Registered at Inebir: What now?

I've gotten pregnant. I've been discharged from Inebir. Now what?

After many months or years of trying, after multiple tests, a diagnosis, and one or more treatments, you have finally achieved the long-awaited positive result. Everything is going well; you have heard the most beautiful sound in the world: its little heart beating… The gynecologist confirms that everything is fine, and it is time to discharge you from Inebir.

 You have sMixed feelings: on the one hand, the joy of knowing that everything is alright, and on the other hand, a feeling of helplessness, of uncertainty… We understand. We've built a relationship, you've been kept informed every step of the way, and now the feeling of uncertainty is overwhelming. What do I do now? Who will be monitoring my pregnancy? What appointments will I have? These are just some of the questions flooding your minds…

Well, today, in broad strokes, we want to tell you what the monitoring of a normal pregnancy is like.

Although the monitoring process is generally similar across all autonomous communities' social security systems, there are often slight differences. Today we'll tell you how it works. monitoring in Andalusia:

• First visit: Around week 8
  This can be with the midwife at the health center or your primary care physician. At this appointment, you should bring your INEBIR discharge report, which includes the date of your last menstrual period, so they can determine how many weeks pregnant you are. If you don't want to disclose that the pregnancy resulted from assisted reproductive technology, simply provide your corrected last menstrual period date.
  During this visit, you will usually be informed about how your pregnancy will be monitored. They will update your medical history, calculate your body mass index, open your pregnancy record, and order the first-trimester blood tests, including blood type and the necessary screening tests. If you have risk factors, such as age, medical history, etc., they will also order a glucose tolerance test (O'Sullivan test).
  During this visit, they will advise you on the use of folic acid (which you will already be taking) and smoking cessation (very important), as well as vaccination against the flu if it is the season for infections.
  They will schedule your appointment with the obstetrician and the next appointment at the health center.
• Second visit: week 11-13
  During this visit, the first obstetric ultrasound is performed, the main objectives of which are:
  • Confirm the normal progression of the pregnancy
  • Confirm gestational age.
  • Measure NT (nuchal translucency), so that together with the analysis that you have already carried out, the risk of chromosomal abnormalities in the baby can be assessed.
  If your first-trimester screening is normal, you will receive a letter at your home address confirming this. If any abnormalities are found or further testing is required, you will be contacted by phone. It is important to keep this information up to date at your health center.
• Third visit: Weeks 16-18
  This appointment is usually with your midwife.
  She will ask how you are feeling. She will review the screening results and the rest of the tests with you. She will update your weight and BMI. She will give you health recommendations and perform a fetal auscultation with a device called a Doppler: You will be able to hear the baby's heartbeat again! Although this time you won't see it.
  They will schedule your next visit to the hospital for the morphology ultrasound.
• Fourth visit: Week 18-22
  Second obstetric ultrasound, in this case it is the morphological ultrasound (20-week ultrasound).
  The purpose of this ultrasound is:
  • To confirm a healthy pregnancy progression
  • Screening for structural fetal malformations (this examination can detect 70% of serious malformations).
  They will assess whether there are any risk factors or if everything is within normal limits.
• Fifth visit: Around week 24
  With your midwife. It's similar to the third visit. She will update your medical history, perform a fetal auscultation, and order your second-trimester blood tests (O'Sullivan test, serology, complete blood count, general biochemistry, etc.).
  It will indicate vaccination against pertussis (Between weeks 28-32).
  If you are Rh negative, you should consider receiving anti-D immunoglobulin. However, some hospitals now perform fetal Rh testing using maternal blood, so if you are Rh negative and your baby is also Rh negative, you can avoid the blood test. Not all hospitals offer this service; some will administer the injection if you are Rh negative but the father/donor is Rh positive.
• Sixth visit: Around week 28
  With your pregnancy doctor. They will give you the results of your second-trimester blood tests, including the O'Sullivan test, and tell you if you need to have a glucose tolerance test. They will update your medical history. They will measure the height of your uterus to see if it's appropriate for your stage of pregnancy and will also perform a fetal auscultation.
• Seventh visit: week 32-34
  Third obstetric ultrasound. The objectives of this ultrasound are:
  • Screening for late-onset structural abnormalities
  • Assessment of fetal growth and well-being.
  • Assess fetal positioning (head down, breech, etc.).
  If the baby isn't head-down (cephalic presentation), you'll likely be given another ultrasound appointment to confirm if the baby has turned. If the baby isn't in the correct position, depending on the hospital, they will consider performing an external cephalic version, breech delivery, or a scheduled cesarean section.
• Eighth visit: week 35-37
  With the midwife.
  Update of your medical history, weight, and BMI. Request for third-trimester blood tests (including coagulation tests for epidural anesthesia). You will also be asked to take a vaginal swab test (vaginal and rectal swab to detect the presence of Group B Streptococcus. If positive, you will need antibiotics during labor).
  She will sign you up for childbirth preparation classes.
  Ninth visit: week 37-38
  Pregnancy doctor.
  During this visit, the doctor will give you the results of the coagulation tests and the Group B Streptococcus screening.
  Your medical history, weight, and BMI will be updated. A uterine height palpation and fetal auscultation will be performed.
  It will remind you that there is a postpartum visit you must attend after giving birth.
• Tenth visit: Week 38-39
  This visit depends on whether there is any pregnancy-related pathology or not:
  If there is no pathology: you will be scheduled for a fetal well-being consultation from week 38 onwards, to perform a cardiotocographic recording and you will be given a final appointment with obstetrics, to give you an induction date if you do not go into labor on your own.
  If there is any type of pathology (hypertension, diabetes, etc.) or there is a suspicion that your baby is too big or too small: you will be called in from week 36-37.
• Last obstetrics visit
  During this visit you will undergo tests to assess fetal well-being (cardiotocography, ultrasound, and echo-doppler if there is obstetric pathology or high risk).
  From week 41 onwards, you will be scheduled for an appointment at the Emergency Department of the Labor and Delivery Unit to assess whether labor induction is necessary. The same procedure will be followed if it is decided to end the pregnancy before week 41.

It goes without saying that, even after we discharge you, you can always count on us and call or write to us if you have any questions, or simply to tell us how everything is going! We love it when you send us photos of your little ones' ultrasounds and when you visit us after they've been born.. !! Congratulations!!