In this podcast episode,Trish is joined by Trystan White, a midwife and former labor and delivery nurse.
Together, they discuss pregnancy from weeks 8 to 12.
- Early signs of pregnancy
- Preparing for the first prenatal visit
- The importance of choosing the right healthcare provider
Trystan also shares information about common genetic tests during this period of pregnancy, tips to manage morning sickness, and the importance of a suitable diet.
The conversation also touches on matters like handling prenatal appointments, testing in pregnancy, advocating for one's health, and the right to change a healthcare provider if one isn’t comfortable.
00:00 Introduction and Guest Introduction
01:01 Reminiscing About Nursing Experiences
02:13 Transition from Nursing to Midwifery
03:26 Personal Adoption Stories
08:39 Pregnancy Unpacked: Weeks 8 to 12
12:38 Choosing a Healthcare Provider
14:48 First Prenatal Visit and Tests
27:05 Dealing with Morning Sickness
30:50 Diet and Nutrition During Pregnancy
33:42 Scheduling and Preparing for Future Appointments
34:44 Choosing Between a Midwife and an Obstetrician
41:44 Changing Providers and Final Thoughts
Trish also covers the basics of fetal development during this critical stage of pregnancy!
DM @labor.nurse.mama on Instagram the word “PROVIDER” for a list of questions to ask your provider!
Connect w/ Trish:
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Next Steps with LNM:
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If you have a scheduled cesarean, take our Belly Birth Masterclass and own that experience.
If you are a newly pregnant mama or just had the babe, you want to join our private pregnancy and postpartum membership, Calm Mama Society.
Remember, my advice is not medical advice. Always discuss what you learn with your team. See my Disclaimer here! Also, We make a small commission from some of the links (you don’t pay any more for using our links); however some of the recommendations, we do not earn anything; we love ’em and want you to know about them.
Trish: [00:00:00] Hey mamas, welcome to the birth experience with labor nurse mama, yours truly. I am so happy to have you here. Make sure you hit subscribe and please leave us a review. We are doing a drawing at the end of each month. If you leave a review and send us an email and let us know, we're going to send out a nice little prize to one lucky winner every single month.
Okay, you guys, we're going to unpack your pregnancy. So 8 to 12 weeks is what we're talking about today, and it's a two punch part. I'm going to chat with my friend Tristan, who I'm so excited about. She was a labor and delivery nurse that I worked with for many years on night shift. We got into some trouble together, so I'm super excited about having her here, and I know you guys are going to love her.
And then after I chat with Tristan, We're gonna talk [00:01:00] about what's going on with your little bean, your little baby. So join me as we unpack weeks 8 to 12.
Hello, everyone. I am, I know it, never mind. I say this every episode, but I really truly am so stinking excited about this episode. I have a friend of mine that I've known for a very long time and haven't seen for a long time. Who is going to join me today on part two of Pregnancy Unpacked, where we're going to talk about your pregnancy from week 8 to 12 and Tristan, I, it's funny you guys, I had to confirm her last name because we worked together years and years ago when I was a newbie labor and delivery nurse and I only have that last name cemented in my head, but please welcome Tristan White, and I'm going to let her tell a little bit about herself.
Trystan: [00:02:00] it's good to be here. I'm so excited. I know, I'm so excited too, it's so good to see you. You say you were a newbie nurse, I was not that, I was just a couple years in myself at the time.
Trish: Now we have a long time experience.
Trystan: Oh, I get to the labor and delivery desk now, and I go. Oh, y'all are such babies now, but I love it.
Trish: I love it. Back when we worked together, Tristan was a labor and delivery nurse and we worked on the night shift and we had such a fun crew.
Trystan: We did. We really did. And there's a few of the crew left. Very few. At night? We had, there's a couple, there's a couple left but they're not all night
Trish: shifting Okay.
I was about to say. They came to the sunshine. Yeah. Who in the hell can do it at night? The older you get, it kills you. It does. It's so funny. I did night shift as a, because I left there and started doing travel and I took night shift for the first couple years and [00:03:00] then all of a sudden I was like, wait, I can choose which shift I want.
Why am I choosing night shift? It was awful. And then it was it was so wonderful. Oh my gosh. So Tristan is no longer a labor and delivery nurse. Tell them about you. So
Trystan: I did labor and delivery for about 16 years in some different roles, charge nurse, management, did some education for the nurses for a while.
And then two and a half years ago now I finished midwifery school. And I'm now a CNM working with a great group of other nurse midwives. And we deliver in the hospital and it's great. And how old is your son? He's
Trish: nine now. That, so I knew he was neck to neck with Grayson. Yes. Cause Grayson's nine.
