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Prenatal care: 1st trimester visits

Pregnancy and prenatal care go hand in hand. During the first trimester, prenatal care includes blood tests, a physical exam, conversations about lifestyle and more.

Prenatal care is an important part of a healthy pregnancy. Whether you choose a family physician, obstetrician, midwife or group prenatal care, here's what to expect during the first few prenatal appointments.

The 1st visit

When you find out you're pregnant, make your first prenatal appointment. Set aside time for the first visit to go over your medical history and talk about any risk factors for pregnancy problems that you may have.

Medical history

Your health care provider might ask about:

Your menstrual cycle, gynecological history and any past pregnancies
Your personal and family medical history
Exposure to anything that could be toxic
Medications you take, including prescription and over-the-counter medications, vitamins or supplements
Your lifestyle, including your use of tobacco, alcohol, caffeine and recreational drugs
Travel to areas where malaria, tuberculosis, Zika virus, mpox — also called monkeypox — or other infectious diseases are common

Share information about sensitive issues, such as domestic abuse or past drug use, too. This will help your health care provider take the best care of you — and your baby.

Your due date is not a prediction of when you will have your baby. It's simply the date that you will be 40 weeks pregnant. Few people give birth on their due dates. Still, establishing your due date — or estimated date of delivery — is important. It allows your health care provider to monitor your baby's growth and the progress of your pregnancy. Your due date also helps with scheduling tests and procedures, so they are done at the right time.

To estimate your due date, your health care provider will use the date your last period started, add seven days and count back three months. The due date will be about 40 weeks from the first day of your last period. Your health care provider can use a fetal ultrasound to help confirm the date. Typically, if the due date calculated with your last period and the due date calculated with an early ultrasound differ by more than seven days, the ultrasound is used to set the due date.

Physical exam

To find out how much weight you need to gain for a healthy pregnancy, your health care provider will measure your weight and height and calculate your body mass index.

Your health care provider might do a physical exam, including a breast exam and a pelvic exam. You might need a Pap test, depending on how long it's been since your last Pap test. Depending on your situation, you may need exams of your heart, lungs and thyroid.

At your first prenatal visit, blood tests might be done to:

Check your blood type. This includes your Rh status. Rh factor is an inherited trait that refers to a protein found on the surface of red blood cells. Your pregnancy might need special care if you're Rh negative and your baby's father is Rh positive.
Measure your hemoglobin. Hemoglobin is an iron-rich protein found in red blood cells that allows the cells to carry oxygen from your lungs to other parts of your body. Hemoglobin also carries carbon dioxide from other parts of your body to your lungs so that it can be exhaled. Low hemoglobin or a low level of red blood cells is a sign of anemia. Anemia can make you feel very tired, and it may affect your pregnancy.
Check immunity to certain infections. This typically includes rubella and chickenpox (varicella) — unless proof of vaccination or natural immunity is documented in your medical history.
Detect exposure to other infections. Your health care provider will suggest blood tests to detect infections such as hepatitis B, syphilis, gonorrhea, chlamydia and HIV , the virus that causes AIDS . A urine sample might also be tested for signs of a bladder or urinary tract infection.

Tests for fetal concerns

Prenatal tests can provide valuable information about your baby's health. Your health care provider will typically offer a variety of prenatal genetic screening tests. They may include ultrasound or blood tests to check for certain fetal genetic problems, such as Down syndrome.

Lifestyle issues

Your health care provider might discuss the importance of nutrition and prenatal vitamins. Ask about exercise, sex, dental care, vaccinations and travel during pregnancy, as well as other lifestyle issues. You might also talk about your work environment and the use of medications during pregnancy. If you smoke, ask your health care provider for suggestions to help you quit.

Discomforts of pregnancy

You might notice changes in your body early in your pregnancy. Your breasts might be tender and swollen. Nausea with or without vomiting (morning sickness) is also common. Talk to your health care provider if your morning sickness is severe.

Other 1st trimester visits

Your next prenatal visits — often scheduled about every four weeks during the first trimester — might be shorter than the first. Near the end of the first trimester — by about 12 to 14 weeks of pregnancy — you might be able to hear your baby's heartbeat with a small device, called a Doppler, that bounces sound waves off your baby's heart. Your health care provider may offer a first trimester ultrasound, too.

Your prenatal appointments are an ideal time to discuss questions you have. During your first visit, find out how to reach your health care team between appointments in case concerns come up. Knowing help is available can offer peace of mind.

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Lockwood CJ, et al. Prenatal care: Initial assessment. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
Prenatal care and tests. Office on Women's Health. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests. Accessed July 9, 2018.
Cunningham FG, et al., eds. Prenatal care. In: Williams Obstetrics. 25th ed. New York, N.Y.: McGraw-Hill Education; 2018. https://www.accessmedicine.mhmedical.com. Accessed July 9, 2018.
Lockwood CJ, et al. Prenatal care: Second and third trimesters. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization. http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/. Accessed July 9, 2018.
Bastian LA, et al. Clinical manifestations and early diagnosis of pregnancy. https://www.uptodate.com/contents/search. Accessed July 9, 2018.

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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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Prenatal care and tests

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

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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.

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15 Crucial Questions Every Woman Needs to Ask Her OB/GYN During Pregnancy

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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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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Your Prenatal Care Appointments

If you're pregnant, especially if it's for the first time, you may be wondering what will happen at your prenatal care appointments with your doctor or midwife . Here's a rundown of everything you can expect at each appointment, including tests and exams.

Your First Prenatal Care Appointment

Your first prenatal appointment will probably be your longest one. Here you will give your doctor, midwife, or nurse your complete health and pregnancy history. This information is important because it will give your practitioner a good idea of how healthy you are and what type of problems you are most likely to experience during your pregnancy. You will learn what your estimated due date is as well.

There are many areas that may be checked during your physical exam, including:

Blood pressure
Breast exam
Pelvic exam
Pregnancy test
Ultrasound (if you're having pain or bleeding or underwent fertility treatments)
Urine screen for protein and sugar

You will probably be seen for your first appointment between 8 and 10 weeks gestation, though you may be seen earlier if you're having problems or if it's your doctor or midwife's policy.

Your Second Appointment

Your second prenatal appointment usually takes place about a month after your first appointment, unless you're having problems or need specific prenatal testing that is best performed in a specific time range. Here is what will most likely happen during this visit:

Blood pressure check
Listen to a fetal heartbeat using a Doppler
Record your weight
Urine screen for sugar and protein

Your baby's first heartbeat can usually be heard with a Doppler between 8 and 12 weeks gestation. If you have trouble hearing the baby's heartbeat, you will probably be asked to wait until your next visit when your baby is a bit bigger. Sometimes an ultrasound will be ordered as well.

Additional Testing

Additional testing may be performed at this appointment as needed. There are some optional tests you, your doctor, or your midwife may request:

Chorionic villus sampling (CVS) (diagnostic test for many genetic diseases)
Early amniocentesis (diagnostic test for many genetic diseases)
Nuchal fold test (screening for Down syndrome)

Be sure to discuss all of your options regarding these tests, including the risks and benefits, how the test results are given, and whether the test is a screening test or a diagnostic test.

