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Your First Prenatal Visit

If you did not meet with your health care provider before you were pregnant, your first prenatal visit will generally be around 8 weeks after your LMP (last menstrual period ). If this applies to you, you should schedule a prenatal visit as soon as you know you are pregnant!

Even if you are not a first-time mother, prenatal visits are still important since every pregnancy is different. This initial visit will probably be one of the longest. It will be helpful if you arrive prepared with vital dates and information. This is also a good opportunity to bring a list of questions that you and your partner have about your pregnancy, prenatal care, and birth options.

What to Expect at Your First Pregnancy Appointment

Your doctor will ask for your medical history, including:.

  • Medical and/or psychosocial problems
  • Blood pressure, height, and weight
  • Breast and cervical exam
  • Date of your last menstrual period (an accurate LMP is helpful when determining gestational age and due date)
  • Birth control methods
  • History of abortions and/or miscarriages
  • Hospitalizations
  • Medications you are taking
  • Medication allergies
  • Your family’s medical history

Your healthcare provider will also perform a physical exam which will include a pap smear , cervical cultures, and possibly an ultrasound if there is a question about how far along you are or if you are experiencing any bleeding or cramping .

Blood will be drawn and several laboratory tests will also be done, including:

  • Hemoglobin/ hematocrit
  • Rh Factor and blood type (if Rh negative, rescreen at 26-28 weeks)
  • Rubella screen
  • Varicella or history of chickenpox, rubella, and hepatitis vaccine
  • Cystic Fibrosis screen
  • Hepatitis B surface antigen
  • Tay Sach’s screen
  • Sickle Cell prep screen
  • Hemoglobin levels
  • Hematocrit levels
  • Specific tests depending on the patient, such as testing for tuberculosis and Hepatitis C

Your healthcare provider will probably want to discuss:

  • Recommendations concerning dental care , cats, raw meat, fish, and gardening
  • Fevers and medications
  • Environmental hazards
  • Travel limitations
  • Miscarriage precautions
  • Prenatal vitamins , supplements, herbs
  • Diet , exercise , nutrition , weight gain
  • Physician/ midwife rotation in the office

Possible questions to ask your provider during your prenatal appointment:

  • Is there a nurse line that I can call if I have questions?
  • If I experience bleeding or cramping, do I call you or your nurse?
  • What do you consider an emergency?
  • Will I need to change my habits regarding sex, exercise, nutrition?
  • When will my next prenatal visit be scheduled?
  • What type of testing do you recommend and when are they to be done? (In case you want to do research the tests to decide if you want them or not.)

If you have not yet discussed labor and delivery issues with your doctor, this is a good time. This helps reduce the chance of surprises when labor arrives. Some questions to ask include:

  • What are your thoughts about natural childbirth ?
  • What situations would warrant a Cesarean ?
  • What situations would warrant an episiotomy ?
  • How long past my expected due date will I be allowed to go before intervening?
  • What is your policy on labor induction?

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The Ultimate Pregnancy Appointment Guide: What to Expect Week by Week at Your Prenatal Visits

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Central to ensuring the health and well-being of you and your growing baby is seeing your care team regularly for touchpoints and milestones that are part of your pregnancy appointment schedule. Diana Kaufman, MD , UnityPoint Health, shares the recommended timeline for prenatal visits, and the importance of each test and discussion that’ll prepare you for a safe pregnancy and delivery.

Confirming Your Pregnancy

Every woman’s body is unique, but it’s a good idea to visit a doctor to confirm a pregnancy when you’re experiencing early symptoms, such as a missed period or you’ve received a positive home pregnancy test. Typically, this visit happens at 6-8 weeks of pregnancy.

Your doctor may confirm your pregnancy through urine tests, blood tests or ultrasounds.

Initial Prenatal Appointment: 5-12 Weeks

Your first prenatal visit consists of important screenings and discussions, so your healthcare team can create a care plan that ensures you and baby stay healthy throughout your pregnancy. Prepare a few things for this visit, including:

  • Complete medical history: It’s important for your doctor to know your past and present health conditions or concerns, medications and any history of disease, substance abuse or known genetic conditions in your family.
  • Insurance information: This includes consents for care, your insurance carrier and other paperwork

Here’s what to expect at your first pregnancy appointment

  • A physical, which will likely include a breast and pelvic exam.
  • A urine sample is collected to check for certain infections and conditions that can occur during pregnancy. Urine tests may be taken at your following prenatal visits as well. Urine drug screening tests are also recommended for women, or their partners, with a history of substance use — including smoking.
  • Routine testing that includes blood draws to check your blood type and complete blood count (CBC) and look for specific diseases including hepatitis, HIV, syphilis and checking for immunity against rubella. Other testing that may occur includes genetic screening and testing for diabetes.

Your care team will review prenatal educational materials with you and remedies for any unpleasant pregnancy symptoms, such as nausea or vomiting . Your team also will provide an estimated due date for baby.

It’s also important to take good care of your teeth and gums during pregnancy. Changing hormone levels make your gums more sensitive to disease, which increases your risk for a low-birth weight or premature baby. Consider making an appointment to see your dentist during your first trimester.

Prenatal Appointment: Second Trimester (13 – 26 Weeks)

During weeks 13-26, you’ll see your doctor every four weeks. It’s a good idea to write down questions or concerns before your appointments to ensure they’re addressed.

At each appointment throughout the rest of your pregnancy, your care team will check the following:

  • Blood pressure
  • Position of baby
  • Baby’s heartbeat

Here are some additional things to expect.

  • Prenatal genetic testing: There are many different options for prenatal genetic testing. Your care team will review these with you.
  • Pregnancy blood tests: These are tailored to your specific needs. Most patients are tested for anemia and diabetes of pregnancy between weeks 24-28. Other recommended tests will be reviewed with you.
  • Ultrasound: It’s common to have an ultrasound in the first trimester to confirm the estimated due date. Ultrasound is also common at 20 weeks to check on baby's growth and development. Further ultrasounds could be needed if changes in your pregnancy make it necessary, such as concerns about baby’s growth or to see if baby is head down.
  • Discuss preterm labor signs: Preterm labor refers to labor that begins before the 37th week of pregnancy and requires medical attention. Knowing what to look for — such as contractions, changes in vaginal discharge  — is important for preventing potential complications.
  • Childbirth classes: It’s a good idea to register for a class  to help you prepare for baby’s arrival.

When to Call Your Doctor

Pregnancy creates new and unfamiliar symptoms in many women. However, some symptoms need attention. Here’s when to call your doctor in the second trimester:

  • Vaginal bleeding, even a small amount
  • Leg pain with numbness or leg weakness
  • Pain or tenderness in one of both calves that doesn’t go away
  • Thoughts of hurting yourself or others
  • Severe headaches that don’t go away with Tylenol
  • Persistent changes in vision such as blurriness or floaters
  • More than five contractions in an hour

Now, your visits to your care team become more frequent — happening every two weeks until you’re 36 weeks pregnant. Your care team continues to monitor you and baby. Here’s what else to expect:

Prenatal Appointments: Third Trimester (27 Weeks – Baby’s Arrival)

  • Check fetal movement: It’s important to be aware of your baby's movements. If you notice a sudden change or absence of fetal movement, let you care team know.
  • Rhogam injections: If an Rh-negative blood type was found during your initial prenatal visit, you’ll receive an injection to prevent immune system complications for future pregnancies. This usually happens at 28 weeks.
  • Additional prenatal testing: Around 35-37 weeks, you’re checked to see if you carry group B streptococcus bacteria . This is one of many bacteria that can live on our skin and typically does not cause problems. However, it can infect a newborn when you deliver. Antibiotics are given during delivery to prevent infection in a newborn if you test positive.

Prenatal Appointments: 36 Weeks – End of Pregnancy

Once you’ve reached 36 weeks, you’ll see your doctor every week until you deliver. These visits are essential for ensuring the well-being of both you and your little one, as well as preparing for a safe and smooth delivery. In addition to routine physical examinations and checking baby’s heartbeat and movement, here’s what else you can expect:

  • Cervical exams: If you’re having frequent contractions or preparing to be induced, your doctor will likely need to perform this exam.
  • Discuss labor signs: You’ll likely discuss signs of labor with your doctor and when to go to the hospital.
  • Discuss birth preferences: It’s not necessary to have a birth plan. Your care team has that covered. Our goal is to keep you and your baby healthy throughout the entire pregnancy and delivery process. However, if you have strong desires or needs for delivery, please discuss those during a prenatal appointment. It’s also helpful to write these things down and bring them to the hospital, since you may not be able to fully express your wishes during labor.