He turned nine in December. So Jace turned
Trystan: nine in October.
Trish: Okay. I knew they were pretty close. So I love that you went from labor and [00:04:00] delivery and I think the best midwives are the ones who worked as a labor and delivery nurse.
Trystan: I think so too. Cause you've got that wealth of knowledge behind you.
Trish: Yeah. And you know all about the 3 a. m. dances and the weird things we do and all those things. So yeah.
Trystan: The night shift has to carry on
Trish: with you. Yes. Yes. Absolutely. So tell everyone a little bit about your story with Jace.
Trystan: We became parents by adoption. We, I always knew. I had reproductive issues, growing up and knew that pregnancy was probably not going to be the route that I was going to become a mom.
And we tried for a few years and just between my husband and I decided advanced fertility treatments were not going to be the decision for us and decided adoption was the road for us. And we. Thankfully had it all fall into our laps very quickly. And we got a phone call at 10 45 at night that, Hey, there's a, there's this little baby here and you have been [00:05:00] chosen to be his parents.
And, eighteen hours later we were walking into the unit where I worked, funnily enough to meet this little boy and he was 24 hours old at the time and he has rocked our worlds and kept us running ever since.
Trish: I bet that walk into the unit that day was like, Something you'll just never forget.
Oh, it's, it
Trystan: was a difference cause I've walked onto that unit so many times at that time and it was just different knowing that I was walking in about to meet my child. Yeah. That's it. I'm going
Trish: to tear up thinking about it. No, it gives me chills because I remember. Meeting Sitara, my daughter, who's adopted the first time and it's making me, oh my gosh, I'm getting emotional myself now.
I remember walking, she was in India and she was in an orphanage and my journey was not as simple as that. But it's funny, I wanted to [00:06:00] ask you, did you use Mike Jennings by chance? We did. Okay. That, way. Yes, it does.
Trystan: That man is amazing. Oh
Trish: my gosh, you guys, so I, we both lived in Chattanooga and there is a man who is just a saint when it comes to adoptions.
And several of my friends were adopting locally while I was waiting for Satara. And some of them got two babies home before I got Satara home because international adoption is so difficult. But that was where my daughter was born. And I knew it. I knew beyond knowing that's where she was. But it was such a difficult journey and Mike Jennings was my lawyer, but we did not do it locally.
I had to ask you that when you said it was quick. I was like, I know who got I know. He's just he's amazing. Yeah. Anyway, and it's not quick for everyone. No. But it just. A lot of people it is.
Trystan: Yeah. Sometimes it does. It surprises you.
Trish: And it's, I hate to say it because it sounds terrible, but even when I was [00:07:00] adopting Satara, they were like, what color skin would you like?
And I was like skin would be fine. Any skin. Any red. Yeah. And that was. And, yeah, that's how we were. Like I just felt very strongly the right baby would be matched with us. And I was so appalled by those questions. And I think that when you go into to, The adoption world and this is my personal opinion, I may get some hate over this, but I feel I know Satara was my daughter, and she was born in another country, but it was only Satara, and I didn't have to worry about all the details that I was going to find her and she was going to find me.
And I didn't need to put, I I did say I preferred a girl because I had four boys at the time, but I was, I just knew the right baby was coming my way, but I knew in my heart that it was going to be a girl. And we were the first adoption, adoptive family for this agency and the last because India was so [00:08:00] difficult.
And so she was the only baby that literally they opened for me and closed for me that's how I feel so anyway that story so so you became a midwife and you are now doing that which is so different but similar yes now you can break water and all the things we couldn't do
Trystan: yes but also get to see people in the office and develop that relationship across the pregnancy and even, when they're not pregnant, across the GYN care and, just a lot across the lifespan.
Trish: So I, we joke inside of my my birth community with my birth students and stuff that there's medwives and there's midwives. I pretty much know which one you lean into because I've worked with you, but would you agree that there are some midwives that are really no different than doctors? Yes,
Trystan: I will.
I'm just going to leave
Trish: it at that. I know, I always joke that they probably have an America's Most Wanted picture of me in [00:09:00] all the labor and delivery units because I'm so open and have a very strong opinion. But anyway, so we're going to talk today about weeks 8 to 12. So I'm trying to do this series.
for women to have a resource because you know how it feels. And sometimes, everybody has a different learning style. Some people want to consume reading things and some people want to hear things, and I thought it would just be fun to, to talk to a midwife about some of these questions.
So I have some questions for you. And I figured we would start with, so last episode or series I talked about zero to four weeks, finding out you're pregnant. Although I would say there are some people who find out between eight and 12 weeks. Would you say
Trystan: that? Yes. Yeah. If you've got irregular periods or you're breastfeeding and you don't know when your last period was or, there's a lot of reasons that you're going to find out a little bit later.