Your Third Appointment

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. Here's what this appointment may look like:

Check your blood pressure
Listen for baby's heartbeat
Measure your abdomen, called "fundal height," to check baby's growth
Urine sample to screen for sugar and protein

Optional Testing

You may also have the following prenatal testing done if you request it:

Amniocentesis (diagnostic test for many genetic diseases)
Neural tube defect (NTD)/Down syndrome screening by way of maternal blood work (several tests can be used including alpha-fetoprotein (AFP), triple screen, and quad screen)

Your Fourth Appointment

You are most likely between 16 to 20 weeks at this point, and it has been about a month since your last appointment. You probably feel like you've grown a lot since your last appointment and you may now be wearing maternity clothes and possibly even feeling your baby move . Here's what this visit may involve:

Measure your fundal height to check baby's growth

You may also have a mid-pregnancy ultrasound screening if you request it or if it's your doctor or midwife's policy.

Your Fifth Appointment

Between 18 to 22 weeks you'll likely have your fifth prenatal care visit. Here's what this appointment may involve:

Check for swelling in your hands and feet
Listen to the baby's heartbeat

Your Sixth Appointment

Your next prenatal care appointment will likely be between 22 to 26 weeks of pregnancy . You are probably still being seen monthly. Here's what this appointment may look like:

Listen to the baby's heartbeat
Measure your fundal height to check baby's growth
Questions about baby's movements

Your Seventh or Eighth Appointment

Between 26 to 28 weeks of pregnancy , you'll likely have another prenatal care appointment. Here's what may happen:

Check blood pressure
Questions about baby's movements

Other Testing and Information

You may have other tests or procedures ordered, like the glucose tolerance test (GTT) used to screen for gestational diabetes or the RhoGam , shot around 28 weeks of gestation for women who are Rh-negative. Your doctor or midwife may also give you information on screening for preterm labor on your own.

Your Eighth, Ninth Appointments and Beyond

Your next appointment will likely be between 28 to 36 weeks of pregnancy. In fact, you're likely to have at least two prenatal visits during this period because you're now being seen every other week. Here's what these appointments may involve:

Palpate to check baby's position (vertex, breech, posterior, etc.)

Screening for Group B strep (GBS) will normally be done between weeks 34 to 36. This involves rectal and vaginal swab. You will continue to be seen every other week until about the 36th week of pregnancy. At this point, your visits will likely be fairly routine with very few extra tests being performed.

Weekly Visits

Between 36 to 40 weeks of pregnancy, you're usually seen every week. Here's what these visits may entail:

You will continue to be seen every week until about the 41st week of pregnancy, at which point you may be seen every few days until your baby is born. Your visits are most likely fairly routine, with very few extra tests being performed.

You may also have an ultrasound to determine what position the baby is in at this point. Your doctor will also try to predict the size of your baby , but this is usually not very accurate. Because of this tendency for inaccuracy, it's not a great idea to have an induction of labor based on the predicted size of your baby.

If you're having a home birth , you may have a home visit during this time frame if your midwife doesn't do her normal prenatal visits there. You will be able to give her a tour of your home and answer questions she may have about where everything is located.

Overdue Pregnancy Visits

At 40 or 41 weeks of pregnancy, you may begin to see your midwife or doctor every few days. Here is what these visits may look like:

Since you are officially past your due date, your midwife or doctor may want to watch you and your baby more carefully until labor begins. This may include the following tests:

Non-stress test (NST)
Biophysical profile (BPP)

These tests will help determine if your practitioner needs to intervene with an induction of labor for the health of your baby or let your pregnancy continue.

National Institute of Child Health and Human Development. What Happens During Prenatal Visits ?

National Institute of Child Health and Human Development. What are some common complications of pregnancy ?

American College of Obstetricians and Gynecologists. How Your Fetus Grows During Pregnancy .

Mayo Clinic Staff. Prenatal Care: 1st Trimester Visits . Mayo Clinic.

By Robin Elise Weiss, PhD, MPH Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.

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What to expect from third trimester prenatal appointments

During the third trimester, you’ll see your doctor every two weeks, then every week, to check for signs of preterm labor and assess your baby's growth and well-being. Here's exactly what will happen, and questions to ask your doctor.

How often will you have prenatal appointments during the third trimester?

What happens at your third trimester appointments, third trimester testing, questions to ask your ob-gyn during your third trimester, remember to discuss postpartum considerations.

By the time you hit the third trimester ( 28 weeks through the end of pregnancy), you're probably anxious for the baby to arrive and want to get some much-needed rest while you can.

The good news is you'll meet with your doctor more frequently to check on the growth and development of your baby, so you'll have a better sense of when it might be "go" time. In the third trimester, you'll have a prenatal appointment every two weeks from 28 to 36 weeks, then you'll have a prenatal visit once a week during the last month until you deliver.

In some practices where multiple practitioners share the on-call pool, you may make your rounds to get to know everyone as your due date draws near. After all, there's a chance your doctor won't be available when you give birth.

Like your previous prenatal appointments, you can expect to get your blood pressure and weight checked. Some practices have you provide a urine sample to screen for protein, sugar, and infection. Your doctor will also evaluate the baby's heartbeat using a Doppler and measure the fundal height (the distance between your pubic bone and the top of your uterus). At this stage, the measurement should match the number of weeks you're pregnant. So, if you're 37 weeks, your fundal height should be around 37 centimeters.

If your baby is measuring too small or too big , your doctor may order a third trimester ultrasound to evaluate their growth and your amniotic fluid levels. And if you have a high-risk pregnancy , your doctor may also order a third trimester ultrasound to do a biophysical profile (BPP) test, where they'll examine your baby's movement and fluid level.

Your doctor may also order an ultrasound if they aren't sure about your baby's position from an abdominal exam. If it turns out your baby is breech, you may be offered an external cephalic version, which are maneuvers done to try to turn your baby into a vertex (head-down) position.

Past your due date ? Your doctor may check your cervix to see if it's softening, effacing (thinning out), and dilating (opening). The cervical exam may give an idea of what method of induction of labor to use if it's needed. (If you do have a pelvic exam late in pregnancy, you might have a little spotting afterward.) Generally, practitioners won't do cervical checks unless they feel it's necessary, so if you're not comfortable, you can decline them.

You were screened to check whether you're Rh-negative during your first trimester. If it turns out you are Rh-negative, you will be given an injection of Rh immune globulin (sometimes called RhIg or RhoGAM) to prevent your body from producing antibodies for the last part of your pregnancy.

And as always, your doctor will also discuss results from previous tests and follow up on issues that were brought up at your last prenatal appointment.

Some questions you can expect from your practitioner are:

How are you feeling?
Do you feel any unusual pain and aches?
Are you experiencing Braxton-Hicks contractions , which are false labor pains?
Are you having contractions?
How often do you feel your baby move?
Do you have any sudden swelling?
How is your mood?
Are you getting enough sleep at night?
How is your diet?

Whether or not they ask, let your doctor know about any symptoms you're having, even if they seem like the usual fatigue, moodiness, or aches and pains.

Be sure to also let your doctor know if you notice your baby is less active than usual (they may ask you to count your baby's movements for a set period of time each day).

Inside pregnancy: Weeks 28 to 37

A 3D animated look at a baby in the third trimester of pregnancy.

Group B strep

Between 36 and 37 weeks, your practitioner will swab your vagina and rectum to check for a common infection called group B strep . If your test is positive, you'll be given antibiotics during labor to help keep you from passing it on to your baby.

(If you've had a group B strep urinary tract infection during this pregnancy, you won't need this test because even though the infection was treated, you'll automatically get antibiotics during labor. Likewise, you'll be automatically treated during labor if you've previously had a baby infected with group B strep.)

Gestational diabetes

If you were diagnosed with gestational diabetes , your doctor will continue to monitor your blood glucose levels and ensure that you're following a healthy diet and exercise routine. Your doctor may also order a third trimester ultrasound to check your baby's growth and development.