Postpartum Visits

After delivering baby, but before you leave the hospital, call your doctor to make your postpartum appointment, if it hasn’t been scheduled yet. This visit typically occurs around 6 weeks after you deliver. Other visits are scheduled based on your individual needs.

These visits are a time for your doctor to check on your healing , discuss normal or abnormal postpartum bleeding, talk about your well-being and any signs of postpartum depression or anxiety , discuss when it’s safe to start exercising again and address other questions or concerns you may have .

Our UnityPoint Health care team is here to care for you and baby throughout the entirety of your pregnancy and beyond. Call us  to schedule your first appointment or if you have questions about any future appointments.

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Medical review policy, latest update:, what over-the-counter medications are safe, what about prescription meds that i might take, do i need to change my beauty routine, how much weight should i gain, what should i eat and avoid eating, what exercise is okay during pregnancy, what vaccinations should i get, how long can i work when i'm pregnant, what pregnancy symptoms are normal, and what's an emergency, first trimester, second trimester, third trimester, can we discuss my birth plan, what should i expect during my labor and delivery, who will deliver my baby, what's the likelihood i'll need a c-section, what should i know if i want a vbac, what support can i get if i want to breastfeed.

The bottom line: Don’t be afraid to call your practitioner if you’re unsure about anything. He or she knows this is likely a new experience for you, and can help you figure out what’s normal and what’s not.

What to Expect When You're Expecting , 5th edition, Heidi Murkoff. WhatToExpect.com, Your First Prenatal Appointment , January 2021. WhatToExpect.com, Medications During Pregnancy: What’s Safe and What’s Not? , March 2021. WhatToExpect.com, How Much Weight You Should Gain During Pregnancy , October 2020. WhatToExpect.com, 19 Best Foods to Eat During Pregnancy , May 2020. WhatToExpect.com, The Best Pregnancy Workouts and Exercises You Can Do While Expecting , July 2021. WhatToExpect.com, Signs of Labor , July 2021. WhatToExpect.com, How to Create a Birth Plan , June 2021. WhatToExpect.com, Having a C-Section (Cesarean Section) , July 2021. WhatToExpect.com, How a Lactation Consultant Can Help You Breastfeed , February 2019. WhatToExpect.com, The COVID-19 Vaccine During Pregnancy , July 2021. WhatToExpect.com, Vaccines to Get Before and During Pregnancy , July 2021. American College of Obstetricians and Gynecologists, Weight Gain During Pregnancy , 2020. American Family Physician, ACOG Updates Recommendations on Vaginal Birth After Previous Cesarean Delivery , January 2011. Food & Drug Administration, Advice about Eating Fish , December 2020.  Kristina Mixer , M.D., OB/GYN, Spectrum Health United Hospital, Greenville, MI. Karen Deighan , M.D., OB/GYN, Loyola University Medical Center, North Riverside, IL.

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Everything to Know About Your Prenatal Appointment Schedule

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Over the course of your pregnancy, you might start to feel like you live at your provider’s office—and that’s actually a good thing. Studies show that moms-to-be and pregnant people who visit their providers regularly during pregnancy deliver much healthier babies on average. Your prenatal appointment schedule will of course vary depending on your provider and your own physical state, but these general guidelines should give you an idea of what to expect. Read on to learn from experts what a typical prenatal visit schedule looks like and how you can prepare.

Prenatal Appointment Schedule

It’s no secret that you’ll see your provider frequently during pregnancy and go through all types of tests and screenings. But exactly how often are prenatal visits scheduled? At a glance, you’ll likely have pregnancy appointments once every month (so every four weeks), between your first prenatal visit and 28 weeks of pregnancy, says Stephanie Hack , MD, ob-gyn and host of the Lady Parts Doctor podcast. Between 28 and 36 weeks, you’ll see your provider twice a month. After 36 weeks, as you get closer to delivery, that will increase to weekly—and may increase to bi-weekly after 40 weeks, Hack explains. Read on for an in-depth breakdown of the types of tests and routines to expect at each prenatal visit.

Pregnancy Appointment Schedule for First Trimester

During the first (and second) trimester, there will be optional testing to look for chromosomal and genetic abnormalities. Keep in mind that these tests aren’t mandatory and may not even be recommended, depending on your individual circumstances. It’s always best to discuss what prenatal tests are beneficial specifically for you with your provider.

First prenatal appointment

When you’ll have your first prenatal appointment can vary, as it’ll depend on when you get a positive pregnancy test . Hack says the first prenatal appointment usually takes place between 8 and 12 weeks. “By this point, an ultrasound can reveal a clear image of your developing baby, showing a healthy fetus and confirming the sound of its heartbeat,” says Cary Dicken , MD, a reproductive endocrinologist and infertility specialist at RMA of NY–Long Island. Along with a possible transvaginal ultrasound, the first visit will also include:

  • A full workup of your medical and family history
  • A thorough physical examination
  • Blood work to test for infections and anemia
  • Urine analysis
  • Blood pressure check
  • Pap smear, depending on when your last one was

Additional tests may also be recommended, depending on your personal history and risk for complications. These include:

First trimester screen

This noninvasive optional screening is usually time sensitive and completed between weeks 11 and 13. It includes the nuchal translucency ultrasound and a blood test. Your provider will evaluate the results from both of these screenings along with your age to assess baby’s risk for certain chromosomal issues and conditions, such as Down syndrome. This screening is usually recommended in conjunction with other noninvasive testing, detailed below.

Cell-free DNA test

Also known as noninvasive prenatal testing (NIPT) or NIPS, this test is optional. Blood tests look for the most common chromosomal abnormalities that can affect pregnancy. While you can get NIPT at any age, experts usually recommend it for those over age 35. If you do opt for the testing, you can also use it to find out baby’s sex.

Chorionic villus sampling (CVS) is another optional test that occurs between 10 and 12 weeks of pregnancy. However, this one is invasive, as it takes tissue samples from the placenta to analyze genetic information about the pregnancy, Johns Hopkins Medicine notes. The test is usually recommended for those over 35, those with a family history of genetic conditions or those with positive high-risk results from their other noninvasive prenatal screenings.

Prenatal Appointment Schedule for Second Trimester

During your prenatal appointments in the second trimester, “the focus will primarily be on monitoring your ongoing progress, the growth of your baby and their development,” Dicken says. “Your provider will closely monitor key indicators such as weight and blood pressure.” You can also expect some more testing, as well as the mid-pregnancy anatomy scan. Below, what to know about your pregnancy appointments timeline for the second trimester.

Week 14 prenatal visit

During the second trimester, you’ll see your provider about every four weeks. At every appointment, you’ll have to provide a urine sample for analysis, do a weigh-in and get your blood pressure taken.

Amniocentesis

This test is optional, but it’s an almost definitive way to assess the genetic abnormalities that may be affecting your pregnancy. It’s usually done between 15 and 20 weeks of pregnancy. Like the others, amniocentesis is recommended for women over age 35 or those with a family history of genetic conditions. It’s also recommended for those with abnormal results from their quad or sequential screening, which, according to Penn Medicine , uses a subsequent blood test, combined with the results from the first trimester screening to asses overall risk of chromosal and genetic conditions.

Triple/Quad screen test

Also conducted between weeks 15 and 22, this is another optional prenatal screening that looks at the risk of the pregnancy being affected by any of the three most common genetic disorders: Down syndrome, Edwards syndrome and neural tube defects , the American Pregnancy Association notes. The screening can also look at the risk of complications such as fetal growth restriction and preeclampsia .

Mid-pregnancy anatomy scan

This scan is also sometimes called the 20-week ultrasound, but it’s important to note it can occur anytime between weeks 18 and 22, Dicken says. As the name would suggest, it tells expectant parents baby’s sex, as well as evaluates baby’s growth; the formation of baby’s internal organs; amniotic fluid levels and the location of the placenta.

Week 24 prenatal visit

You’ll have your next visit following the anatomy scan around 24 weeks. This will be a routine check-up with a weigh in, monitoring of your blood pressure and a urine analysis.

Glucose challenge screening

The glucose challenge screening occurs between weeks 24 and 28 and is used to assess the risk of gestational diabetes . During this screening, your provider will have you drink a very sweet beverage and draw your blood an hour later to check your blood glucose levels.

Glucose tolerance test

This test is normally only given if your one-hour glucose screening result is abnormal. The glucose tolerance test is longer and requires fasting for a few hours prior to your appointment. Your provider will offer you another extremely sweet drink and then draw your blood an hour later, two hours later and three hours later to assess whether or not you have gestational diabetes. If the results are positive, know the condition can be managed through diet , exercise and, if needed, medication.

