Scott Webb (Host): Today, we're going to learn about the importance of prenatal care from Dr. Maija Swanson. She's a family medicine and obstetrics physician, and she's here to tell us how what she does differs from the work of OB-GYNs and what she loves most about her job.

Host: This is Ask the Experts, the podcast from Salinas Valley Health. I'm Scott Webb. Doctor, thanks so much for your time today. We're going to talk about the importance of prenatal care. But before we get to that, just a little bit sort of about yourself and sort of defining the terms. So, what is the difference between obstetrics and OB-GYN?

Dr. Maija Swanson: Yeah. So, that's a really good question. It's one that I think a lot of people don't know the difference between the two. And so, the main difference is in our training and then our overall scope of practice. So for an OB-GYN, you know, their training is solely in women's health, dealing with both gynecologic and obstetric concerns in the clinic, as well as doing surgery and things like that. For family medicine and obstetrics, we see both males and females, all ages of life, from babies to elderly individuals. And then also, a lot of us do prenatal care. So for myself and most of the other physicians in my group, we've all done our training in full spectrum family medicine and then did a fellowship in obstetrics to better learn how to take care of pregnant women and do more complicated prenatal care and deliveries including C-sections. So again, the big difference is kind of in our scope of practice and the types of people that we see.

Host: Yeah, it's good to define the terms because in my mind sometimes I'm like, "Well, aren't they kind of the same thing?" And they may be kind of the same thing. But as you say, the difference in the scope and the types of patients, the age of patients perhaps that you see. So, let's talk about prenatal care then. Why is prenatal care so important for moms and babies?

Dr. Maija Swanson: So, prenatal care is pivotal to having a healthy pregnancy as well as a healthy mom and a healthy baby. You know, there are a lot of complications that can come up during a pregnancy. Things from, you know, managing preexisting conditions like diabetes or thyroid disorders, as well as issues that arise during the pregnancy, like diabetes of pregnancy or high blood pressure of pregnancy.

And so, those are things that can both cause problems for mom's health and also cause problems for babies' development. And they're only things that we might catch if someone is coming for routine prenatal care. And so, that's a big part of why it's so important to start prenatal care early on in the pregnancy and then continue it as recommended throughout the entirety of the pregnancy.

Host: Yeah. And so when we think about whether that's that first appointment or the prenatal appointments in general, what can folks expect when they come for those appointments?

Dr. Maija Swanson: What happens during the appointments varies depending on where we are in the pregnancy. But in general, all the appointments after, you know, about 10 to 12 weeks of gestational age, include listening to baby's heartbeat, which is how we reassure ourselves that everything is okay with the baby. So, that's always part of it. And then, you know, talking about any relevant blood work or other testing that's necessary at that point in the pregnancy and then making sure that we're addressing, you know, any other concerns or problems that come up.

Host: Yeah, definitely. And let's think then about the timing. When's a good time for that first appointment? I've spoken with other experts and the prenatal care shouldn't necessarily begin once a couple is pregnant. It really should probably begin before that. But from your perspective, from an expert's perspective, when's a good time for that first appointment?

Dr. Maija Swanson: Yeah. So, exactly what you said. I always recommend having an appointment if someone is planning on becoming pregnant, just so that we can make sure that all other aspects of their health are optimized in order to have the safest pregnancy that we possibly can. So, yeah, again, ideally, before you even know you're pregnant or before you start trying. But a lot of times that doesn't happen. You know, a lot of pregnancies are unplanned and unexpected. And so, as soon as you have a positive pregnancy test would be what I'd recommend in that scenario.

Host: Yeah. As you say some pregnancies are unplanned. So, let's talk about the spacing of the appointments. Are they sort of less frequent at the beginning and do they sort of ramp up and get closer or more often as we get closer to giving birth?

Dr. Maija Swanson: Yeah. So, the initial appointments, usually we do for the first trimester and into about halfway through the second trimester an appointment every four weeks or so. After that, we increase the frequency to every two weeks. And then, towards the end of the pregnancy, it's usually every week, sometimes even more than once a week if there is a concern about the baby, if we're needing to do more frequent ultrasounds or listen to baby's heartbeat more frequently to make sure everything is okay. But in general, yeah, starting at every four weeks and then increasing to every week at the end of the pregnancy.

Host: Yeah, that was definitely my experience. I felt like we were there a lot. You know, that last month or so, I felt like we were there more than we were at home. Yeah, that definitely checks out. So once a baby is born, do you continue to care for moms and babies and be, you know, kind of a part of things?

Dr. Maija Swanson: I do. Yeah. And I think that's one of the key differences between an OBGYN and a family medicine doctor who has additional training and obstetrics is that that's one of my favorite things about what I do as well, is that after delivering the baby, I see both mom and baby in the hospital while they're there, and then see them both for followup in my clinic. And those joint visits can be super fun afterwards where, you know, we're checking in, making sure everything's going well with both of them. And yeah, it's, again, one of the more special things about family medicine and obstetrics.

Host: Yeah, I'm sure it's really gratifying. Especially, you know, if moms and couples came in before they ever got pregnant or right after that pregnancy test, and then you're there all the way through and then the baby's born. So as we wrap up here, doctor, what would be your final thoughts and takeaways when we think about the importance of prenatal care and how you can help moms, you know, mates, babies, and so on.

Dr. Maija Swanson: Yeah. Well, I think the last thing I would say is one other kind of piece in differentiating OB-GYNs from family medicine doctors who do OB also is kind of based on the risk of the pregnancy. And so, making sure that anyone who's pregnant or thinking of becoming pregnant and trying to decide what type of doctor they should see is based on any preexisting conditions that they have, but always something that we will work through if someone calls and wants to make an appointment. We always determine whether or not it's a good fit with us. But you know, there are a lot of patients who we end up referring to our OB-GYN colleagues just for more complicated cases. But I definitely always encourage everyone to explore the option of having a family medicine doctor do their prenatal care and their delivery because it is a different experience than working with an OB-GYN.

Host: Yeah, different for sure. My wife, when we had our daughter, she was 36, so we were both shocked to find that she was of advanced maternal age.

Dr. Maija Swanson: Yes.

Host: That's direct quote. And she looked at me and she's like, "I don't feel of advanced maternal age." And I said, "Well, you are."

Dr. Maija Swanson: Yep.

Host: Just get over it and deal with it. And that's how we ended up with, you know, an OB versus someone like yourself, more of a family medicine doctor. So anyway, this has been so great today. Great to have your time, learn more about prenatal care and how you can help folks and you stay well.

Dr. Maija Swanson: Thank you. Thanks for your time. Appreciate it.

Host: And for a full list of all of our podcasts, go to salinasvalleyhealth.com/podcasts. And if you found this podcast to be helpful, please be sure to tell a friend, neighbor or family member, and subscribe, rate, and review this podcast and check out the entire podcast library for additional topics of interest. This is Ask the Experts from Salinas Valley Health. I'm Scott Webb. Stay well, and we'll talk again next time.