Preeclampsia

Preeclampsia (very high blood pressure) usually develops during the third trimester. Some of the signs of preeclampsia are sudden swelling in the face and hands and protein in the urine. Most of the time, patients with preeclampsia have no symptoms and it's incidentally diagnosed in the office with new onset high blood pressure. If you're past 37 weeks of pregnancy, then your doctor may want to deliver your baby. But if you're not at 37 weeks, your doctor will order an ultrasound and heart rate monitoring to check your baby's well-being. In severe cases, your doctor may want to admit you to the hospital and consider delivering your baby early.

Twins and multiples

Carrying twins, triplets, and higher-order multiples is considered a high-risk pregnancy. Because you're at risk for preterm birth , you may need more frequent prenatal appointments, sometimes weekly. You'll also need more tests, including an ultrasound and/or non-stress test, which tracks your babies' heart rate for a period of time. If you're experiencing symptoms of preterm labor, such as contractions, vaginal spotting, and abdominal cramps, be sure to alert your doctor.

Placenta previa

If you were found to have placenta previa, which is what happens when the placenta partially or totally covers the cervix, you'll have a third trimester ultrasound to check whether the previa has resolved. If it hasn't, you'll most likely have a C-section to deliver your baby safely. Some women with placenta previa experience heavy bleeding, and in this case, your doctor may recommend a C-section to deliver your baby earlier. You'll most likely be given corticosteroids to help your baby's lungs develop faster if your delivery is scheduled before 37 weeks.

Additional tests

Your blood may be checked again for anemia, particularly if you were anemic earlier in your pregnancy.

If you're at risk for sexually transmitted infections, you'll be tested again for syphilis, chlamydia, gonorrhea, and HIV.

Vaccination

You should get the Tdap vaccine to help protect you and your baby from pertussis (whooping cough). Even if you've been vaccinated before, the U.S. Centers for Disease Control and Prevention (CDC) recommend all pregnant women get a booster between 27 and 36 weeks.

If flu season is here or approaching, your practitioner should talk with you about the benefits of getting a flu shot if you haven't already had one. Your doctor will also talk to you about the COVID-19 vaccine , which helps protect you from the virus and lessens the severity of the illness if you become sick. Studies show that antibodies are also passed to the fetus.

Before your appointment, it's a good idea to write down any questions you may have for your doctor. This is also a great time to start thinking about your birth plan as well as what to expect postpartum. Here are some common questions you may want to ask:

Where can I take childbirth classes?
Where should I go if I'm in labor and ready to deliver?
What are signs of labor that I should look out for?
What happens if my water breaks or I go into labor in the middle of the night?
What's the difference between my water breaking and leaking fluid/having discharge?
How do Braxton-Hicks contractions feel, and how are they different from real labor contractions?
How should I time my contractions?
If my contractions are getting more intense and closer together, should I give you a call or head straight to the labor and delivery center?
Will you be there throughout my labor or at my delivery?
What exactly happens during delivery?
How long should I expect to stay at the hospital?
Does the hospital offer lactation support if I'm breastfeeding?
Will the hospital reach out to my baby's pediatrician to transfer records after giving birth?
When should I schedule a postpartum appointment?

Since you may not be in any shape to make important decisions right after delivery, now's the time to start talking about whether you want your baby boy circumcised, whether you plan to breastfeed, and what you'd like to do for contraception after you have your baby. (Of course, you can always change your mind between now and then.)

And if you haven't found a doctor for your baby, it's time to get started. Your practitioner can give you some names.

Finally, your practitioner may screen you for signs of depression during pregnancy. But don't wait to be asked. If you're feeling depressed or anxious, let your caregiver know. They can refer you to someone who can help.

They may also ask you about your support network at home after you've given birth and mention the signs of postpartum depression (PPD) . It's helpful to know how to distinguish normal " baby blues " brought on by fatigue and hormones from true postpartum depression. If you think you may be suffering from depression or anxiety, it's important to get help immediately.

Learn more about what to expect at your prenatal appointments:

What to expect at your prenatal visits
Your first prenatal visit
Second-trimester prenatal visits

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Prenatal visits: What to expect and how to prepare

doctor examining a pregnant women's belly with a stethoscope

Your third trimester pregnancy guide and checklist

third trimester expecting mom and partner

What happens at second trimester prenatal appointments

Pregnant woman getting blood pressure checked

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

Kids's Health. Prenatal Tests: Third Trimester. [Accessed August 2021]

Mayo Clinic. Biophysical Profile https://www.mayoclinic.org/tests-procedures/biophysical-profile/about/pac-20393061 Opens a new window [Accessed August 2021]

Lamaze. Check Your Cervix at Prenatal Appointments? You Don't Have to — Here's Why Some Decline https://www.lamaze.org/Giving-Birth-with-Confidence/GBWC-Post/check-your-cervix-at-prenatal-appointments-you-dont-have-to-heres-why-some-decline-1 Opens a new window [Accessed August 2021]

American College of Obstetricians and Gynecologists. The Rh Factor: How It Can Affect Your Pregnancy. https://www.acog.org/womens-health/faqs/the-rh-factor-how-it-can-affect-your-pregnancy Opens a new window [Accessed August 2021]

U.S. National Library of Medicine. High Blood Pressure in Pregnancy. https://medlineplus.gov/highbloodpressureinpregnancy.html Opens a new window [Accessed August 2021]

Mayo Clinic. Preterm Labor. https://www.mayoclinic.org/diseases-conditions/preterm-labor/symptoms-causes/syc-20376842 Opens a new window [Accessed August 2021]

Mayo Clinic. Placenta Previa. https://www.mayoclinic.org/diseases-conditions/placenta-previa/symptoms-causes/syc-20352768 Opens a new window [Accessed August 2021]

Centers for Disease Control and Prevention. COVID-19 Vaccines While Pregnant or Breastfeeding. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html Opens a new window [Accessed August 2021]

Where to go next

woman holding card with text: active labor

> 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.

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

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!

6 Tips For Finding The Best Maternity Clothes

7 Breastfeeding Myths & Realities

The Best Postpartum Care Plan For New Mothers

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Sign up for essence newsletters the keep the black women at the forefront of conversation., here’s what these black ob-gyns want you to know before starting your pregnancy journey.

Here’s What These Black OB-GYNs Want You To Know Before Starting Your Pregnancy Journey

Maternity care begins at preconception , and three Black OB-GYNs sat down with ESSENCE to discuss what they want you to know before starting your pregnancy journey.

For Black women, the statistics can be scary, especially when considering that “more than 80% of pregnancy-related deaths in the U.S. are preventable” and “Black women are three times more likely to die from a pregnancy-related cause than white women.” But knowing and recognizing the warning signs and taking preventative measures could save your life, and Drs. Cooper, Ejiogu, and Odunsi provide some helpful tips on how to prepare your body before pregnancy.

Chidera C. Ejiogu, MD is a Houston based obstetrics specialist at UTHealth Houston and UT Physicians Women’s Centers. She told ESSENCE “[i]t is most imperative in preparations for pregnancy to make your mind and body the best vehicle possible – this includes adequate nutrition/supplementation, optimization of existing health conditions, and stabilization of one’s mental health.”

Joy A. Cooper, MD MSC calls herself “The Olivia Pope of Ob-Gyn.” In addition to her medical practice, the Oakland based OB-GYN, Cooper is the CEO and co-founder of Culture Care , “a telemedicine startup company that connects Black women with Black doctors.”