Pregnancy Appointment Schedule for Third Trimester

You’ve reached the home stretch! As mentioned, your prenatal appointments will be a bit more frequent in the third trimester, as you’ll see your provider every two to three weeks and then weekly as you get closer to meeting baby. These appointments may also involve some new tests to monitor baby’s heart rate and overall well-being.

Week 28 prenatal visit

Your first prenatal appointment in the third trimester will be around week 28. At this visit, your provider will conduct a urine analysis, do a weigh-in, check your blood pressure and chat with you about any questions, concerns or symptoms you may have.

Nonstress test

The nonstress test is a way for your provider to assess baby’s well-being, Hack says. Not everyone gets this test though. It’s generally recommended if there’s ever decreased fetal movement or for high-risk pregnancies. You’ll have sensors attached to your belly with soft belts. These allow your provider to listen to baby’s fetal heart rate and see how it responds to baby’s movement. While the first nonstress test occurs around 28 weeks, your provider may want to repeat it later on, depending on how the pregnancy is progressing.

Week 30, 32 and 34 prenatal visits

Because your provider will be checking in with you every two to three weeks, you’ll likely have visits at weeks 30, 32 and 34. At these appointments, you’ll get weighed, do a urine test and have your blood pressure taken.

Group B strep test

Group B strep (GBS) is a bacteria that can naturally occur in the body, including the vaginal and rectal areas. While it’s typically not harmful to you, it can be harmful to baby if they’re exposed to it during a vaginal birth. For this reason, between 36 and 37 weeks, your provider will swab your vagina and rectum to screen for GBS, Dicken says. If it’s positive and you’re hoping for a vaginal birth, you may need antibiotics.

Weeks 37, 38 and 39 prenatal visit

After 36 weeks, your prenatal appointments will increase to at least weekly until childbirth. As with previous visits, you’ll get a urine test, your blood pressure checked and do a weigh-in. Hack and Dicken note your provider may also:

  • Do any necessary repeat testing for sexually transmitted infections
  • Perform an in-office ultrasound to look at baby’s positioning (i.e. head down, breech , etc.)
  • Do a pelvic exam to evaluate cervical effacement and dilation
  • Discuss your birth plan and pain management preferences

“It’s also a valuable time for you to receive guidance and information about labor, postpartum care and life with a newborn, to help you feel more prepared,” Dicken says.

Week 40 prenatal visit

By this point, you’ll no doubt be pretty eager to meet baby. You’ll get the routine examination at this visit, including a urine test, blood pressure check and weigh-in. For high-risk pregnancies, your provider may also discuss increasing your visits to monitor baby’s health with weekly or biweekly nonstress tests and ultrasounds (otherwise known as a biophysical profile . Or, they may ask you to do kick counts at home to get a sense of baby’s well-being.

Reasons Why Your Prenatal Appointment Schedule Might Change

How frequently you have prenatal appointments will depend on how you and baby are progressing. If there are any complications that arise, like gestational diabetes, preeclampsia or other high-risk factors, you may need to come in more frequently. “Sometimes, things might change in your pregnancy that require more attention from your healthcare provider,” Dicken says. “It could be something like a complication, or maybe just needing a bit more monitoring as you get closer to your due date.

Questions to Ask About Your Prenatal Appointment Schedule

With all the phrases, tests and symptoms thrown at you during pregnancy, it’s natural to have some (a lot) of questions—and these questions may change as your pregnancy progresses, depending on personal symptoms, circumstances and concerns. Below, some topics to keep in mind as you head into your pregnancy appointments each trimester:

  • Questions for the first trimester: Hack recommends asking about nutrition, supplements and any lifestyle changes that should be made. “Make sure to discuss any pre-pregnancy health conditions you may have, or previous pregnancy complications, so you understand how they may impact your current pregnancy,” she adds. Dickens agrees, noting that you’ll also want to ask about any aspect of prenatal care you don’t understand, as well as how to manage early pregnancy symptoms .
  • Questions for the second trimester: As pregnancy moves into the second trimester, experts recommend asking questions about fetal development, childbirth classes and staying active.
  • Questions for the third trimester: Experts recommend asking questions about labor signs , pain management, birth plans, breastfeeding and postpartum care .

Regardless of what questions you have, Dickens stresses the importance of open and honest communication. “Ask questions that address your concerns, help you understand the progress of your pregnancy and prepare you for childbirth and postpartum.”

Frequently Asked Questions

Can you do virtual prenatal visits.

While some visits may be done over the phone or video chat, both Hack and Dicken note that when physical exams are required, the pregnancy appointments will need to be in-person.

How often do you go to the doctor when pregnant?

You’ll have monthly prenatal appointments during weeks 4 to 28, and bi-monthly appointments between weeks 28 and 36. After that, as you get closer to delivery, your provider will want to see you weekly or even more frequently. Ultimately, how often you go to your provider during pregnancy will depend on how you and baby are progressing.

When do prenatal appointments become weekly?

Prenatal appointments become weekly towards the end of pregnancy, typically after 36 weeks, Hack says.

How many postpartum visits will I have?

According to Dickens, you can expect to have at least one, but the frequency will depend on your personal circumstances surrounding birth and postpartum. Your provider should ideally contact you via phone shortly after birth, Hack notes, but the first in-person postpartum visit may not happen until 4 to 6 weeks after birth for someone without complications. For women with more complicated medical histories or birth experiences, your initial postpartum visit may be sooner. “For example, you may have a visit at two weeks postpartum after a cesarean section so that your incision may be evaluated, and then come back for your postpartum visit two to four weeks later,” Hack explains. During the postpartum visits, your provider will check in on your physical and emotional health, as well as discuss your postpartum recovery, birth control options, breastfeeding and newborn care.

While this is a good cheat sheet of what a prenatal appointment schedule typically looks like, know it “differs from person to person and even pregnancy to pregnancy,” Hack says. One of the best things you can do for your health and baby’s? “Maintain a good line of communication with your healthcare provider throughout your pregnancy,” she adds. This includes asking for clarifications, expressing concerns and raising your hand whenever something feels off.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Cary L. Dicken , MD, is a reproductive endocrinologist and infertility specialist at RMA of NY–Long Island. She earned her medical degree from Albert Einstein College of Medicine and completed her residency at Columbia University.

Stephanie Hack , MD, MPH, is board certified ob-gyn and host of the Lady Parts Doctor podcast. She obtained her medical degree from Lewis Katz School of Medicine at Temple University, as well as a masters degree in public health. She completed her residency at Georgetown University Hospital and Washington Hospital Center.

Science and Babies: Private Decisions, Public Dilemmas, Prenatal Care: Having Healthy Babies , 1990

Johns Hopkins Medicine, Chorionic Villus Sampling (CVS)

Penn Medicine, Sequential Screening (Combined First and Second Trimester Screening)

American Pregnancy Association, Triple Screen Test

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What happens during prenatal visits?

What happens during prenatal visits varies depending on how far along you are in your pregnancy.

Schedule your first prenatal visit as soon as you think you are pregnant, even if you have confirmed your pregnancy with a home pregnancy test. Early and regular prenatal visits help your health care provider monitor your health and the growth of the fetus.

The First Visit

Your first prenatal visit will probably be scheduled sometime after your eighth week of pregnancy. Most health care providers won't schedule a visit any earlier unless you have a medical condition, have had problems with a pregnancy in the past, or have symptoms such as spotting or bleeding, stomach pain, or severe nausea and vomiting. 1

You've probably heard pregnancy discussed in terms of months and trimesters (units of about 3 months). Your health care provider and health information might use weeks instead. Here's a chart that can help you understand pregnancy stages in terms of trimesters, months, and weeks.

Because your first visit will be one of your longest, allow plenty of time.

During the visit, you can expect your health care provider to do the following: 1

  • Answer your questions. This is a great time to ask questions and share any concerns you may have. Keep a running list for your visit.
  • Check your urine sample for infection and to confirm your pregnancy.
  • Check your blood pressure, weight, and height.
  • Calculate your due date based on your last menstrual cycle and ultrasound exam.
  • Ask about your health, including previous conditions, surgeries, or pregnancies.
  • Ask about your family health and genetic history.
  • Ask about your lifestyle, including whether you smoke, drink, or take drugs, and whether you exercise regularly.
  • Ask about your stress level.
  • Perform prenatal blood tests to do the following:
  • Determine your blood type and Rh (Rhesus) factor. Rh factor refers to a protein found on red blood cells. If the mother is Rh negative (lacks the protein) and the father is Rh positive (has the protein), the pregnancy requires a special level of care. 2
  • Do a blood count (e.g., hemoglobin, hematocrit).
  • Test for hepatitis B, HIV, rubella, and syphilis.
  • Do a complete physical exam, including a pelvic exam, and cultures for gonorrhea and chlamydia.
  • Do a Pap test or test for human papillomavirus (HPV) or both to screen for cervical cancer and infection with HPV, which can increase risk for cervical cancer. The timing of these tests depends on the schedule recommended by your health care provider.
  • Do an ultrasound test, depending on the week of pregnancy.
  • Offer genetic testing: screening for Down syndrome and other chromosomal problems, cystic fibrosis, other specialized testing depending on history.

