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Understanding the Pregnancy Journey in the US

When you are in a loving and caring relationship, finding out you’re expecting can be really exciting news. However, before you start thinking about enrolling in prenatal courses or planning your baby shower, there are several important issues you will need to consider to have a relatively stress-free pregnancy.

To avoid unpleasant surprises, the first thing you should do is contact your insurance company to learn what health coverage is offered to pregnant women. If you don’t have one, every state has a program that can help you pay for medical care. You may also want to start looking into your parental leave rights to get organized.

In this article we’ll tell you about the pregnancy journey in the US, what health professionals you can choose from, what care you can expect to receive, and what delivery options are available to you.


Understanding the pregnancy journey in US


THE IMPORTANCE OF HAVING A GOOD HEALTH INSURANCE

Pregnancy can be more stressful than needed when you are worried about covering the price of the health care for you and your unborn baby. In general, the cost of pregnancy ranges from $9,000 to $200,000, which is why it’s important to hire a good health insurance company.

Fortunately, coverage for maternity care has improved significantly since the Affordable Care Act (ACA) was passed in 2010. However, although all health insurance companies are now required to offer some coverage for pregnancy costs, the extent to which each company goes varies substantially.

The best insurance policies cover from blood tests and ultrasounds to visits to specialists and the baby’s delivery. How much coverage you can get will be determined by your and your partner’s income and health insurance. There are three types of health insurance plans that offer the best affordable options for pregnancy:


  • • Employer-provided coverage

  • • Affordable care act (ACA) plans

  • Medicaid

If your workplace provides you with health insurance, make an appointment with the HR department to find out what benefits are covered. If you have private insurance, contact them to learn about the terms of your contract for maternity coverage.


NOTE: Remember every state in the United States has a program for those who can’t pay. For example, the Women, Infants and Children (WIC) Program. Programs give medical care, information, advice, and other services important for a healthy pregnancy.

Check what programs are available in your state or speak to a social service worker in your local hospital. You can also try your place of worship and your local community clinic.


PRENATAL TESTS

During your pregnancy, you will need to attend several prenatal check-ups and tests to make sure the baby is developing as expected and you are both well. They will check your blood pressure and weight, check the baby’s heart rate, measure your abdomen to check your baby’s growth, run blood and urine tests, and request some ultrasounds. You mustn't miss any appointments as that’s where possible complications are picked up.

Typically, routine check-ups occur:


  • • Once each month (for weeks 4 through 28)

  • • Twice a month (for weeks 28 through 36)

  • • Weekly (for weeks 36 to birth)

The number of tests offered to you will depend on your medical history, your age, ethnic background, and your results of routine checks. For more information on the number of tests that could be offered to you, visit the official U.S. Department of Health & Human Services. The following tests will be offered to all women.


The first trimester prenatal screening test

During the first trimester, you will have a blood test and an ultrasound to detect any abnormalities in the fetus, reveal the presence or absence of multiples, and confirm your due date.

  • A blood test is performed to check for chromosomal disorders, such as Down syndrome or trisomy 18.

  • An ultrasound for fetal nuchal translucency serves to measure the thickness at the back of the baby's neck. This information, combined with the mother's age, help doctors determine risk to the fetus.


Second trimester prenatal screening test

During the second trimester, your health professional will request an ultrasound scan to check the development of your baby’s organs and systems. It will also help to confirm the sex of the baby. This test is usually done between the 15th and 20th week of pregnancy, which is why it is known as the 18/20-week scan.

You may also be asked to take a Glucose Challenge Screening to check the mother’s risk of gestational diabetes. You will have to consume a special sugary drink before the doctor takes a blood sample to look for high blood sugar levels.


Third trimester prenatal screening tests

During the third trimester, you may have an ultrasound to monitor the overall health of your baby and see if the baby should be delivered early. This is known as the Biophysical profile (BPP).

The doctor may also request you to do a Group B Streptococcus Test between weeks 36 and 37 to look for bacteria that can cause pneumonia or serious infection in your baby.