Okay. Bye. Bye.
Trish: Yes, so what would you say, like, [00:10:00] when we talk about signs early signs of pregnancy, what do you feel like the most common that your mamas report to you?
Trystan: It changes in appetite, nausea, vomiting, so those are two of the biggest ones. I would say probably breast tenderness. And fatigue or, to the next, would be the next top two.
Trish: For me, for my pregnancies, I felt like I had you know how when your foot goes to sleep and then it's waking up? That's what my breasts felt like. And then, I could not stay awake to save my life. And I, it's funny, I was just having a team meeting. I have three doulas that work with me and I was just meeting with them and we were talking about the differences between my husband and I, which, my husband Steve, who I was not married to back then, but he's amazing and he is just so emotionally mature and he cries during movies way more than me and that, because I don't know, like I'm just not a movie crier.
Some I can't hold back. [00:11:00] But, we were talking about that. That's how I knew I was pregnant because I would suddenly be crying during movies or commercials or like especially Hallmark commercials or things like that. So that emotional up and down was a huge oh no, the last time you cried during a movie you were pregnant, which of course I was pregnant a lot, I cried. I have cried a lot during movies, I don't know. Anyway, so those are some of the things you guys can expect to feel some physical signs. Another physical sign is that your breasts suddenly look like you have a blue vein roadmap. That can be another sign as well, which is so bizarre.
But definitely with all the that, Blood flow going and yes, the tenderness you might feel like you don't want to wear a bra anymore. That's always fun. So Let's talk about So because you're a provider and mamas at their first appointments. I wanted to talk [00:12:00] about like the importance of having a provider and prenatal visits?
Trystan: Prenatal care is really important with pregnancy outcomes. We talk about with pregnancy, a lot of people focus on the end result of labor or delivery and getting that baby. But in order to have that healthiest outcome at the end, you've really got to start the care early on because early care can identify some of the risk factors that may pop up later in pregnancy.
Gestational diabetes risk, high blood pressure risk, anything genetically, or do you have a family history of things that could just complicate your pregnancy? And so we can mitigate those risks early on and prepare for those.
Trish: Okay, so when would you suggest that someone, starts choosing a provider and how do they go about that?
What's the normal process? So
Trystan: ideally, we like to see people in the office between [00:13:00] seven to ten weeks we're going to get people in. So as soon as you pee on that stick and find out you're pregnant, you need to be finding a provider. If you don't already have a GYN provider that you see routinely for pap smears and things.
So Start, asking your friends who they see, why they like their provider and calling around and seeing who's accepting, new OB patients at that for that time or your insurance That's a big one. A lot of providers are in network or out of network If your insurance doesn't have maternity care It may be a state's insurance that you're having to get on and so some Providers are going to be more accepting of that insurance than others So there's a lot of factors that go into choosing a provider right in the beginning.
Trish: What about choosing based on where you want to deliver? Do people do that?
Trystan: Yes, that's a big one too. That's one of the biggest questions you're going to need to ask when you get there. Because sometimes you'll be able to find it on their website. Or [00:14:00] sometimes their website will be like, Hey, we're affiliated with this hospital and this hospital.
But you get there and we are affiliated with that hospital, but maybe we just do surgeries at that hospital, but we prefer to deliver it at this other hospital. So that's something that you would want to add to your list of questions at your 1st prenatal visit. Okay.
Trish: And if they say they prefer to deliver at A, but you want to deliver at B, do you think a lot of providers are, have some wiggle room on that?
Do you think they're pretty hardcore on that or does it depend?
Trystan: It would really depend. It would be a conversation of sometimes say for instance, here in town, we've got a hospital we prefer but we have privileges at another hospital. Primarily we go to that other hospital. If you have, if your insurance requires you to go to that hospital, that's why we have those privileges there.
We prefer another hospital mainly because we're right across the street from there. And we prefer that because we can be more present. We're right there during the day.
Trish: Okay, so they have booked their first appointment and they [00:15:00] are super nervous and excited and all the things. What would be some ways that they can prepare for their visit?
Is there anything they need to know or to bring? So
Trystan: bring your insurance cards. When you come, because we're going to, the billing department is going to run your insurance and, bring your list of questions. Most providers at first appointment, you're going to have an ultrasound. We're going to confirm that your dates that baby's measuring.
Match up with your last period make sure that everything looks good. Or have a baby that's in the uterus. And a lot of people aren't prepared for sometimes it's an abdominal ultrasound. Sometimes it's a transvaginal.
Trish: I was just heading in that direction, but what's really.