Dr. Cooper’s advice: “I say begin with the end in mind to maximize having a beautiful, intentional pregnancy,” and echoed Dr. Ejiogu’s comments around mental health. “We tend to know our outer self pretty well, like our wash day regimen or our skincare regimen. But do you know your HDL? Your last pap smear results and when you’re slated for your next one? Your HbA1c? Your blood pressure range? This is the way to know your inner glow, the flow and cadence of your blood labs and screening tests.”

“For more inner glow, know your mental health status. If you are under extreme stress or going through depression, talk to a therapist or other professional now so you can enter pregnancy as your best self and give yourself the best fight against postpartum depression,” Dr. Cooper continued. “Turn those statistics upside down and ask your providers what you can do to improve your outcomes. Make sure you pick a winning lineup. Black patients tend to do better with Black care teams. Assemble yours today.”

Tosin Odunsi, MD, MPH, is a board-certified obstetrician-gynecologist who has practiced in many states across the country, including Washington, Georgia, Florida, and currently, Illinois. This diverse breadth of professional experience has given her an idea of what OB-GYN care could, and should, look like for patients. She is passionate about equitable healthcare, building trusting patient-provider relationships, and improving processes that support continuity of care.

Dr. Odunsi emphasized that “[t]his disparity exists regardless of factors such as higher education and income. Preventing these outcomes starts with understanding unique risks before even getting pregnant.”

“Address risk factors,” says Dr. Odunsi. “The leading cause of death among Black women are heart disease-related complications, including high blood pressure and pre-eclampsia. Have your blood pressure regularly monitored before, during and after pregnancy. You may even want to have a blood pressure monitor at home in case you have symptoms.”

For Dr. Odunsi, mental health is also a top priority. She wants Black women to “[e]stablish a relationship with a therapist or spiritual leader. It is also safe to do low-impact exercise, such as walking and yoga. Additionally, taking a birthing class to learn about what to expect during labor and delivery can help to alleviate some stress.”

Maternity care also does not end with birth. As Dr. Odunsi notes, “the postpartum period is a critical time that is often overlooked. Up to 45 percent of maternal deaths happen in the weeks after delivery, where people are farther away from medical care and a regular support system. If you are not connecting with your baby, have a loss of interest, or are feeling hopeless, be sure to discuss this with your provider.”

Ultimately, starting a family can be a really happy time—”Think of the bundle or bundles of joy that are on the other end of all this manifesting. Happy preparation and procreating!” says Dr. Cooper.

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do ob claim to your insurance every routine prenatal visit?

I’m billed for each appointment and I’ve been to 3 different places and I had copays for a while.

Five things women should ask their OB-GYN about their heart

F rom the time they reach reproductive age, women are encouraged to visit an OB-GYN at least once a year for a wellness exam that may include screening for breast or cervical cancer, sexually transmitted diseases or other issues involving their reproductive organs.

But a growing body of research suggests there's another organ they should be discussing: the heart.

"Cardiovascular risk assessment is important at all ages, particularly during the childbearing years," said cardiologist Dr. Afshan Hameed, a professor of maternal and fetal medicine at the University of California, Irvine. "But I don't think awareness is where it needs to be. We need to be bringing it up to every woman who comes in for OB-GYN care."

Cardiovascular disease is the No. 1 cause of death in women and a leading cause of pregnancy-related deaths. Many of these deaths could be prevented if a woman's cardiovascular risk was discussed more routinely, but especially before, during and after pregnancy, said Mary Canobbio, a clinical nurse specialist in the adult congenital heart program at the University of California, Los Angeles, School of Nursing.

"The average woman contemplating pregnancy does not think her heart is going to be a problem," she said.

Here are five questions women should ask their OB-GYNs about heart health:

Can birth control affect my heart?

While there are many types of birth control, the most commonly prescribed is the oral contraceptive pill. There are three types of pills, all of which involve hormones—either a combination of estrogen and progesterone or progesterone alone.

But oral contraceptives with estrogen have been shown to increase the risk for blood clots, strokes and heart attacks.

Women who have a history of high blood pressure or who have had blood clots are discouraged from taking estrogen, Canobbio said. "Their gynecologist needs to screen them to see which types of birth control are best suited for them. There are alternatives to hormone-based contraception."

How can pregnancy affect my heart, and what should I do to prevent complications?

Ideally, women should optimize their health before becoming pregnant to prevent complications for themselves and their unborn child, Canobbio and Hameed said. That means maintaining a healthy weight, staying physically active, eating a healthy diet, getting blood pressure under control if it's high and making sure blood glucose levels are within the normal range.

"Most women don't think about their heart as they think about pregnancy, but women who have risk factors—such as obesity, high blood pressure or diabetes—should be concerned and talk to their doctor before they get pregnant," Canobbio said. "These women are at higher risk for problems in their pregnancies."

Obesity, for example, can lead to hypertension, or high blood pressure. Many women may not know they have it, she said.

"It depends on how often they see their primary care doctor or OB-GYN before they get pregnant," Canobbio said. "They may not go because they do not think they are sick. We need to work with these women prior to conception to help them lose weight and get blood pressure under control. They may be prediabetic and not know it. These are all risk factors that women going into pregnancy may not know they have."

Having excess weight or obesity increases the risk for gestational diabetes and preeclampsia, a high blood pressure disorder that can harm mother and child. Preeclampsia can advance to eclampsia, which causes seizures. Obesity also raises the risk of having a baby with a heart defect.

Hameed said she has also seen women in her practice who were born with heart defects but did not mention it because they hadn't had any recent problems. Women born with heart defects have a higher risk of giving birth to a child with a heart defect.

Women "may have had heart defects repaired as a child and it never came up again. But this can become important as the patient gets older, particularly when they become pregnant," Hameed said. "A cardiovascular risk assessment should be done at every single pregnancy and during the postpartum period."

Canobbio said that's true for every woman—not just those with risk factors or underlying disease.

"Even though women feel healthy, they need to be aware that today we are more concerned about women's hearts prior to getting pregnant," she said.

Women who have risk factors or underlying cardiovascular disease should discuss the potential effects on their pregnancy with their health care team, Hameed said. This includes foods or activities to avoid, how medications may affect their unborn child, what tests they may need to take and any other questions they may have.

If the mother is at high risk, Hameed said, she should also make sure the hospital where she plans to deliver is equipped to handle any complications that may arise during childbirth.

What symptoms during and after pregnancy might be related to my heart?

There are symptoms a woman may experience during and even after pregnancy that could signal cardiovascular trouble, Hameed said. For example, shortness of breath and exhaustion might be overlooked if the woman assumes she's just worn out from the pregnancy, but they could be symptoms of peripartum cardiomyopathy, an uncommon type of heart failure that occurs toward the end of a pregnancy or in the months that follow.

It can happen to women with no prior diagnosis of heart disease, and because it mimics some symptoms of pregnancy, women may not recognize it as something heart-related, Hameed said.

If I've had pregnancy complications, does this affect my long-term heart health?

Pregnancy complications, also referred to as adverse pregnancy outcomes, include gestational hypertension, preeclampsia, gestational diabetes and babies that are born too soon or too small. Research suggests that women who have had adverse pregnancy outcomes are at greater risk for cardiovascular disease than those who have not.

"Pregnancy is a stress test for the cardiovascular system," Hameed said. Women who develop adverse pregnancy outcomes or blood pressure-related issues during pregnancy "have already gained one risk factor for cardiovascular disease in the future."

A 2021 American Heart Association scientific statement summarized evidence linking pregnancy complications to future maternal cardiovascular disease risks. Up to 15% of pregnant women in the U.S. experience such complications.