WHAT HEALTH PROFESSIONAL SHOULD I CHOOSE?

Choosing the right practitioner is crucial to ensure that you feel heard and safe throughout your pregnancy. You can choose to keep to your family practice doctor, find an obstetrician-gynecologist (OB), or a midwife.

It’s always useful to ask for recommendations. Consider the professional’s reputation, their personality, and even their office location and hours at the time of making a decision.


The family practice doctor

In a low-risk pregnancy, you may want to consider sticking to your family doctor. They have the advantage of knowing your health history, which may help you feel safer. Family doctors can monitor your pregnancy, prescribe any necessary medicine you may need, and perform most of your medical tests. However, you may need to see an obstetrician if any complications arise during pregnancy, labor, or delivery, as most of them cannot perform a c-section.


The Obstetrician (OB)

They are professionals who specialize in pregnancy and childbirth. Your obstetrician will guide you through the entire pregnancy and assist you on the day of delivery. They’ve had surgery training, so they will be able to perform a C-section if necessary. Women with the highest risk pregnancies might need special care from a maternal-fetal medicine specialist.


The certified nurse-midwife (CNM) and the certified professional midwife (CPM)

They offer support during your pregnancy and in postpartum, but they can only assist you in low risk, and healthy pregnancies. Midwives will design a birth plan together with you to help you deliver your baby where you decide whether it is in a hospital, at home, or a special birthing center. If any complications arise during your pregnancy, labor, or delivery, you will have to be referred to an ob-gyn.

Midwives often work with Doulas. They are labor coaches who provide physical and emotional support to women during labor and delivery. They can help you with breathing techniques, relaxation, and positioning. Check with your health insurance company if they cover the cost of a doula, and make sure the person you choose is certified by Doulas of North America (DONA) or another professional group.


WHERE CAN I GIVE BIRTH?

If you’re in good health and have a relatively risk-free pregnancy, you have the right to choose where to give birth. Although most women choose to give birth in a hospital, other available options may be more suitable to you. Let’s examine the pros and cons of each of them to help you make your decision.


Hospital birth

Most mothers in the U.S. decide to deliver their babies in a hospital. The main reason behind this is that hospitals have a clear advantage over other options: they offer highly qualified doctors with access to advanced medical equipment in case of complications. When choosing the hospital, it’s worth visiting them beforehand to get a feel for the place. Consider its distance to your home; how many people will be allowed in the room; whether it offers private rooms, support with breastfeeding (if that’s what you want to do), and a 24-hs available pain relief service during labor.


Birth or Birthing Center

Nowadays, many hospitals have on-site birth centers that offer a cozier atmosphere to women who have uncomplicated pregnancies. The idea behind is that pregnancy and the baby’s delivery is a natural process that should be treated accordingly. This is why they allow more support people with you in the room, and they often offer access to birthing tubs, birthing balls, big beds, and comfortable chairs.

Your baby will be delivered by the same midwife who provided care for you during your pregnancy, which helps mothers feel safe and at ease. However, remember that if you choose this place to give birth, you won’t have access to an epidural. Midwives can offer some form of pain relief, but they are not trained doctors.

Make sure the birthing center of your choosing meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers. They must have doctors who can work at a nearby hospital in case of problems with the mom or baby.


Home Birth

If you’ve had a low-risk pregnancy, and you possess a strong after-care support system, you may choose to give birth in the comfort of your own home. A certified nurse-midwife or a doctor can help you deliver your baby in a safe and controlled environment. However, in case of emergency you will need to be referred to the nearest hospital as your health professional will not have access to medical equipment or a variety of pain relief options. If you live far away from a hospital, homebirth may not be the best choice.


NOTE: Many health insurance companies do not cover the cost of care for home births. So, check your plan if you'd like to deliver at home.

[Pregnancy journey in US]

We hope the information we compiled has been useful. We wish you plenty of happiness and wonderful moments with your newborn!