And I remember when I got pregnant with Lainey and I went in for that first visit and I was like, what the hell is that? And what do you think you're going to do with it? Yeah. So [00:16:00]
Trystan: I've had several people come and go, did not expect that. Yeah.
Trish: I just got violated.
Trystan: Yeah, so they, we can't see Abdominally. Yeah,
We're gonna go in vaginally with an ultrasound one to see baby and confirm heartbeat and things like that.
Trish: Yeah. I love that. Tristan's a, like a labor delivery person because I'm very real and blunt around here, but the thing that was so funny to me, I remember laying there and the lady was putting a condom on it, , and I was like.
I was like, my eyes were like darting around like a deer trapped in a, whatever they get trapped in. And I was like, what is happening? No one prepared me for that. I had no idea that was coming. And I was so shocked. Yeah. Yeah. So just so you guys know, it looks like a giant sex toy.
Trystan: It does. It
Yeah. And it's shocking if you're not prepared. And what's funny is I did [00:17:00] a reel with one, like I showed a picture and I think, I can't remember if we pulled the audience or what, but we got a lot of reaction out of that one. I bet. Yeah. Yeah. So they've gotten the ultrasound. What other tests, what are you what other tests are they going to have?
And then what are you going to do when you come in?
Trystan: So when I come in, I sit down and I go over the ultrasound. Yeah. Everything's great with that ultrasound. My first question to them is, what are your biggest questions? Cause majority of the time they come in either looking like a deer in the headlights because it wasn't something that's planned and they're like, I have no idea what I'm about to do.
Or people come in with a laundry list of Everything, but we're going to review, what foods are recommended, what, have you started a prenatal vitamin? What symptoms are you currently having? How are you currently managing that nausea? If you're having it. We're going to go over blood work.
We typically do some lab draws at that first visit.[00:18:00] We want to get blood type. A lot of places we do an STD panel. So that's something that people don't expect the first time. We're just going to make sure everything's all clear at that first visit.
Trish: And I know that they also are going to start their normal things that they're going to be having at every visit as well, correct?
So what are some of the things that will begin, like blood pressure and urine and Blood pressure,
Trystan: urine, weight. We're going to be checking weight. It makes sure we're not losing too much weight if you're having a lot of nausea vomiting. We also, you know towards the end of pregnancy don't want to be gaining too much weight, but we're gonna be doing weight blood pressure urine dip so expect to pee in a cup every time you go.
Trish: Yeah Don't pee right before you walk in the office like i've done before but sometimes you can't help it. You can't wait You see
Trystan: we'll give you a cup of water. We know you're gonna have to go in about 15 more minutes Yeah. So when
Trish: you say dipping urine, explain that because some people don't know what that means.
Trystan: So with the [00:19:00] urine dips, we check your urine for any kind of blood. We check and make sure you're, you don't have a bladder infection. Pregnancy, you're more prone to having bladder infections and without symptoms even. We want to make sure you're not spilling protein or ketones. There's Glucose.
There's a lot of things that with pregnancy can affect your kidneys and we want to make sure your kidneys are functioning well. And one way we can do that is looking at your urine. Okay,
Trish: so they've done those things, they're probably gonna get a lot of labs done at the first visit.
Trystan: Yes, a lot of blood work, people go, oh my word, how many tubes of blood are you gonna draw for me?
We're like little vampires.
Trish: Yeah, so you're gonna get all of those things done, they're gonna get your blood type, she, you're gonna take a history, I would assume.
Trystan: Yes, we're going to get your medical history. We're gonna ask you about your family history in detail, any thing on your father's side, your mother's [00:20:00] side bring your partner, because we're going to want to know about your partner side, not necessarily their medical history side so much, but what's the genetic history?
Is there any history of birth defects? Is there anybody that's a carrier for, thank you. Recessive traits of, any kind excuse me all of that plays, different genetic factors. We want to make sure, baby's not going to be affected by any of that culturally and ethnicity can play a role in how developmental.
And birth defects as well. So we're going to be asking those questions. We're going to ask about your sexual history. So be prepared for those questions.
Trish: Yeah. So if you don't want him to hear. Exactly. You need to know it's coming. Yes.
Trystan: No, that's coming. Because we want to know that we're starting out with a clean sexual history free of any STDs that can affect a developing fetus.
Trish: So something that I think a lot of people don't know is that. [00:21:00] If your partner has been married before and his ex had a baby, tell him some things that can play a role. Because I think it's pretty fascinating if she had preeclampsia or.
Trystan: Okay, yeah.
Trish: Okay. Okay. Okay. Which is so weird. Yeah.
Trystan: So people have heard about preeclampsia.