"The heart has to work extra hard during pregnancy to support both mother and child," said Canobbio, a co-author of the report. Doing so may unearth weaknesses in the mother's cardiovascular system that should be carefully monitored in the years that follow.

How can menopause affect my heart?

Estrogen is a natural hormone that provides women with some protection from heart disease. When estrogen levels drop during menopause, a woman's risk for cardiovascular disease increases. This makes it another good time to speak with a doctor, who may order tests to identify risk factors that may need to be addressed, Canobbio said. It's also important to look at family history.

"A lot of women don't appreciate that the cardiovascular problems of their parents and grandparents that developed as they aged may become their problems," she said. "If there is a history of heart disease or stroke or high blood pressure, then they should talk to their gynecologist or primary care physician to get an evaluation of where they stand."

Menopause can also cause a lot of symptoms—such as hot flashes, night sweats and sleep disturbances—that are treatable with hormone replacement therapy. Some studies suggest these therapies, taken early in menopause, may provide some cardiovascular benefits, help prevent Type 2 diabetes and protect against bone loss, according to a 2020 AHA report summarizing research in this area.

However, a 2023 study in the journal Hypertension found at least one form of hormone replacement therapy may increase blood pressure risks. And other studies have shown some types of hormone replacement therapy can increase the risk for blood clots in some women.

Canobbio said women should discuss their individual risks and potential benefits of hormone replacement therapy with their health care team, ideally early in menopause.

Regardless of the stage of life they're in, women should ask their OB-GYNs and other members of their health care team about their heart health and what they can do to lower their risks, Hameed said.

"When we look at prevention, there are many steps we can take," she said. "We have to look at all of a woman's cardiovascular risk factors and help her modify them to prevent the onset of cardiovascular disease in the future."

Provided by American Heart Association

Research Article
Open access
Published: 13 April 2024

Custodial and perinatal care patterns of women who received prenatal care while incarcerated in the Arkansas state prison system, 2014–2019

Melissa J. Zielinski ORCID: orcid.org/0000-0002-1125-110X 1 ,
Mollee Steely Smith 1 &
Alleigh Stahman 1

Health & Justice volume 12 , Article number: 16 ( 2024 ) Cite this article

17 Accesses

Metrics details

The extraordinary growth in women’s incarceration over the past several decades has resulted in calls for expansion of research into their unique needs and experiences, including those related to pregnancy and perinatal care. However, while research into the health outcomes of women who are incarcerated while pregnant has grown, research on women’s custodial and perinatal care patterns has remained nearly non-existent. Here, we sought to describe (1) the characteristics of the population of women who came to be incarcerated in a state prison system during pregnancy and (2) the characteristics of women’s custodial and perinatal care patterns during and after incarceration.

We conducted a retrospective chart review of the population of women who received perinatal care while incarcerated in the Arkansas state prison system over a 5-year period from June 2014 to May 2019. Electronic medical records and state prison records were merged to form our study population. Data were from 212 women ( M age = 28.4 years; 75.0% non-Latina White) with a singleton pregnancy who received at least one obstetric care visit while incarcerated.

Drug-related convictions were the most common crimes leading to women’s incarceration while pregnant, and violent crime convictions were rare. Nearly half (43.4%) of women who gave birth in custody did so within 90 days of admission and the great majority (80.4%) released within 1-year of giving birth, including 13.3% who released within 30 days.

The frequency with which women who became incarcerated while pregnant released from prison either prior to or shortly after giving birth was a striking, novel finding of this study given the implications for perinatal care disruption among a high-risk population and the harms of forced separation from infants within hours of birth.

Conclusions

Diversionary programs for pregnant women convicted of crimes, particularly in states without current access, are urgently needed and should be a priority for future policy work.

Introduction

Women were the fasting growing incarcerated population in the United States from 1980 to 2019, increasing approximately 550% and at a rate twice as high as men during that interval (Carson, 2022 ; Zeng, 2022 ). In 2020, women’s imprisonment fell by 23% due to the COVID-19 pandemic; however, this trend is quickly reversing (Kajstura & Sawyer, 2023 ). Minority women are disproportionately incarcerated; Black women are incarcerated at a rate 2.3 times greater than White women and Latina women at a rate 1.5 times greater than White women (Grassley et al., 2019 ). An estimated 61% of women entering prison are mothers (Carson, 2022 ; Shlafer et al., 2015 ; Sufrin et al., 2019 ) and recent estimates suggest 3-6% are currently pregnant—thus, approximately 3,000 women entering prisons and 55,000 women entering jails per year are pregnant (Sufrin et al., 2019 ; Sufrin, Jones, Sufrin et al., 2020a , b ). Women’s incarceration therefore carries with it the need for gender-specific considerations such as how carceral systems will respond to motherhood, pregnancy, and childbirth.

There is a small body of research examining the medical care and health outcomes of women who were incarcerated while pregnant (Baker, 2019 ; Bell et al., 2004 ; Carter Ramirez et al., 2020 ; Knight & Plugge, 2005a , b ; Shlafer et al., 2021a ; Steely Smith et al., 2024 ), including how incarceration history (Cordero et al., 1991 ; Egley et al., 1992 ; Hessami et al., 2022 ; Howard et al., 2009 , 2011 ; Kyei-Aboagye et al., 2000 ) and programming receipt (Bard et al., 2016 ; Shlafer et al., 2021a ; Shlafer et al., 2021b ) intersect with birth outcomes. However, research on the custodial and perinatal care patterns of women who become incarcerated while pregnant remains virtually non-existent. The few existing studies that examined the intersection of custody, pregnancy, and perinatal care are dated and focused exclusively on the duration and timing of incarceration during pregnancy in relation to specific outcomes, such as birth-weight (Howard et al., 2009 , 2011 ; Martin et al., 1997a ; Martin, Reiger, Martin et al., 1997a , b ). For example, Cordero and colleagues ( 1991 ) found that pregnant women who were incarcerated for over 120 days were more likely to birth term infants of normal birth weight compared to those with less than 90-day sentences. Martin et al. ( 1997a , b ) found that the greater number of weeks spent incarcerated during pregnancy was positively correlated with increases in infant birth weight. More recent studies examining care quality have raised questions about whether carceral care meets community standards. In a recent systemic review and meta-analysis of prenatal care and pregnancy outcomes among women who were incarcerated while pregnant in the U.S., Hessami and colleagues ( 2022 ) found that 34% received inadequate prenatal care when examining the total number of prenatal visits and timing of visits related to weeks of gestation (i.e., fewer than the number of clinically recommended prenatal visits). Together, Hessami et al. ( 2022 ) and much of the existing literature focus on the simple number of carceral prenatal visits. Little to no research has examined pregnancy and postpartum acute care utilization during incarceration or time between prison intake, childbirth, and release. Also, to our knowledge, no studies have examined the criminal legal histories of women who are incarcerated while pregnant in-depth, including incarceration before or after the current pregnancy or disciplinary violations during pregnancy and the postpartum period. This information is important to understanding the public health and financial costs versus purported public safety benefits of incarcerating people who are pregnant and/or will give birth in custody.

The current study

The primary aim of this study was to examine the custodial and perinatal care patterns of women who entered Arkansas’ state prison system while pregnant. Due to the limited knowledge regarding the intersection of women’s pregnancies and the timing of their incarceration, we wanted to understand (1) to what degree women’s incarceration overlapped with their pregnancies and (2) the characteristics of perinatal care provided to incarcerated women. In Arkansas, all people who are incarcerated while pregnant are held within the same state prison facility and all perinatal care—including childbirth services—is provided through a single medical center. This provided a unique opportunity to comprehensively link custodial and perinatal care records during the study period. Our specific, policy-relevant research questions were as follows:

What are the criminal legal histories and outcomes of women who are incarcerated while pregnant?

