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Pregnancy Labs

Updated: Apr 1, 2023

Lab work is a routine component of the care I provide as a midwife.

Many, if not most, women dread getting their blood work done and don’t necessarily look forward to things like PAP tests or vaginal swabs.

But I have good news— labs don’t have to be SO terrible.

I perform lab work in the comfort of your home. That means no more sitting in a room with awful fluorescent lighting or interacting with a technician you’ve never met before.

This may not affect you much at all... But for some mamas who get super anxious around needles or with their legs up in stirrups .... this conversation is a BIG DEAL!

I treat lab work as a continuation of the holistic model I offer in all other aspects of care.

I am gentle and grounded in my approach to something that is often cold and impersonal. I will always always always ask your consent before approaching the process and THROUGHOUT the process of lab work.

Blood draws, vaginal culture swabs, urine samples —all happen at YOUR pace and in YOUR space.

These changes alone can transform the way people think about the clinical components of maternity care. Initial prenatal blood work includes the following:

Blood Type- This test determines your blood type (O, A, B or AB) and whether or not you have the Rh factor (Rhesus factor) on your blood cells. Rh is an inherited trait that refers to a specific protein found on the surface of red blood cells. If your blood has the protein, you are Rh positive. If your blood lacks the protein, you are Rh negative. If you are Rh negative and your baby is Rh positive, a subsequent baby could develop a life-threatening anemia. There is a product that can be administered after the birth to prevent this. See below. Antibody Screen- This test detects unusual antibodies that can cause damage to your developing baby. If present, special tests and monitoring may be needed during pregnancy. If you are Rh negative and haven’t started to produce Rh antibodies, you can receive an injection of a blood product called RH immune globulin, during the pregnancy or after the birth. This immune globulin prevents your body from producing Rh antibodies. We will discuss indications as well as benefits, risks, and your choices. Complete Blood Count- A complete blood count (CBC) gives important information about the kinds and numbers of cells in the blood, especially red blood cells, white blood cells, and platelets. A CBC test includes:

  • White blood cell (WBC, leukocyte) count. White blood cells protect the body against infection. If an infection develops, white blood cells attack and destroy the bacteria, virus, or other organism causing it. White blood cells are bigger than red blood cells but fewer in number. When a person has a bacterial infection, the number of white cells rises very quickly.

  • Red blood cell (RBC) count. Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so it can be exhaled. If the RBC count is low (anemia), the body may not be getting the oxygen it needs. If the count is too high (a condition called polycythemia), there is a chance that the red blood cells will clump together and block tiny blood vessels (capillaries). This also makes it hard for your red blood cells to carry oxygen.

  • Hematocrit (HCT, packed cell volume, PCV). This test measures the amount of space (volume) red blood cells take up in the blood. The value is given as a percentage of red blood cells in a volume of blood. For example, a hematocrit of 38 means that 38% of the blood’s volume is made of red blood cells. Hematocrit and hemoglobin values are the two major tests that show if anemia or polycythemia is present.

  • Hemoglobin (Hgb). The hemoglobin molecule fills up the red blood cells. It carries oxygen and gives the blood cell its red color. The hemoglobin test measures the amount of hemoglobin in blood and is a good measure of the blood’s ability to carry oxygen throughout the body.

  • Platelet (thrombocyte) count. Platelets (thrombocytes) are the smallest type of blood cell. They are important in blood clotting

Syphilis (RPR)- A test for exposure to syphilis. Syphilis is a sexually transmitted disease that can be transmitted to the developing baby during pregnancy. Untreated babies can have health problems such as cataracts, deafness, or seizures, and death. Treatment for syphilis can be started early in the pregnancy so that the baby is not affected. Hepatitis B (HBV)- A test for infection with the Hepatitis B virus which can cause severe illness, liver damage and even death. Many people are infected and don’t know they have symptoms. The virus is highly contagious and easily passed to the baby during the birth process.

Human Immunodeficiency Virus (HIV)- A test that checks for the virus that causes AIDS. If you have HIV infection, special medications can be given during pregnancy and birth which can reduce the chances of you passing the virus to your unborn child. Rubella (German Measles)- A blood test to determine if you are protected from Rubella. Most adults have developed immunity to this virus through natural infection or vaccination as children. Though rare, Rubella contracted during pregnancy can have serious consequences for the developing baby such as heart problems, hearing and vision loss, intellectual disability, and liver or spleen damage. Later on in your pregnancy, around 28 weeks, you may be offered another CBC blood test to check your iron levels again. In some cases, this test will also check whether you have developed pregnancy diabetes.

Lastly at 35-37 weeks:

Screening culture for Group B Strep which is a swab that YOU will do yourself at your prenatal visit.

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