And more and more research that is being done with preeclampsia is actually looking into the father's genetics playing a role in causing preeclampsia. So if, his previous partner had preeclampsia, you possibly are going to be at risk for preeclampsia in this pregnancy because of. That research that has come about of father's genetics.
Trish: So it, do you guys flag them if that you do find this out? We
Trystan: do. We do. We will mark that on there, just to see how the other kids was there any complications in with those deliveries? I'm like, okay, let me just mark that. Yeah. Mark that
Trish: on [00:22:00] there. Yeah. I think it's such a weird fact that it's just fascinating.
Okay. So what about, so we are talking about up to 12 weeks. So one thing I wanted to talk about is some of the genetic tests. Some of the blood tests, the nuchal scan. If you could talk about what are those tests and what are you guys looking
Trystan: for? You'll get asked a lot about do you want to do any of the genetic screenings or even carrier screenings, especially if it's your first baby I'll start with carrier screening.
So carrier screening is just blood work. None of these are invasive. So carrier screening will. Check you to see if you are a carrier for cystic fibrosis, vital muscle atrophy, or a fragile X syndrome. Those are recessive traits that if you're a carrier for one, we would want to test the father baby about one in 30.
To 40 people or a carrier for cystic fibrosis. So if your partner is a carrier [00:23:00] as well, you've got a 1 in 4 chance of maybe having cystic fibrosis. And so that's just an example of one of those carriers. So your provider will talk to you about that kind of testing. They'll talk to you about non invasive prenatal screening.
Where we do just another blood draw, more blood check chromosomes. And we look at the chromosomes of baby, primarily for trisomy 13, trisomy 18, and trisomy 21. Most people know trisomy 21 is Down syndrome. We also look at the sex chromosomes in that test. We can tell gender. With that test, a lot of people like, yes, I want to do that because I can know the gender of the baby as early as 10 weeks.
You have to be 10 weeks for this particular test to be run. But it's so much more than that, because you get a lot of information off that test. So your provider is going to talk to you about that as well. And why it might be a good reason for you to do that based on, whatever risk factors pop up in your history.
There's, early on with depending on when you've [00:24:00] had your skin, they may do a nuchal translucency with that scan. Where they look at the back of the baby's neck with that ultrasound and depending on the measurement, it may show an increased risk for down syndrome. Usually they pair that with additional blood work and they don't base it just off that.
And if any of those are off, they'd probably talk to you about going to see a high risk doctor during your pregnancy.
Trish: So do you see more people? So let me rewind. When I was pregnant with Grayson, some of those blood genetic tests were pretty new and you had to pay out of pocket. You didn't get them included.
So are they more included now by insurance, some of
Trystan: them? Yes a clog, the governing body of the obstetricians and gynecologists are actually recommending them as screening tests now. So they're more widely covered by insurance. They're not completely, they're not completely covered where there's no cost, depending on your insurance carrier.
There's [00:25:00] a little bit of out of pocket cost, and that can range anywhere from. 50 to 120, depending on the company that your provider has contracted with for that type of test. And so that's a conversation to have when they're bringing up this test. How much is it going to cost me? And a lot of these companies do have a sliding scale payment system.
If you do not have insurance at all of your self pay and you want these additional tests, they do have assistance for these types of tests as well. Okay,
Trish: so now they have done all of that. Let me ask you this because I think it's funny. Do you think a lot of people choose to do it to find out the gender?
Trystan: One hundred percent.
Trish: Okay. One hundred percent. I figured by your face when you said that that was the case. So they've scheduled, they've come, they've seen you, they've talked to you. So what are some tips that you give [00:26:00] to moms who maybe are. Super nauseous. I hate to say morning sickness because it's all day ever.
Yeah, who named it that I don't
Trystan: know a man named it that so the first thing I try to do is b6 and unisong is my go to So there's a prescription medication called day collegious that is the same ingredients and so this is definitely something that you need to talk to your own provider about, but is something that I recommend to my patients.
Vitamin B6 is great. With for nausea, and so we'll try that over the counter 1st before going on to prescription medications, but also things like sour candies and small frequent meals and always tell my patients, especially if they're throwing up 1st thing in the morning, if you're. Waking up in the middle of the night, like you gotta go pee in the middle of the night, keep some crackers or a small snack by your bed.
Put something on your stomach in the middle of the night when you get up. That can help ease that acid [00:27:00] that you're feeling first thing in the morning. Ginger peppermints, things like that are great. And what works for one person doesn't necessarily work for another person. So it's all about trial and error?
Trish: yes, it's the same. One, what works with one pregnancy may not work with the other, but I did the same thing. I kept crackers by my bed, and if I had to get up to go, I wouldn't even open my eyes. I would just grab one, feel for it, grab it, eat it, and then go to the bathroom and then come back.