How does pregnancy, childbirth, and perinatal care intersect with incarceration, including prison entry and release?

Study population

A total of 212 unique women with a singleton pregnancy for which they received at least one obstetric care visit while incarcerated in an Arkansas’ state prison between June 2014 and May 2019 were included in our study population. The mean age was 28.4 years (SD = 5.1 years) and ranged from 18 to 43 years. Most women were non-Latina White (75.0%), consistent with the demographics of the prison during the time that the study occurred; others identified as non-Latina Black (11.8%), Latina (7.1%), or non-Latina and another race (6.1%). The great majority of women had been pregnant at least once before (89.6%); some (10.8%) had a previous pregnancy while incarcerated in the same prison.

Detailed information about the health characteristics and outcomes of the women included in the study population, as well as those of their infants, are reported elsewhere (see Steely Smith et al., 2024 ). In brief, many women had complex physical health histories and over half had histories of illicit substance use and/or mental illness. Of the 219 singleton pregnancies included in the overall study, Footnote 1 66.7% resulted in the birth of a live infant while the mother was still in custody, 6.8% resulted in a pregnancy loss in custody (e.g., miscarriage, intrauterine fetal death, ectopic pregnancy), and 26.5% had not concluded prior to release from prison. Here, we report data from each individual’s first incarceration while pregnant, thus the slightly lower sample size.

This study was reviewed and approved by the Institutional Review Board at the University of Arkansas for Medical Sciences. During the study period, all people who were determined to be pregnant upon intake to Arkansas’ prison system were transferred to a single prison where they received their perinatal services from a nearby university hospital system. Data for this study were thus able to be comprehensively aggregated from a combination of prison administrative records and electronic medical records (EMR) from the perinatal service provider. EMRs to be included were identified based on a group of chart indicators including presence of a “prisoner” flag and/or addresses indicative of incarceration. Perinatal care receipt in the clinic associated with the prison was also required.

Data aggregated from the prison administrative records provided by the Arkansas Department of Corrections included: basic demographics; all movements within the prison system (e.g., dates and locations of intakes, transfers, releases); all associated convictions and corresponding administrative data (e.g., date(s), case number(s), county of conviction); and records of all disciplinary violations and associated sanctions incurred. This data was provided for all people who were incarcerated in the state prison to which pregnant people were transferred for at least one day between June 1, 2014, and May 31, 2019, with information current through the date of the data pull.

Data extracted from the perinatal service provider’s EMR included a wide range of information about the current pregnancy; health service receipt; current and prior medical and obstetric history; childbirth information; and infant outcomes (see Steely Smith et al., 2024 for greater detail). For the current study, we largely utilized variables which recorded the dates and counts associated with women’s health service receipt (e.g., perinatal visit dates and counts; admission and discharge dates associated with hospitalization for childbirth).

Information across the prison and EMR sources was matched using available identifiers, which allowed us to (1) calculate new variables of interest (e.g., time from prison intake to prison release, time from prison intake to childbirth) and (2) segment Department of Corrections data with respect to incarceration during pregnancy (e.g., whether particular events such as convictions and disciplinaries occurred prior to, during, or after pregnancy). All analyses were descriptive and were conducted using IBM SPSS Statistics version 28.0.

The custodial and perinatal care patterns of our study population are summarized in Tables 1 and 2 , with descriptives separated into groups based on prenatal care outcome given the impact of these outcomes (i.e., gave birth to a live infant in custody, still pregnant when released from prison, and experienced pregnancy loss in custody) on many of our variables of interest. We also present custodial patterns for the full population.

Custodial patterns

Drug-related offenses were the most common crimes leading to women’s incarceration while pregnant, with 60.4% of the population having a conviction with this classification; this crime type was considerably more common than any other offense (Table 1 ). Incarceration due to violent crime was relatively rare, as was incarceration due to child abuse or maltreatment, with 9.9% and 4.7% of the population having a conviction with this classification respectively. Notably, nearly half of the population was incarcerated in the state’s prison system for the first time. The great majority of women were serving relatively short sentences, with 78.8% released from prison within one year. Moreover, just 14.6% were reincarcerated in the state’s prison system within the year that followed release, and 33.0% had a record of reincarceration in the state’s prison system considering any time within the study period.

Disciplinary violations and sanctions

Our examination of disciplinary violations revealed that 75.0% of the study population did not receive any disciplinary violations during their pregnancy. Of those still incarcerated after pregnancy had ended (i.e., following childbirth or loss), 72.6% had no disciplinary violations in the interval between childbirth and release.

The three most common disciplinary violations that were recorded during pregnancy were related to keeping order; 41 women (19.3%) were cited for “failure to obey a staff order,” 29 women (13.7%) for “creating unnecessary noise,” and 17 women (8.0%) for “failure to keep one’s person or quarters within regulation.” Citations related to violence were very rare; there were 4 women (1.9%) who were cited for “provoking or agitating a fight” and 3 women (1.4%) cited for “verbal or written threat or physical assault.” Notably, isolation was used as a sanction in some cases; 4 women (1.8%) were sanctioned to isolation during their pregnancy, with 2 women having been isolated for 15 days and 2 women having been isolated for 30 days.

For those who remained incarcerated following childbirth or loss, the most common violations were the same as those that were recorded during pregnancy (21.5% for “failure to obey a staff order,” 15.2% for “creating unnecessary noise,” and 10.8% for “failure to keep one’s person or quarters within regulation”). There was more variety in citations associated with violence, but overall prevalence remained limited. Three women (1.9%) each were cited for “battery on another resident,” “provoking a fight,” “destruction of property,” and “throwing/ejecting bodily fluids;” 2 women (1.4%) were cited for “verbal or written threat or physical assault”; and 1 woman (0.6%) each were cited for “battery on a staff,” “sexual threats,” and “battery upon another resident without serious injury.” A total of 8 women (5.1%) were recorded as having been sanctioned to time in isolation, including 5 women for 30 days, 1 woman for 45 days, and 2 women for 140 + days.

Perinatal care patterns, childbirth, and time in prison

Perinatal care patterns generally varied by prenatal care outcome, which would have been determined by a combination of gestational age at prison intake and time remaining in one’s sentence.

Women who gave birth to a live infant in custody

Of the 143 women who ultimately gave birth to a live infant in custody, 43.4% delivered within 90 days of prison admission, including 9.8% who delivered within 30 days ( Median = 106 days; Range = 0-261 days). On average, these women received 9 prenatal visits ( Range = 0–25 visits), with those entering prison in their third trimester receiving an average of 6 prenatal visits ( Range = 0–11 visits). Notably, 8 women were at or beyond 37 weeks gestation at their first prenatal visit in prison, with the latest being 38.43 weeks gestation. One additional woman had no prenatal visits due to being diverted directly to the hospital for childbirth during her initial transport from the intake prison to the prison where all pregnant women are housed; this individual also released from prison less than 3 months after prison intake. The overwhelming majority of women (88.1%) were seen for their first prison-based prenatal visit within 14 days of prison intake. However, 4 women were seen for their first prenatal visit more than 30 days after intake. Footnote 2

Generally, women who gave birth to a live infant in custody were hospitalized a total of 2 days for childbirth and childbirth recovery. However, 2 women (1.4%) spent less than 24 h hospitalized and 32 (22.4%) spent less than a full 48 h hospitalized prior to discharge. Upon return to the prison, women received an average of 2 postpartum care visits ( Range = 0–9). Although most women received 2 visits, 19 women (13.3%) received only 1 visit and 6 women (4.2%) received no visits, likely due to being released within a month of giving birth.