Prenatal Visit Schedule

If your pregnancy is healthy, your health care provider will set up a regular schedule for visits that will probably look about like this: 1

Later Prenatal Visits

As your pregnancy progresses, your prenatal visits will vary greatly. During most visits, you can expect your health care provider to do the following:

  • Check your blood pressure.
  • Measure your weight gain.
  • Measure your abdomen to check your developing infant's growth—"fundal height" (once you begin to "show").
  • Check the fetal heart rate.
  • Check your hands and feet for swelling.
  • Feel your abdomen to find the fetus's position (later in pregnancy).
  • Do tests, such as blood tests or an ultrasound exam.

Talk to you about your questions or concerns. It's a good idea to write down your questions and bring them with you.

Several of these visits will include special tests to check for gestational diabetes (usually between 24 and 28 weeks) 3 and other conditions, depending on your age and family history.

In addition, the Centers for Disease Control and Prevention and the American Academy of Pediatrics released new vaccine guidelines for 2013 , including a recommendation for pregnant women to receive a booster of whooping cough (pertussis) vaccine. The guidelines recommend the shot be given between 27 and 36 weeks of pregnancy. 4

  • Centers for Disease Control and Prevention. (2013). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (TDAP) in pregnant women―Advisory Committee on Immunization Practices (ACIP), 2012. Retrieved September 20, 2013, from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6207a4.htm

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Prenatal care and tests

pregnant ob visit

Medical checkups and screening tests help keep you and your baby healthy during pregnancy. This is called prenatal care. It also involves education and counseling about how to handle different aspects of your pregnancy. During your visits, your doctor may discuss many issues, such as healthy eating and physical activity, screening tests you might need, and what to expect during labor and delivery.

Choosing a prenatal care provider

You will see your prenatal care provider many times before you have your baby. So you want to be sure that the person you choose has a good reputation, and listens to and respects you. You will want to find out if the doctor or midwife can deliver your baby in the place you want to give birth , such as a specific hospital or birthing center. Your provider also should be willing and able to give you the information and support you need to make an informed choice about whether to breastfeed or bottle-feed.

Health care providers that care for women during pregnancy include:

  • Obstetricians (OB) are medical doctors who specialize in the care of pregnant women and in delivering babies. OBs also have special training in surgery so they are also able to do a cesarean delivery . Women who have health problems or are at risk for pregnancy complications should see an obstetrician. Women with the highest risk pregnancies might need special care from a maternal-fetal medicine specialist .
  • Family practice doctors are medical doctors who provide care for the whole family through all stages of life. This includes care during pregnancy and delivery, and following birth. Most family practice doctors cannot perform cesarean deliveries.
  • A certified nurse-midwife (CNM) and certified professional midwife (CPM) are trained to provide pregnancy and postpartum care. Midwives can be a good option for healthy women at low risk for problems during pregnancy, labor, or delivery. A CNM is educated in both nursing and midwifery. Most CNMs practice in hospitals and birth centers. A CPM is required to have experience delivering babies in home settings because most CPMs practice in homes and birthing centers. All midwives should have a back-up plan with an obstetrician in case of a problem or emergency.

Ask your primary care doctor, friends, and family members for provider recommendations. When making your choice, think about:

  • Personality and bedside manner
  • The provider's gender and age
  • Office location and hours
  • Whether you always will be seen by the same provider during office checkups and delivery
  • Who covers for the provider when she or he is not available
  • Where you want to deliver
  • How the provider handles phone consultations and after-hour calls

What is a doula?

A doula (DOO-luh) is a professional labor coach, who gives physical and emotional support to women during labor and delivery. They offer advice on breathing, relaxation, movement, and positioning. Doulas also give emotional support and comfort to women and their partners during labor and birth. Doulas and midwives often work together during a woman's labor. A recent study showed that continuous doula support during labor was linked to shorter labors and much lower use of:

  • Pain medicines
  • Oxytocin (ok-see-TOHS-uhn) (medicine to help labor progress)
  • Cesarean delivery

Check with your health insurance company to find out if they will cover the cost of a doula. When choosing a doula, find out if she is certified by Doulas of North America (DONA) or another professional group.

Places to deliver your baby

Many women have strong views about where and how they'd like to deliver their babies. In general, women can choose to deliver at a hospital, birth center, or at home. You will need to contact your health insurance provider to find out what options are available. Also, find out if the doctor or midwife you are considering can deliver your baby in the place you want to give birth.

Hospitals are a good choice for women with health problems, pregnancy complications, or those who are at risk for problems during labor and delivery. Hospitals offer the most advanced medical equipment and highly trained doctors for pregnant women and their babies. In a hospital, doctors can do a cesarean delivery if you or your baby is in danger during labor. Women can get epidurals or many other pain relief options. Also, more and more hospitals now offer on-site birth centers, which aim to offer a style of care similar to standalone birth centers.

Questions to ask when choosing a hospital:

  • Is it close to your home?
  • Is a doctor who can give pain relief, such as an epidural, at the hospital 24-hours a day?
  • Do you like the feel of the labor and delivery rooms?
  • Are private rooms available?
  • How many support people can you invite into the room with you?
  • Does it have a neonatal intensive care unit (NICU) in case of serious problems with the baby?
  • Can the baby stay in the room with you?
  • Does the hospital have the staff and set-up to support successful breastfeeding?
  • Does it have an on-site birth center?

Birth or birthing centers give women a "homey" environment in which to labor and give birth. They try to make labor and delivery a natural and personal process by doing away with most high-tech equipment and routine procedures. So, you will not automatically be hooked up to an IV. Likewise, you won't have an electronic fetal monitor around your belly the whole time. Instead, the midwife or nurse will check in on your baby from time to time with a handheld machine. Once the baby is born, all exams and care will occur in your room. Usually certified nurse-midwives, not obstetricians, deliver babies at birth centers. Healthy women who are at low risk for problems during pregnancy, labor, and delivery may choose to deliver at a birth center.

Women can not receive epidurals at a birth center, although some pain medicines may be available. If a cesarean delivery becomes necessary, women must be moved to a hospital for the procedure. After delivery, babies with problems can receive basic emergency care while being moved to a hospital.

Many birthing centers have showers or tubs in their rooms for laboring women. They also tend to have comforts of home like large beds and rocking chairs. In general, birth centers allow more people in the delivery room than do hospitals.

Birth centers can be inside of hospitals, a part of a hospital or completely separate facilities. If you want to deliver at a birth center, make sure it meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers. Accredited birth centers must have doctors who can work at a nearby hospital in case of problems with the mom or baby. Also, make sure the birth center has the staff and set-up to support successful breastfeeding.

Homebirth is an option for healthy pregnant women with no risk factors for complications during pregnancy, labor or delivery. It is also important women have a strong after-care support system at home. Some certified nurse midwives and doctors will deliver babies at home. Many health insurance companies do not cover the cost of care for homebirths. So check with your plan if you'd like to deliver at home.

Homebirths are common in many countries in Europe. But in the United States, planned homebirths are not supported by the American Congress of Obstetricians and Gynecologists (ACOG). ACOG states that hospitals are the safest place to deliver a baby. In case of an emergency, says ACOG, a hospital's equipment and highly trained doctors can provide the best care for a woman and her baby.

If you are thinking about a homebirth, you need to weigh the pros and cons. The main advantage is that you will be able to experience labor and delivery in the privacy and comfort of your own home. Since there will be no routine medical procedures, you will have control of your experience.

The main disadvantage of a homebirth is that in case of a problem, you and the baby will not have immediate hospital/medical care. It will have to wait until you are transferred to the hospital. Plus, women who deliver at home have no options for pain relief.

To ensure your safety and that of your baby, you must have a highly trained and experienced midwife along with a fail-safe back-up plan. You will need fast, reliable transportation to a hospital. If you live far away from a hospital, homebirth may not be the best choice. Your midwife must be experienced and have the necessary skills and supplies to start emergency care for you and your baby if need be. Your midwife should also have access to a doctor 24 hours a day.

Prenatal checkups

During pregnancy, regular checkups are very important. This consistent care can help keep you and your baby healthy, spot problems if they occur, and prevent problems during delivery. Typically, routine checkups occur:

  • Once each month for weeks four through 28
  • Twice a month for weeks 28 through 36
  • Weekly for weeks 36 to birth

Women with high-risk pregnancies need to see their doctors more often.