I was so sick that I'm feeling a little nauseous right now talking about this. Because it's literally trauma. I have PTSD. When you're that sick, I was so sick. So as far as what, let's say you have a mama who it's going beyond the normal sickness. What do you call that? And what do you, okay. And what do you do for that?
Trystan: So we would move on to prescription medications for sure at [00:28:00] that time period. Sometimes it's scheduled medication that you're going to take throughout the day. Sometimes we have to do scheduled IV fluids just to keep you hydrated. Occasionally we have to refer to high risk physicians to get home health to do pumps or IV fluids at home.
There's a little, hyperthesis is a different beast and I feel so bad for my patients that have to deal with it. Yeah,
Trish: can you imagine I can't imagine I have a really good friend who went through it, but I have a coaching group now where I coach women, especially in the birth space that want to turn their business into an online business.
One of my girls who is a sex coach for postpartum moms she. She still has home health, but she's feeling better now, but she was so sick. And I thought, oh, I just can't even, I can't imagine, because it's a really depressing feeling when it's just normal morning sickness or sickness, whatever you want to call it.[00:29:00]
But wow, what a especially, I know I have a lot of students who Went through a lot of IVF or whatever they did to get pregnant and then they're so sick and then they hate their pregnancy and then they're struggling with emotions and guilt and all the things and they just can't be happy about it.
So if you're out there struggling with that, we are so sorry and. Make sure you're getting the help and it's okay to take the medications and all of that. Okay, so What about diet? What do you because you mentioned that you'll talk to them about things to eat things not to eat things not to drink
Trystan: I Take a very simple approach when I'm talking about what to eat and what not to eat in pregnancy First thing I'm like don't start drinking alcohol if you've never Been a drinker and stop if you are a drinker, first of all, don't drink in pregnancy.
But as far as what [00:30:00] to eat, what not to eat in pregnancy, my, my one sentence line is healthy diet. Good, solid nutrition as best you can. First try, first trimester. is whatever you can keep down. We'll worry about health and balanced diet in second trimester, hopefully when the nausea goes away.
But first trimester, if it sounds good and you can hold it down, eat it. I don't care if it's a bag of Cheetos, okay? I really don't. If it sounds good and you hold it down, it's caloric intake at that point. But it's protein. It's Fruits and vegetables, and if it's cooked, eat it, wash your fruits and vegetables if it's pasteurized, eat it just make safe food choices, as I try to keep it as simple as possible.
Trish: I remember, so when I got pregnant with Grayson, I was on an assignment in California, and I was so sick and labor and delivery smells don't help, [00:31:00] not at all. So I used to put peppermint, like a little bit of peppermint oil, under my nostrils. But I remember I called Leigh, because Leigh was my midwife, and she was, I was so scared because not only was I sick, I was old.
So I'm like, I'm 42. I'm overly scared about everything, and I had a few miscarriages prior to that, so I was just a nervous wreck. But I remember calling her and I was like, all I can keep down are the, what are those like orange peanut butter crackers, you know what I'm saying? That is legit, yeah, all I could keep down.
And I never eat those. Like I think we had 'em maybe on the break, in the break room or something and then that's all I could keep down. And she was like, as long as you are getting something, your baby's gonna take what it needs, you'll be the one who suffers. So just get something in . And I really ate. So many of [00:32:00] those so many of those so yes, if you guys don't feel guilty at this point It's like survival of the fittest.
Just whatever you can keep down. Okay. So what about For these moms as far as going forward, what would their checkup? Like their next visit, like when would that be? And do they normally see the same provider? Or what would that?
Trystan: And so as far as visits, normally visits are every four weeks until you get to the 28 week mark.
And so when you hit third trimester, you start being seen every two weeks. And then when you hit 36 weeks, you're generally seen weekly until you have a baby. As far as who you see each of those visits, that's a question that you need to ask your provider at that very first visit, how do visits work?
Who am I going to see? Is it going to be the same person every time? Because every office is going to have a different setup. Some offices are going to rotate you through the providers and you get who you get. Some [00:33:00] offices are going to, you're going to see the same person throughout and whoever delivers your baby may be the person that's on call.
So those are all questions to. Write down and ask your provider that very first visit, how their call structure works.
Trish: Okay. And what about choosing to see a midwife or to see the obstetrician and can everyone choose that or how does that work?
Trystan: So if you are generally healthy and don't really have a whole lot of health issues, you can absolutely choose a midwife.
Transcribed Things that may knock you out of choosing a midwife is if you've had a previous C section. Depending on your location of where you're choosing to deliver certain hospitals may have different policies, certain offices may have different policies where they want you to see the obstetrician if you're trying for a VBAC or something.