Time from childbirth to release from prison ranged from as few as 5 days to 5.4 years, though the great majority of women in this category (80.4%) went on to be released from prison within 1 year of giving birth. Among those who released within 1 year of giving birth, 91 (79.1%) released within 6 months, including 19 (16.5%) who released within 30 days.

Women who were still pregnant when released from prison

Women who released from prison while still pregnant were much less likely than those who gave birth in custody to have entered prison in their third trimester of pregnancy; 88.9% were in their first or second trimester. They commensurately had fewer prenatal visits while in custody, having received an average of 6 prenatal care visits ( Range = 1–15). The great majority (85.2%) were seen for their first prison-based prenatal visit within 14 days of prison intake, and all but 1 woman was seen within 30 days of prison intake.

Women who experienced pregnancy loss in custody

Similar to those who did not give birth in custody, women who experienced a loss during incarceration were more likely to enter prison in early pregnancy. Loss most often occurred prior to the 20th week of pregnancy, though two women experienced a pregnancy loss after 20 weeks gestational age, including one after 40 weeks gestation.

Other care intersections with birthing hospital

While conducting our chart review, data extractors noted that some women’s care at the birthing hospital included services other than those rendered during childbirth; data on these services were also extracted to describe these care intersections more fully. These services included pregnancy-related triage visits and hospital admissions, which were experienced by 22.3% and 4.6% of the overall study population respectively. Triage visits during pregnancy were most common among women who ultimately gave birth to a live infant in custody; 29.4% of women who gave birth to a live infant in custody had at least one triage visit during pregnancy compared to 5.6% of those who released from prison while still pregnant and 13.3% of those who experienced pregnancy loss in custody. Among those who gave birth to a live infant in custody, 10 women (7.0%) had a postpartum triage visit and 7 women (4.9%) had a postpartum hospital admission while still incarcerated.

Chart records also revealed that 29.2% of the study population received emergency care in the birthing hospital either before their incarceration (19.3%) and/or after it (17.0%). Footnote 3 Of the total population, 25.5% had been to the emergency department of the birthing hospital prior to incarceration for non-trauma-related physical health concerns, 6.6% for a traumatic injury or assault, 2.8% for a drug overdose, 2.4% for a suicide attempt, 3.3% for other psychiatric concerns, and 6.1% for another presenting concern.

This study is the most comprehensive report to date on the custodial and perinatal care patterns of a population of women who were incarcerated while pregnant. We found that nearly half of all pregnant women who entered the Arkansas state prison system over the five-year period studied were incarcerated in this system for the first time and that the vast majority went on to be released from prison in less than one year. As is true of women who become incarcerated more generally, the great majority were incarcerated for drug-related crime. Few were incarcerated due to crimes that were designated as violent, and prison disciplinary records revealed that even fewer were recorded as engaging in violent behavior while incarcerated. These top-level findings indicate that many women in this population could have been safely diverted from prison, and a high likelihood that diversion would be more appropriate given the notable lack of evidence-based programs for addiction within Arkansas’ prisons (Horton, 2024 ).

Relatedly, a particularly striking finding of our study was the frequency with which women who gave birth in custody were released very shortly thereafter. Nearly 2 in 3 women with a live birth in custody were released from prison within 6 months of childbirth; one woman released less one week after giving birth. Thus, mothers and their newborn infants incurred the dramatic and often non-reversible implications of birth in custody—including forced separation during a critical time for health-promoting contact (e.g., skin-to-skin, breastfeeding)—due to what amounted to, in most cases, requiring that a new mother serve out very few remaining days of a prison sentence. This requirement comes at the additional cost of disrupting early bonding opportunities and introducing risk for termination of the mother’s parental rights (Gifford et al., 2021 ); it is also likely to result in infants being raised in caregiving environments marked by psychosocial stress and instability (Pendleton et al., 2022 ). Diversionary programs or prison nurseries have been used by some U.S. states in an attempt to alleviate or delay the consequences of separation, but the structure and eligibility requirements of these programs are highly variable (Justice-Involved Women & Children, 2023 ). Footnote 4 Data from the present study support maximally inclusive eligibility criteria for such diversionary programs given the natural occurrence of short sentences and non-violent convictions among those who become incarcerated while pregnant.

Another notable finding of our study was the existence of ultra-brief incarcerations of pregnant women who ultimately released prior to childbirth, including for some women who entered prison during their third trimester. While it may be tempting to consider these women “lucky” to have been released prior to childbirth (i.e., having avoided forced separation from infants), there are yet significant harms possible for women in this group. Specifically, women who were receiving prenatal care prior to incarceration would have experienced at least three interruptions in fetal and maternal monitoring as they moved from the community to jail, jail to prison, and prison back to the community. Women who had not received prenatal care prior to incarceration would have lost prenatal care access upon release, and the likelihood of them being able to establish with a community-based provider, particularly in late pregnancy, is unknown.

Importantly, the negative impact of incarceration on prenatal care was not limited to women who were released prior to childbirth. In our study, nine prenatal visits were the average for women who gave birth in custody; however, many women who entered prison in their third trimester and subsequently gave birth in custody had fewer than the minimum of eight clinically recommended prenatal visits in the third trimester for non-high risk or uncomplicated pregnancies (American College of Obstetricians and Gynecologists & American Academy of Pediatrics, 2017). Future research on the impact of prenatal care interruptions and quality, more generally, would be useful; however, taken together, the prenatal care patterns highlighted by our findings provide more evidence that diverting pregnant women from incarceration should be the norm rather than the exception. In absence of such diversionary programs, carceral facilities should be required to provide pregnant women who are returning to the community with comprehensive reentry support, including help establishing or reestablishing community prenatal care and other indicated healthcare services (e.g., addiction treatment).

At the systems level, it is important to highlight that the burden of incarcerating pregnant women is already heavy; prisons must cover the costs of childbirth in custody, arrange for infant placements, and provide perinatal care. Future studies aimed at estimating the costs of this care and the downstream effects of infant separation versus community-based diversion and/or treatment would be particularly valuable and policy-relevant additions to the literature. There is also a need for research on the experiences of kinship caregivers (often grandmothers or aunts) who assume custody of infants born to incarcerated mothers and on the outcomes of children born to a mother who is incarcerated. While research on the longer-term outcomes of both mothers and infants would be beneficial, policymakers must not wait for such research to weigh any purported benefit of incarcerating pregnant people and from childbirth in custody against the clear societal harms that result from these practices.

Limitations

Our study had several limitations, including that our study population was constrained to women in prison within a single state, potentially limiting generalizability. Our study scope was also limited by the available data sources, making us unable to describe the population’s pre- or post-prison perinatal care or broader criminal legal system involvement (e.g., arrest history, length of stay in jail prior to prison intake, incarceration history in other states) more comprehensively. Further, prison intake data was limited by missingness and thus the demographic characteristics we were able to report for our sample were also limited; information on factors that are known to intersect with health outcomes and social needs (e.g., socioeconomic status) would have been valuable if available. Additionally, our study occurred entirely prior to the COVID-19 pandemic, and we are unable to speak to how our results may have differed in the interval since. However, given the dearth of data on our research questions, our findings still have critical policy implications. Finally, while we used a very rigorous search strategy to identify our study population, it is possible that some cases that would have qualified may have still been missed; there was no way to verify our population list as prison administrative data does not include data regarding pregnancy status.