At your first visit your doctor will perform a full physical exam, take your blood for lab tests, and calculate your due date. Your doctor might also do a breast exam, a pelvic exam to check your uterus (womb), and a cervical exam, including a Pap test. During this first visit, your doctor will ask you lots of questions about your lifestyle, relationships, and health habits. It's important to be honest with your doctor.

After the first visit, most prenatal visits will include:

  • Checking your blood pressure and weight
  • Checking the baby's heart rate
  • Measuring your abdomen to check your baby's growth

You also will have some routine tests throughout your pregnancy, such as tests to look for anemia , tests to measure risk of gestational diabetes , and tests to look for harmful infections.

Become a partner with your doctor to manage your care. Keep all of your appointments — every one is important! Ask questions and read to educate yourself about this exciting time.

Monitor your baby's activity

After 28 weeks, keep track of your baby's movement. This will help you to notice if your baby is moving less than normal, which could be a sign that your baby is in distress and needs a doctor's care. An easy way to do this is the "count-to-10" approach. Count your baby's movements in the evening — the time of day when the fetus tends to be most active. Lie down if you have trouble feeling your baby move. Most women count 10 movements within about 20 minutes. But it is rare for a woman to count less than 10 movements within two hours at times when the baby is active. Count your baby's movements every day so you know what is normal for you. Call your doctor if you count less than 10 movements within two hours or if you notice your baby is moving less than normal. If your baby is not moving at all, call your doctor right away.

Prenatal tests

Tests are used during pregnancy to check your and your baby's health. At your fist prenatal visit, your doctor will use tests to check for a number of things, such as:

  • Your blood type and Rh factor
  • Infections, such as toxoplasmosis and sexually transmitted infections (STIs), including hepatitis B , syphilis , chlamydia , and HIV
  • Signs that you are immune to rubella (German measles) and chicken pox

Throughout your pregnancy, your doctor or midwife may suggest a number of other tests, too. Some tests are suggested for all women, such as screenings for gestational diabetes, Down syndrome, and HIV. Other tests might be offered based on your:

  • Personal or family health history
  • Ethnic background
  • Results of routine tests

Some tests are screening tests. They detect risks for or signs of possible health problems in you or your baby. Based on screening test results, your doctor might suggest diagnostic tests. Diagnostic tests confirm or rule out health problems in you or your baby.

Understanding prenatal tests and test results

If your doctor suggests certain prenatal tests, don't be afraid to ask lots of questions. Learning about the test, why your doctor is suggesting it for you, and what the test results could mean can help you cope with any worries or fears you might have. Keep in mind that screening tests do not diagnose problems. They evaluate risk. So if a screening test comes back abnormal, this doesn't mean there is a problem with your baby. More information is needed. Your doctor can explain what test results mean and possible next steps.

Avoid keepsake ultrasounds

You might think a keepsake ultrasound is a must-have for your scrapbook. But, doctors advise against ultrasound when there is no medical need to do so. Some companies sell "keepsake" ultrasound videos and images. Although ultrasound is considered safe for medical purposes, exposure to ultrasound energy for a keepsake video or image may put a mother and her unborn baby at risk. Don't take that chance.

High-risk pregnancy

Pregnancies with a greater chance of complications are called "high-risk." But this doesn't mean there will be problems. The following factors may increase the risk of problems during pregnancy:

  • Very young age or older than 35
  • Overweight or underweight
  • Problems in previous pregnancy
  • Health conditions you have before you become pregnant, such as high blood pressure , diabetes , autoimmune disorders , cancer , and HIV
  • Pregnancy with twins or other multiples

Health problems also may develop during a pregnancy that make it high-risk, such as gestational diabetes or preeclampsia . See Pregnancy complications to learn more.

Women with high-risk pregnancies need prenatal care more often and sometimes from a specially trained doctor. A maternal-fetal medicine specialist is a medical doctor that cares for high-risk pregnancies.

If your pregnancy is considered high risk, you might worry about your unborn baby's health and have trouble enjoying your pregnancy. Share your concerns with your doctor. Your doctor can explain your risks and the chances of a real problem. Also, be sure to follow your doctor's advice. For example, if your doctor tells you to take it easy, then ask your partner, family members, and friends to help you out in the months ahead. You will feel better knowing that you are doing all you can to care for your unborn baby.

Paying for prenatal care

Pregnancy can be stressful if you are worried about affording health care for you and your unborn baby. For many women, the extra expenses of prenatal care and preparing for the new baby are overwhelming. The good news is that women in every state can get help to pay for medical care during their pregnancies. Every state in the United States has a program to help. Programs give medical care, information, advice, and other services important for a healthy pregnancy.

Learn more about programs available in your state.

You may also find help through these places:

  • Local hospital or social service agencies – Ask to speak with a social worker on staff. She or he will be able to tell you where to go for help.
  • Community clinics – Some areas have free clinics or clinics that provide free care to women in need.
  • Women, Infants and Children (WIC) Program – This government program is available in every state. It provides help with food, nutritional counseling, and access to health services for women, infants, and children.
  • Places of worship

More information on prenatal care and tests

Read more from womenshealth.gov.

  • Pregnancy and Medicines Fact Sheet - This fact sheet provides information on the safety of using medicines while pregnant.

Explore other publications and websites

  • Chorionic Villus Sampling (CVS) (Copyright © March of Dimes) - Chorionic villus sampling (CVS) is a prenatal test that can diagnose or rule out certain birth defects. The test is generally performed between 10 and 12 weeks after a woman's last menstrual period. This fact sheet provides information about this test, and how the test sample is taken.
  • Folic Acid (Copyright © March of Dimes) - This fact sheet stresses the importance of getting higher amounts of folic acid during pregnancy in order to prevent neural tube defects in unborn children.
  • Folic Acid: Questions and Answers - The purpose of this question and answer sheet is to educate women of childbearing age on the importance of consuming folic acid every day to reduce the risk of spina bifida.
  • For Women With Diabetes: Your Guide to Pregnancy - This booklet discusses pregnancy in women with diabetes. If you have type 1 or type 2 diabetes and you are pregnant or hoping to get pregnant soon, you can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy.
  • Genetics Home Reference - This website provides information on specific genetic conditions and the genes or chromosomes responsible for these conditions.
  • Guidelines for Vaccinating Pregnant Women - This publication provides information on routine and other vaccines and whether they are recommended for use during pregnancy.
  • How Your Baby Grows (Copyright © March of Dimes) - This site provides information on the development of your baby and the changes in your body during each month of pregnancy. In addition, for each month, it provides information on when to go for prenatal care appointments and general tips to take care of yourself and your baby.
  • Pregnancy Registries - Pregnancy registries help women make informed and educated decisions about using medicines during pregnancy. If you are pregnant and currently taking medicine — or have been exposed to a medicine during your pregnancy — you may be able to participate and help in the collection of this information. This website provides a list of pregnancy registries that are enrolling pregnant women.
  • Pregnancy, Breastfeeding, and Bone Health - This publication provides information on pregnancy-associated osteoporosis, lactation and bone loss, and what you can do to keep your bones healthy during pregnancy.
  • Prenatal Care: First-Trimester Visits (Copyright © Mayo Foundation) - This fact sheet explains what to expect during routine exams with your doctor. In addition, if you have a condition that makes your pregnancy high-risk, special tests may be performed on a regular basis to check the baby's health.
  • Ten Tips for a Healthy Pregnancy (Copyright © Lamaze International) - This easy-to-read fact sheet provides 10 simple recommendations to help mothers have a healthy pregnancy.
  • Ultrasound (Copyright © March of Dimes) - This fact sheet discusses the use of an ultrasound in prenatal care at each trimester.

Connect with other organizations

  • American Academy of Family Physicians
  • American Association of Birth Centers
  • American College of Obstetricians and Gynecologists
  • Center for Research on Reproduction and Women's Health, University of Pennsylvania Medical Center
  • Dona International
  • March of Dimes
  • Maternal and Child Health Bureau, HRSA, HHS
  • National Association for Down Syndrome
  • National Center on Birth Defects and Developmental Disabilities, CDC
  • Public Information and Communications Branch, NICHD, NIH, HHS
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pregnant ob visit

Evaluation of the Obstetric Patient

  • Physical Examination |
  • Treatment |

Once pregnant, women require routine prenatal care to help safeguard their health and the health of the fetus. Also, evaluation is often required for symptoms and signs of illness. Common symptoms that are often pregnancy-related include

Vaginal bleeding

Pelvic pain

Lower-extremity edema

Specific obstetric disorders and nonobstetric disorders in pregnant woman are discussed elsewhere.

