but worth a reminder. After seeing a positive pregnancy test it may be beneficial to cut out alcohol, tobacco, other illicit drugs.
When it comes to food:
Raw or undercooked eggs should be avoided unless pasteurized eggs are used
Certain types of fish high in mercury should be limited. Pregnant women should limit their intake of tuna (fresh and frozen), shark, swordfish, marlin, orange roughy and escolar to no more than 150 grams (5 ounces) per month. This pdf from the City of Ottawa has a great visual.
Soft-ripened cheeses, deli meats, and refrigerated ready-to-eat foods (including cheese from unpasteurized milk) should be limited as they may cause listeriosis - which is quite serious in pregnancy.
Prep for nausea & vomiting
Nausea and vomiting during pregnancy was the worst pregnancy symptom for me. There is medication that your family doctor can prescribe that can help reduce the nausea - but it’s not an acute medication (like taking a pain reliever for instance). You need to continuously take it in order for it to work. Sometimes I have clients taking it all the way until the third trimester (maybe at it’s lowest dose) because it keeps the nausea and vomiting at bay.
There are also evidence-based ‘alternative’ treatments like ginger, Vitamin B6 and acupressure/acupuncture that can also be helpful. In my first trimester visits with clients, I’m often preparing them for these symptoms and outline what they should have at the ready. Check out this blog post that I wrote outlining what these supplements can do.
I’m often asked if acupuncture is safe in the first trimester, and it is - as long as the ‘forbidden’ points are avoided. The common points used for nausea and vomiting are considered safe in pregnancy.
Next Steps
I hope this post was informative. If you’re likely to start with any of these right now, check to see which midwives service your area. It may be worth a chat to see if someone is available for your birth.
Naturopathic Doctors are well positioned to help with the rest (as we obviously don’t ‘catch’ babies). I personally like to see clients at least once in the first trimester to review lab results and diet, discuss risk (ex. preeclampsia or gestational diabetes), and support any symptoms that might be causing distress. If you’re in Ontario, Canada and would like to learn more about my approach or book an appointment, I’d love to see you virtually or in-person.