But generally if it's your first baby,[00:34:00] you are more than, come on, come see a midwife.
Trish: So now I'm curious, do you do VVACs?
Trystan: We, some of our providers, we do. But not your midwives? just because of how the hospitals have their policies
Trish: set up. Which you're probably still antiquated if I know Tennessee.
Yeah. Yeah. I can get in trouble because I'm not employed by a hospital at this point, but I don't know if but I have a birth course that is just for VBACs, the VBAC lab. I spend a lot of time doing research with these mamas, and it's funny here in Nashville, we have home birth midwives that do VBACs, so you just have a range.
Trystan: A range. And across the state, it's vastly different, and I've worked at different places across the state as a labor nurse,
Trish: and it's You did travel too, didn't you? I did. I think I remember that. I remember when you did travel. I love travel nursing. I love it so much. I don't remember, did you do it after you, totally on a side note you [00:35:00] guys, but did you do it after you got married or before?
Trystan: I did do some
Trish: after, both. I thought so. Both before and after. Because I, I feel like you were traveling when I first started or you had just come back from a travel assignment when I first started.
Trystan: Probably, I was probably traveling because I was traveling in 2007. Seven.
Trish: Yeah, I think, I feel like you came back after I started there.
And I, it probably put, you probably the reason. You put the bug in me.
Trystan: I'm probably, I'm responsible for a lot of
Trish: that. It's just I learned of course I went from where we were working, where we were doing all sorts of shit backwards. So many things. God, do you remember the rates we used to push?
Potosin, again, side note. Holy smokes! And that was in a lot of other hospitals too. But not in California. Not in
Trish: no. Which is where I went. And they were like, You're what? I learned [00:36:00] more on that first assignment. It was a four week assignment. And I was like, I don't think I can continue working there.
I'm going to lose my license. This is not okay.
Trystan: Oh, yeah. Oh, girl, there, there were worse places than where we have worked together because there was some places I've been to that I was like, oh, can this be over? Can this be over?
Trish: I did most of mine in California, they're union, mostly union hospitals, so I didn't have to experience that.
But I remember being there and telling them that we had no doctor in house at night, we had no blood in house at night it was scary and we had just transitioned to high risk, do you remember that? Anyway, side note, okay, so back to the topic at hand, but that's what you get around here, you guys.
So now we, let me see, I've totally got myself off. Where are we at? So now for their [00:37:00] appointments going ahead, we've already said they're going to have the blood. They won't have blood work. Why am I saying that? They'll have the dip, the urine dip. And blood pressures. And I wanted to ask you, do you guys test for GBS early in pregnancy too, like urine?
Trystan: urine, the first urine that we do the first visit, they'll run for culture. And if GBS shows up on it, then yes.
Trish: And then they're positive. That's that. And they're positive. Yeah. Do you agree with that? Can I get you in a little bit of trouble? Because we'll just call you Mitchell.
Trystan: The jury is out on that one.
Trish: Okay. The jury is out on that one. I have a strong opinion on that. But, anyway. Okay. So I won't get her in trouble. The jury is out on that one. Okay. So I'm just trying to think of anything else while we have you on here. Now, let me ask you this, what if a patient comes to [00:38:00] their first appointment and, so what, let me rewind again, what I tell my students, especially, because I get a lot of students who come to me before they even get pregnant, and then I have some that haven't even gone to the doctor yet, because we have the pregnancy postpartum membership as well, and I tell them to really do their research, like you said, ask other moms because they're going to give you the real deal.
Don't look. Reviews online can be botched at times unless it's a screenshot with someone's name and then I always recommend to go into a Facebook, local mom's Facebook group and ask there. And then I always say, ask who was your OB, who was your provider? And then ask them if they say they loved him.
Why did you love them? Because the reasons can be all over the place and it may not be in alignment with because i've had some That you know, they say I loved them because they would induce me whenever I want that might not be exactly what you want. So Just being [00:39:00] detailed what it so and then I tell them Their first appointment like they, they can go and interview providers before they have their legs in the air.
Oh, getting a pap smear. We didn't talk about that. That's when you have smear the first appointment, right? Or not
Trystan: always. No. If you need a pap smear, generally we're going to wait until the second trimester.
Trish: Is that newer? Cause I don't think, I think they did it with me. The. First one, when I, because I literally am so bad about going regularly.
Trystan: that may be a group preference for us as the midwives. You're just more, there's just more bleeding. Things are more vascular, especially the first trimester. So we're not going to go poking around on the cervix at first trimester.
Trish: We'll always take less poking around if we can take it.
Okay. All right. I forgot about that.
Trystan: But if you're date on your pap smear, I'm not gonna go pap you during your pregnancy.