The initial routine prenatal visit should occur between 6 and 8 weeks gestation.

Follow-up visits should occur at

About 4-week intervals until 28 weeks

2-week intervals from 28 to 36 weeks

Weekly thereafter until delivery

Prenatal visits may be scheduled more frequently if risk of a poor pregnancy outcome is high or less frequently if risk is very low.

Prenatal care includes

Screening for disorders

Taking measures to reduce fetal and maternal risks

General reference

1. Shaw GM, O'Malley CD, Wasserman CR, et al : Maternal periconceptional use of multivitamins and reduced risk for conotruncal heart defects and limb deficiencies among offspring. Am J Med Genet 59:536–545, 1995. doi:10.1002/ajmg.1320590428

During the initial visit, clinicians should obtain a full medical history, including

Previous and current disorders

Drug use (therapeutic, social, and illicit)

Risk factors for complications of pregnancy (see table Pregnancy Risk Assessment )

Obstetric history, with the outcome of all previous pregnancies, including maternal and fetal complications (eg, gestational diabetes, preeclampsia, congenital malformations, stillbirth)

Family history should include all chronic disorders in family members to identify possible hereditary disorders ( genetic evaluation ).

During subsequent visits, queries focus on interim developments, particularly vaginal bleeding or fluid discharge, headache, changes in vision, edema of face or fingers, and changes in frequency or intensity of fetal movement.

Gravidity and parity

Gravidity is the number of confirmed pregnancies; a pregnant woman is a gravida. Parity is the number of deliveries after 20 weeks. Multifetal pregnancy is counted as one in terms of gravidity and parity. Abortus is the number of pregnancy losses (abortions) before 20 weeks regardless of cause (eg, spontaneous, therapeutic, or elective abortion; ectopic pregnancy). Sum of parity and abortus equals gravidity.

Parity is often recorded as 4 numbers:

Number of term deliveries (after 37 weeks)

Number of premature deliveries ( > 20 and < 37 weeks)

Number of abortions

Number of living children

Thus, a woman who is pregnant and has had one term delivery, one set of twins born at 32 weeks, and 2 abortions is gravida 5, para 1-1-2-3.

Physical Examination

A full general examination, including blood pressure (BP), height, and weight, is done first. Body mass index (BMI) should be calculated and recorded. BP and weight should be measured at each prenatal visit.

In the initial obstetric examination, speculum and bimanual pelvic examination is done for the following reasons:

To check for lesions or discharge

To note the color and consistency of the cervix

To obtain cervical samples for testing

Also, fetal heart rate and, in patients presenting later in pregnancy, lie of the fetus are assessed (see figure Leopold maneuver ).

Pelvic capacity can be estimated clinically by evaluating various measurements with the middle finger during bimanual examination. If the distance from the underside of the pubic symphysis to the sacral promontory is > 11.5 cm, the pelvic inlet is almost certainly adequate. Normally, distance between the ischial spines is ≥ 9 cm, length of the sacrospinous ligaments is 4 to ≥ 5 cm, and the subpubic arch is ≥ 90 ° .

During subsequent visits, BP and weight assessment is important. Obstetric examination focuses on uterine size, fundal height (in cm above the symphysis pubis), fetal heart rate and activity, and maternal diet, weight gain, and overall well-being. Speculum and bimanual examination is usually not needed unless vaginal discharge or bleeding, leakage of fluid, or pain is present.

Laboratory testing

Prenatal evaluation involves urine tests and blood tests. Initial laboratory evaluation is thorough; some components are repeated during follow-up visits (see table Components of Routine Prenatal Evaluation).

If a woman has Rh-negative blood, she may be at risk of developing Rh(D) antibodies, and if the father has Rh-positive blood, the fetus may be at risk of developing erythroblastosis fetalis . Rh(D) antibody levels should be measured in pregnant women at the initial prenatal visit and again at about 26 to 28 weeks. At that time, women who have Rh-negative blood are given a prophylactic dose of Rh(D) immune globulin. Additional measures may be necessary to prevent development of maternal Rh antibodies.

Urine is also tested for protein. Proteinuria before 20 weeks gestation suggests kidney disease. Proteinuria after 20 weeks gestation may indicate preeclampsia .

Generally, women are routinely screened for gestational diabetes between 24 and 28 weeks using a 50-g, 1-hour test. However, if women have significant risk factors for gestational diabetes, they are screened during the 1st trimester. These risk factors include

Gestational diabetes or a macrosomic neonate (weight > 4500 g at birth) in a previous pregnancy

Unexplained fetal losses

A strong family history of diabetes in 1st-degree relatives

A history of persistent glucosuria

Body mass index (BMI) > 30 kg/m2

Polycystic ovary syndrome with insulin resistance

If the 1st-trimester test is normal, the 50-g test should repeated at 24 to 28 weeks, followed, if abnormal, by a 3-hour test. Abnormal results on both tests confirms the diagnosis of gestational diabetes.

Women at high risk of aneuploidy (eg, those > 35 years, those who have had a child with Down syndrome) should be offered screening with maternal serum cell-free DNA .

In some pregnant women, blood tests to screen for thyroid disorders (measurement of thyroid-stimulating hormone [TSH]) are done. These women may include those who

Have symptoms

Come from an area where moderate to severe iodine insufficiency occurs

Have a family or personal history of thyroid disorders

Have type 1 diabetes

Have a history of infertility, preterm delivery, or miscarriage

Have had head or neck radiation therapy

Are morbidly obese (BMI > 40 kg/m2)

Are > 30 years

Ultrasonography

Most obstetricians recommend at least one ultrasound examination during each pregnancy, ideally between 16 and 20 weeks, when estimated delivery date (EDD) can still be confirmed fairly accurately and when placental location and fetal anatomy can be evaluated. Estimates of gestational age are based on measurements of fetal head circumference, biparietal diameter, abdominal circumference, and femur length. Measurement of fetal crown-rump length during the 1st trimester is particularly accurate in predicting EDD: to within about 5 days when measurements are made at < 12 weeks gestation and to within about 7 days at 12 to 15 weeks. Ultrasonography during the 3rd trimester is accurate for predicting EDD to within about 2 to 3 weeks.

Specific indications for ultrasonography include

Investigation of abnormalities during the 1st trimester (eg, indicated by abnormal results of noninvasive maternal screening tests)

Risk assessment for chromosomal abnormalities (eg, Down syndrome) including nuchal translucency measurement

Need for detailed assessment of fetal anatomy (usually at about 16 to 20 weeks), possibly including fetal echocardiography at 20 weeks if risk of congenital heart defects is high (eg, in women who have type 1 diabetes or have had a child with a congenital heart defect)

Detection of multifetal pregnancy, hydatidiform mole, polyhydramnios, placenta previa, or ectopic pregnancy

Determination of placental location, fetal position and size, and size of the uterus in relation to given gestational dates (too small or too large)

Ultrasonography is also used for needle guidance during chorionic villus sampling , amniocentesis , and fetal transfusion. High-resolution ultrasonography includes techniques that maximize sensitivity for detecting fetal malformations.

If ultrasonography is needed during the 1st trimester (eg, to evaluate pain, bleeding, or viability of pregnancy), use of an endovaginal transducer maximizes diagnostic accuracy; evidence of an intrauterine pregnancy (gestational sac or fetal pole) can be seen as early as 4 to 5 weeks and is seen at 7 to 8 weeks in > 95% of cases. With real-time ultrasonography, fetal movements and heart motion can be directly observed as early as 5 to 6 weeks.

Other imaging

Conventional x-rays can induce spontaneous abortion or congenital malformations, particularly during early pregnancy. Risk is remote (up to about 1/million) with each x-ray of an extremity or of the neck, head, or chest if the uterus is shielded. Risk is higher with abdominal, pelvic, and lower back x-rays. Thus, for all women of childbearing age, an imaging test with less ionizing radiation (eg, ultrasonography) should be substituted when possible, or if x-rays are needed, the uterus should be shielded (because pregnancy is possible).

Medically necessary x-rays or other imaging should not be postponed because of pregnancy. However, elective x-rays are postponed until after pregnancy.

Problems identified during evaluation are managed.

Women are counseled about exercise and diet and advised to follow the Institute of Medicine guidelines for weight gain, which are based on prepregnancy body mass index (BMI—see table Guidelines for Weight Gain During Pregnancy ). Nutritional supplements are prescribed.

What to avoid, what to expect, and when to obtain further evaluation are explained. Couples are encouraged to attend childbirth classes.

Diet and supplements

To provide nutrition for the fetus, most women require about 250 kcal extra daily; most calories should come from protein. If maternal weight gain is excessive ( > 1.4 kg/month during the early months) or inadequate ( < 0.9 kg/month), diet must be modified further. Weight-loss dieting during pregnancy is not recommended, even for morbidly obese women.

Most pregnant women need a daily oral iron supplement of ferrous sulfate 300 mg or ferrous gluconate 450 mg, which may be better tolerated. Woman with anemia should take the supplements twice a day.

All women should be given oral prenatal vitamins that contain folate 400 mcg (0.4 mg), taken once a day; folate reduces risk of neural tube defects. For women who have had a fetus or infant with a neural tube defect, the recommended daily dose is 4000 mcg (4 mg).

Physical activity

Exercise during pregnancy has minimal risks and has demonstrated benefits for most pregnant women, including maintenance or improvement of physical fitness, control of gestational weight gain, reduction in low back pain, and possibly a reduction in risk of developing gestational diabetes or preeclampsia. Moderate exercise is not a direct cause of any adverse pregnancy outcome; however, pregnant women may be at greater risk of injuries to joints, falling, and abdominal trauma. Abdominal trauma can result in abruptio placentae, which can lead to fetal morbidity or death.

Most experts agree that exercise during pregnancy is safe and can improve pregnancy outcomes (eg, reduced excessive gestational weight gain, gestational diabetes [ 1 ]).

Sexual intercourse can be continued throughout pregnancy unless vaginal bleeding, pain, leakage of amniotic fluid, or uterine contractions occur.

The safest time to travel during pregnancy is between 14 and 28 weeks, but there is no absolute contraindication to travel at any time during pregnancy. Pregnant women should wear seat belts regardless of gestational age and type of vehicle.

Travel on airplanes is safe until 36 weeks gestation. The primary reason for this restriction is the risk of labor and delivery in an unfamiliar environment.

During any kind of travel, pregnant women should stretch and straighten their legs and ankles periodically to prevent venous stasis and the possibility of thrombosis. For example, on long flights, they should walk or stretch every 2 to 3 hours. In some cases, the clinician may recommend thromboprophylaxis for prolonged travel.

Immunizations

Vaccines for measles, mumps, rubella, and varicella should not be used during pregnancy.

Although the COVID 19 vaccine has not been specifically evaluated in pregnant women, the American College of Obstetricians and Gynecologists (ACOG) recommends that COVID-19 vaccines not be withheld from pregnant women who meet the criteria for vaccination based on the Advisory Committee on Immunization Practices (ACIP) recommended priority groups. Various COVID 19 vaccines have received authorization for emergency use from the Food and Drug Administration (FDA) and the World Health Organization (WHO) as listed on its Emergency Use Listing. (See also the Centers for Disease Control and Prevention: COVID-19 vaccination .)

Because pregnant women with Rh-negative blood are at risk of developing Rh(D) antibodies, they are given Rh(D) immune globulin 300 mcg IM in any of the following situations:

After any significant vaginal bleeding or other sign of placental hemorrhage or placental abruption

After a spontaneous or therapeutic abortion

After amniocentesis or chorionic villus sampling

Prophylactically at 28 weeks

If the neonate has Rh(D)-positive blood, after delivery

Modifiable risk factors

Pregnant women should not use alcohol and tobacco and should avoid exposure to secondhand smoke.

They should also avoid the following:

Exposure to chemicals or paint fumes

Direct handling of cat litter (due to risk of toxoplasmosis)

Prolonged temperature elevation (eg, in a hot tub or sauna)

Exposure to people with active viral infections (eg, rubella, parvovirus infection [fifth disease], varicella)

Women with substance abuse problems should be monitored by a specialist in high-risk pregnancy . Screening for domestic violence and depression should be done.

Drugs and vitamins that are not medically indicated should be discouraged (see Drugs in Pregnancy ).

Symptoms requiring evaluation

Women should be advised to seek evaluation for unusual headaches, visual disturbances, pelvic pain or cramping, vaginal bleeding, rupture of membranes, extreme swelling of the hands or face, diminished urine volume, any prolonged illness or infection, or persistent symptoms of labor.

Multiparous women with a history of rapid labor should notify the physician at the first symptom of labor.

Treatment reference

1. Syed H, Slayman T, Thoma KD: ACOG [American College of Obstetricians and Gynecologists] Committee Opinion No. 804 : Physical activity and exercise during pregnancy and the postpartum period. 2020. PMID: 33481513. doi: 10.1097/AOG.0000000000004266

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  • > Prenatal Visit Schedule: What To Expect During Each Appointment

Prenatal Visit Schedule: What To Expect During Each Appointment

Prenatal care is an important part of a healthy pregnancy and allows your doctor to regularly monitor you and your baby . But what should you expect when it comes to your prenatal visit schedule?

Basically, you’ll visit your doctor once a month at the beginning of your pregnancy and then once a week at the end of your pregnancy. That said, it’s important to schedule your first prenatal visit as soon as you see a positive pregnancy test!

In this article, the experts at Mustela discuss how your prenatal visit schedule will most likely look and what to expect during each appointment.

Prenatal Visit Schedule: First Trimester

Expecting mom ready to schedule prenatal visit

This is such an exciting time in your life! When you saw the positive pregnancy test , you were probably four to six weeks pregnant, so go ahead and call your doctor to schedule your first appointment.

During the first trimester , you will have your initial prenatal visit, and then your doctor will schedule your visits every four weeks or once a month.

Check with the doctor or staff for a printout of your prenatal visit schedule.

What To Expect At Your First Appointment

Your first prenatal visit will be around six to nine weeks and will most likely be the lengthiest of all your appointments, so block out a good bit of time on your calendar.

Your doctor will ask a good bit of detailed questions and perform a pretty thorough check. Let’s take a look at what they’ll do during this appointment.

Medical History

Your doctor will ask questions about your:

  • Last menstrual cycle so they can give you a due date
  • Gynecological history
  • Obstetrical history (any past pregnancies)
  • Personal and family medical history
  • Supplements or medicines you’re taking (if any)
  • Lifestyle (use of tobacco products, alcohol, and caffeine; eating and exercising habits)
  • Recent travel adventures
  • Feelings of depression or anxiety (if any)

Your doctor will order various lab work to check your blood for:

  • Blood type and Rh status
  • Hemoglobin levels
  • Infections such as hepatitis B, syphilis, gonorrhea, chlamydia, and HIV
  • Thyroid levels
  • Any other important screenings

Physical Exam

To give you and your baby the best care, your doctor will need to do a thorough physical exam, which most likely will also include a Pap smear to detect any abnormal cervical cells.

Your doctor’s observation also includes:

  • Checking your blood pressure
  • Measuring your height and weight to determine your recommended weight gain for a healthy pregnancy
  • A breast exam
  • A pelvic exam
  • Screening your heart, lungs, and thyroid

Discuss any pregnancy discomforts , such as nausea and fatigue, with your doctor. Be honest with your doctor so they can take care of you and your baby to the best of their knowledge.

woman at her scheduled prenatal visit

Some doctors also do an ultrasound during the first trimester to confirm or date your pregnancy. (Your first prenatal visit will vary based on the specific policies of your doctor’s office.)

What To Expect At Your 12-Week Appointment

You're nearing the end of your first trimester! During this appointment, you can expect your doctor to check the following:

  • Weight and blood pressure
  • Urine for sugar and protein levels
  • Your baby’s heartbeat (This will be the first time you’ll hear it!)
  • Size of your uterus
  • Hands and feet for any swelling

Prenatal Visit Schedule: Second Trimester

pregnant woman having her belly measured

Assuming you have a healthy pregnancy and no further examinations are necessary, this is what your prenatal visit schedule will look like during your second trimester :

  • Four-month appointment (around 16 weeks)
  • Five-month appointment (around 20 weeks)
  • Six-month appointment (around 24 weeks)

What To Expect During Routine Appointments

Many of your appointments from here on out will look similar regarding what your doctor will check for. During these visits, you can expect your doctor to look at:

  • Your baby’s heartbeat
  • Your fundal height (The size of your uterus is used to assess fetal growth and development. Your doctor will get this measurement by measuring the length from the top of your uterus to the top of your pubic bone. This measurement should match how many weeks you are. Example: If you’re 20 weeks pregnant, your fundal height should equal 20 centimeters.)
  • Hands and feet for swelling
  • Any symptoms you’ve been experiencing

At this point in your pregnancy, you may notice your skin becoming dry and starting to stretch a bit. Don’t worry; it’s completely normal!

To tackle dry skin, try Mustela’s Stretch Marks Cream . This velvety, hard-working cream delivers immediate moisture and comfort to your skin!