Trish: Okay. Yeah. See, I never was, 'cause I tend to just, I got pregnant a lot, so I tend to just [00:40:00] go when I was pregnant. So I was semi-regular, but okay. So what if they come and they're like, I do not like this person.
Can they change?
Trystan: Yes, you can. You have to remember that you are the one employing your provider. You are the one that. Needs to develop the relationship with that provider throughout your pregnancy. Y'all have to develop a trust in that relationship because this is a big thing. Your pregnancy and delivering a baby is a very big thing.
It's a big milestone in people's lives. And if you don't jive with that person, you can't develop trust with that person.
Trish: And you need to trust your provider. And
Trystan: you need to trust your provider. But realizing that you need to make sure you're trying to do that early on in the process because it's easier to switch providers early on than [00:41:00] later on in the pregnancy because if you get to 36 weeks and have this realization of, oh, I don't this person, it's a lot harder to find somebody that's going to take you late in pregnancy because some provide, there's a lot of providers that only take so many people due per month.
So keeping that in mind.
Trish: And I, that, this is one of the things I teach my mamas is to start asking those big questions early on that are really important to them, even about the delivery, because if you're not in alignment with that, if your provider is not going to support the choices that you have, then it's better to find one earlier.
But a lot of first time moms really don't even know what it is to know that they want. So that, that can be a little difficult, but I actually have a student who is 39 and five now probably. And she went to her 38 week appointment and her doctor really upset her and was really rude. And she just [00:42:00] switched.
Yeah, and her provider, yeah, so she switched. So you can switch, but it was hard. It was a lot of legwork. So you gotta keep that in mind as well. So it's better to really do your due diligence before you choose. And then, And then, and we do have a list of provider questions that you guys can have.
So if you, we'll link it in the show notes for you for looking for your provider as well. Thank you so much, Tristan. It was so nice to see you. It was so good to see you too. I'm so excited. And thank you so much for coming and sharing all your knowledge with everyone. Anytime. Hey mamas, I hope you enjoyed our chat with Tristan, one of my good friends who is an amazing midwife, and she was an incredible labor and delivery nurse.
I had so much fun talking to her about what to expect during this really important time of your pregnancy. But now, really quickly, Before we sign off, I want to talk about what is happening with your [00:43:00] little baby. So once you hit around 11 weeks, your baby is no longer referred to as an embryo, but is now called a fetus.
Now I always called mine a baby, I don't know about you, totally, we actually called The baby bean or whatever we decided to call it during week eight, your baby is starting to make some movements, but you're not going to feel them yet. And the baby is about the size of a little tiny kidney bean. And this is sometimes this is where people find out that they are pregnant.
And like Tristan mentioned, you can also get your pregnancy confirmed with your midwife, with your provider or at the doctor's office. Now, around week 9, your baby has all of their internal organs in the right spots, ready to go. Heart, lungs, liver, brain, kidneys, all the things. Very immature, but they're going to continue to develop.
And the thing [00:44:00] about this stage of pregnancy is that everything is developing at like hyper speed. Around week 10, your baby is going to start moving and bending their little arms and legs, and your uterus is now about the size of a grapefruit. Is that not just crazy? So crazy to me how quickly everything changes and grows and how incredible our bodies are.
Okay, side note. Week 11, the baby's little face bones have begun to are formed and their ears are beginning to develop and their eyes are developing, but they're closed. They're not going to open for a couple more months. And then around week 12, Your little kidney bean is now the size of a plum.
They go from like a kidney bean at week nine ish to a plum. How insane is that? And their body [00:45:00] parts and their little tiny organs are formed, but they just need to grow. So all the parts are there. They're just this tiny little human that Just now needs to grow and be nourished. So as we were talking, you want to take care of your beautiful body and your precious baby by eating as healthy as you can.
And if you need help, you're not feeling well, get. Help because you do not have to deal with that on your own. Now, when you go to that first doctor's office, like we were saying, if you don't know when your last period was, this appointment's going to tell you exactly how far along you are, or. pretty close and also give you your due date, which is super exciting.
All right, you guys, so for this first trimester, remember, take your prenatals, continually taking a folic acid [00:46:00] and eat a healthy, balanced diet and then purposeful. And gentle movements, unless you were already working out like a crazy person, or you have a fitness routine, don't go start in a new one.
Just do what you can, maybe taking a short little daily walk. Make sure you're staying hydrated. And remember to start thinking about those key decisions, like where do you want to birth your baby? Is it at home? And is it a birth center and a conventional hospital? Choosing your provider ASAP, because like we said, you need to go to that first appointment soon.
All right, you guys, congratulations on your new pregnancy. We will see you again next week. Bye for now.