And our Stretch Marks Oil treats recently formed stretch marks. It’s a fast-absorbing oil that hydrates your skin throughout your pregnancy!

What To Expect During Your 20-Week Sonogram:

Sometime around your 20-week appointment, your doctor will schedule an ultrasound to determine the gender of your baby! During this sonogram, your sonographer will take a look at:

  • Baby’s size and all their major organs
  • Amniotic fluid
  • Location of placenta

Your sonographer passes this information to your doctor to give them a clear picture (literally!) of the overall health of your baby and your pregnancy.

Prenatal Visit Schedule: Third Trimester

woman following her prenatal visit schedule

During your third trimester , your prenatal visits will be every two weeks until the last month of your pregnancy, when you’ll have them every week. So that means your prenatal visit schedule will look like this:

What To Expect At Your Seventh- and Eighth-Month Visits

During your seventh and eighth months of pregnancy, expect your doctor to check the following:

  • Urine for sugar and protein
  • Your fundal height (top of your uterus)
  • Size and position of your baby
  • Feet and hands for swelling
  • Varicose veins in your legs
  • Glucose screen test (read below for more information)
  • Group B strep test (read below for more information)
  • Blood test for anemia
  • Any symptoms you’ve been having

up-close of a pregnant woman's belly

Glucose Screen Test

This test is used to determine if you have gestational diabetes. Once you arrive at your doctor’s office, be prepared to have your blood drawn first.

Next, you’ll drink a very sugary drink that tastes like flat orange soda. Some women enjoy the taste, while others feel a little queasy afterward!

After you consume the entire drink, you’ll wait one hour before having your blood drawn again. If your blood work comes back with elevated numbers, your doctor will order the next level of tests, which is used to officially diagnose gestational diabetes.

Should you need to take the second test (no studying required!), you’ll have to fast before the appointment. Just like with the initial round of tests, your doctor will draw your blood first and then have you consume the drink.

The only difference is this time, your blood will be drawn every hour for three hours. Be prepared to stay in your doctor’s office for three to four hours.

If the results from this test also come back elevated, your doctor will discuss management techniques for gestational diabetes.

But don’t let this information worry you. Most women who monitor their blood sugar levels and work closely with their doctor have perfectly normal pregnancies and healthy babies!

woman waiting for her next prenatal visit

Group B Strep Test

Group B Strep (GBS) is bacteria that can be found in the vaginas of healthy women. (It’s not related to strep, the throat infection.)

If you are a carrier of GBS, your baby can catch the infection during delivery when they pass through the birth canal. While this bacteria isn’t harmful to you, it can be dangerous for your baby.

To check for GBS, your doctor will perform a test just like they would a Pap smear. If the test shows that you’re a carrier, you’ll receive antibiotics through an IV once you’re in labor. This way, you won’t pass the infection to your baby!

You’re routinely tested for GBS around the seventh or eighth month of pregnancy so your doctors can be prepared to give you the antibiotics at the onset of labor.

What To Expect During Your Ninth Month

Similar to months seven and eight, your doctor will closely monitor you and your baby during this time. Since you’re getting closer to your due date, expect a few additional observations from your doctor.

During your last month of pregnancy, they will take a look at:

  • Your cervix by an internal examination to check for effacement (thinning) and dilation (opening)
  • Baby’s heartbeat
  • Baby’s size (At this point in your pregnancy, your doctor may give you an estimation of your baby’s weight. They can tell your baby’s presentation: head or bottom first, and their position: front- or rear-facing.)
  • Any questions or concerns you may have about delivery

A Beautiful Pregnancy And Beautiful Skin

Pregnant woman contemplating her prenatal visit schedule

Throughout these nine months , your prenatal visits are special moments of checking on your sweet little baby. It’s exciting to see your belly grow with each visit! But that also means possible stretch marks.

The good news is that Mustela offers a line of prenatal products, including our Stretch Marks Cream and Bust Firming Serum , to soothe and hydrate your skin while you manage the busyness of your prenatal visit schedule.

Let Mustela help you start your beautiful pregnancy with beautiful skin!

Essential Care Multi-Purpose Lotion *NEW*

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  3. What to expect at your first prenatal appointment

    When to schedule your first prenatal visit. As soon as you get a positive result on a home pregnancy test, book an appointment with an obstetrician, family physician, or midwife.Depending on the practice, it's normal for another provider in the office, like a nurse practitioner or physician assistant, to handle your first visit.

  4. First Prenatal Visit: What to Expect at First Pregnancy Appointment

    The most common tests at your first prenatal visit will likely include: [3] Urine test. Your urine may be checked for protein, glucose (sugar), white blood cells, blood and bacteria. Bloodwork. A sample of your blood will be used to determine blood type and Rh status and check for anemia. Trusted Source Mayo Clinic Rh factor blood test See All ...

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    When to schedule a prenatal visit. Make an appointment for your first prenatal visit once you're aware you are pregnant - when you receive a positive home pregnancy test, for example. Booking it around week 8 of pregnancy is typical. You'll come back regularly in the weeks and months following that initial appointment.

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    If you did not meet with your health care provider before you were pregnant, your first prenatal visit will generally be around 8 weeks after your LMP (last menstrual period ). If this applies to you, you should schedule a prenatal visit as soon as you know you are pregnant! Even if you are not a first-time mother, prenatal visits are still ...

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    If your first prenatal appointment comes later in your pregnancy, around 10 or 12 weeks or later, your provider may use a traditional ultrasound or Doppler to check the fetal heartbeat. Earlier ...

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    Typical prenatal appointment schedule. The number of visits you'll have in a typical pregnancy usually total about 10 to 15, depending on when you find out you're expecting and the timing of your first checkup. In most complication-free pregnancies, you can expect to have a prenatal appointment with the following frequency: Weeks 4 to 28 ...

  9. How Often Do You Need Prenatal Visits?

    For a healthy pregnancy, your doctor will probably want to see you on the following recommended schedule: Weeks 4 to 28 — One prenatal visit every four weeks. Weeks 28 to 36 — One prenatal ...

  10. How Often Do I Need Prenatal Visits?

    For a healthy pregnancy, your doctor will probably want to see you on the following recommended schedule of prenatal visits: Weeks 4 to 28: 1 prenatal visit a month. Weeks 28 to 36: 1 prenatal ...

  11. Prenatal care: 3rd trimester visits

    During the third trimester, prenatal care might include vaginal exams to check the baby's position. By Mayo Clinic Staff. Prenatal care is an important part of a healthy pregnancy, especially as your due date approaches. Your health care provider might ask you to schedule prenatal care appointments during your third trimester about every 2 or 4 ...

  12. Your Prenatal Care Appointments

    Towards the third prenatal visit, you're most likely around 14 to 16 weeks pregnant. You're probably feeling better and the most dangerous part of pregnancy is over. You are now probably feeling more confident in your pregnancy and sharing your good news. It has been about a month since you've seen the midwife or doctor.

  13. Prenatal care: 2nd trimester visits

    During the second trimester, prenatal care includes routine lab tests and measurements of your baby's growth. You might consider prenatal testing, too. By Mayo Clinic Staff. The goal of prenatal care is to ensure that you and your baby remain healthy during your entire pregnancy. Ideally, prenatal care starts as soon as you think you're pregnant.

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    Typically, this visit happens at 6-8 weeks of pregnancy. Your doctor may confirm your pregnancy through urine tests, blood tests or ultrasounds. Initial Prenatal Appointment: 5-12 Weeks. Your first prenatal visit consists of important screenings and discussions, so your healthcare team can create a care plan that ensures you and baby stay ...

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    At a glance, you'll likely have pregnancy appointments once every month (so every four weeks), between your first prenatal visit and 28 weeks of pregnancy, says Stephanie Hack, MD, ob-gyn and host of the Lady Parts Doctor podcast. Between 28 and 36 weeks, you'll see your provider twice a month. After 36 weeks, as you get closer to delivery ...

  17. What happens during prenatal visits?

    What happens during prenatal visits varies depending on how far along you are in your pregnancy. Schedule your first prenatal visit as soon as you think you are pregnant, even if you have confirmed your pregnancy with a home pregnancy test. Early and regular prenatal visits help your health care provider monitor your health and the growth of the fetus.

  18. Third trimester: What happens at your prenatal appointments

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    So that means your prenatal visit schedule will look like this: 28 weeks 30 weeks 32 weeks 34 weeks 36 weeks 37 weeks 38 weeks 39 weeks 40 weeks What To Expect At Your Seventh- and Eighth-Month Visits During your seventh and eighth months of pregnancy, expect your doctor to check the following: Weight and blood pressure Urine for sugar and ...

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