Estelle vs. Gamble (1976) established that all incarcerated persons are entitled to health care for “serious medical needs;” however, adherence to professional standards for perinatal care in carceral settings (e.g., ACOG, 2021 ; NCCHC, 2020 ; Sufrin, 2018 ) is not monitored or enforced, resulting in varied policies, programs, and outcomes across the U.S. (Buchanan, 2012 ). State and federal initiatives have begun to expand support for women who are incarcerated during pregnancy (Kotlar et al., 2015 ; Schroeder & Bell, 2005 ); however services vary widely in their accessibly and provision of care (Shlafer et al., 2022 ; Wilson et al., 2022 ). Indeed, it is notable that even amongst the growing body of literature on enhanced perinatal programs in carceral settings (e.g., Wilson et al., 2022 ), comprehensive programs specifically targeting mental health and addiction amongst this population are rare (Steely Smith, Wilson et al., 2023a ; Steely Smith et al., 2023b ). Footnote 5

Taken together, our findings and those from past studies at the intersection of incarceration and pregnancy raise critical questions about when and for whom incarceration—rather than diversion to community-based treatment or alternative sentencing—is acceptable. Programs that divert pregnant women who come into contact with the criminal legal system from prisons and jails have tremendous potential to reduce the many harms associated with incarceration and to promote the health of future generations. Until such programs are realized, our work further underscores the need for more and higher quality behavioral health treatment in women’s prisons, as has been voiced for decades (cf. Messina & Esparza, 2022 ). Without change, the collateral consequences and cyclical harms of relying on incarceration as a response to addiction and its impact on future generations will continue to unfold.

Data availability

Portions of the dataset that was generated and analyzed in this study is available from the corresponding author on reasonable request. Variables that could be identifying, including in combination with public records, will be removed prior to sharing.

Some women had multiple pregnancies in custody during the study period.

The reason for the lengthy interval between prison intake and first prenatal visit is unknown. In 3 of the 4 cases, women were seen for their first prenatal visit within less than 3 days of arrival at the prison providing prenatal care. Gestational age at first prenatal visit in these cases indicates that women were pregnant prior to prison entry; thus, the delay may have been caused either by delayed transfer to the prison providing prenatal care and/or due to delayed knowledge of the pregnancy.

Fifteen women had an emergency care visit in the birthing hospital both before and after giving birth there while incarcerated.

For example, in Tennessee, people who give birth in custody may be granted furlough for up to six months for parental bonding—delaying but not preventing separation. Other states (e.g., California, Minnesota, Missouri, New Jersey, Texas, and Wisconsin) fully divert to community-based alternatives though sometimes eligibility criteria are barriers to participation by individuals who would seem to be good candidates for diversion.

MOUD continuation during pregnancy if started pre-incarceration is a notable exception, though it is commonly discontinued postpartum (Sufrin et al., 2020 ).

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Acknowledgements

The authors are grateful to Horace “Trey” Spencer for his contributions to data aggregation and analyses. They also wish to thank the Arkansas Department of Correction for providing the correctional data used in this project.

Execution of this study was supported by a pilot award to the first author from UAMS’ Translational Research Institute which is funded through the National Center for Advancing Translational Sciences (Study ID: 324431; UL1 TR003107; PI: James). Manuscript preparation was also supported by K23DA048162 (PI: Zielinski) and T32DA022981 (PI: Kilts), which provided salary support for the first and second authors.

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MZ conceived of this study, led grant writing, and obtaining funding. All authors contributed to data aggregation, manuscript writing, and manuscript revisions. MS led data analyses.

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Zielinski, M.J., Smith, M.S. & Stahman, A. Custodial and perinatal care patterns of women who received prenatal care while incarcerated in the Arkansas state prison system, 2014–2019. Health Justice 12 , 16 (2024). https://doi.org/10.1186/s40352-024-00268-7

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Qualitative analysis of mothers’ perception related to the delivery of information regarding preterm births

Doriane Randriamboarison 1 na1 ,
Elisa Fustec 2 na1 ,
Isabelle Enderlé 2 , 3 ,
Mathilde Yverneau 1 , 3 ,
Karine Le Breton 1 , 2 ,
Linda Lassel 2 ,
Nadia Mazille-Orfanos 1 &
Patrick Pladys 1 , 3

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Preterm birth is a major health issue due to its potential outcomes and socioeconomic impact. Prenatal counseling is of major importance for parents because it is believed that the risk of preterm birth is associated with a higher parental mental burden. Nowadays in France, the content and delivery of antenatal counseling is based on personal experience since there is a lack of official guidelines. The goal of the study was to evaluate maternal perception of antenatal information delivered in the setting of preterm births.

A qualitative study was performed using semi-structured individual interviews of 15 mothers with a child born > 26–34 GW. Data analysis was based on a constant comparative method.

Concerning prenatal counseling content, parents wanted to be informed of their role in the care of their preterm child more so than statistics that were not always considered relevant. Parents’ reactions to the announcement of the risk of a preterm birth was dominated by stupefaction, uncertainty and anxiety. When it comes to the setting of prenatal counseling, patients’ room was deemed an appropriate setting by parents and ideally the presence of a coparent was appreciated as it increased patients’ understanding. The physicians’ attitude during the counseling was considered appropriate and described as empathic and optimistic. The importance of support throughout the hospitalization in the form of other parents’ experiences, healthcare professionals and the possibility to preemptively visit the NICU was emphasized by participants. Delivery experience was dominated by a sense of uncertainty, and urgency. Some leads for improvement included additional support of information such as virtual NICU visit; participants also insisted on continuity of care and the multidisciplinary aspect of counseling (obstetrician, neonatologist, midwife, nurse, lactation consultant and psychologist).

Highlighting parents’ expectations about prenatal counseling could lead to the establishment of overall general guidelines. However, some topics like the use of statistics and mentioning the risk of death underline the importance of a personalized information.

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Introduction

According to the latest French National Prenatal Survey (NPS), the rate of preterm birth was 7% in 2021, which represents about 46,000 newborns [ 1 ].This rate has remained stable since 2016. Most of preterm deliveries happen between 32 and 36 GW (5.3%), and1.7% occurbetween 22 and 31 GW [ 1 ].

Preterm birth has long term effects and even though survival without neuromotor or sensory disabilities has improved in the last decades from 45.5% in 1997 to 62% in 2011 [ 2 ], ex-preterm infants present more neurodevelopmental complications and motor disorders such as cerebral palsy, cognitive disabilities, school learning disabilities [ 3 , 4 ]. Considering all these outcomes and their socioeconomic impact,preterm birth represents a major health issue. Therefore, preventingpreterm labor and neonatal complications associated with a preterm birth is of utmost importance [ 2 ]. An integral part of high-risk pregnancy management is announcing to the parents that their pregnancy is no longer as they had envisioned it. It is the healthcare professional’s responsibility to make sure the patient understands all the information necessary to apprehend the medical course and to make informed decisions [ 5 ]. In this setting, communication in addition to bringing emotional support and conveying empathy also plays a legal role. This information is delivered during an antenatal consultation.

During the antenatal consultation, neonatologists focus on neonatal complications and how to manage them. This has been shown to be helpful for parents [ 6 ]. It contributes to psycho-social support, lowers risk of postpartum depression and mother-infant bonding disorder [ 7 ]. However, this new knowledge may also contribute to parents’ anxiety [ 8 ]. Parents’ needs and expectations regarding antenatal counseling are not always correctly understood by clinicians [ 9 , 10 ]. Furthermore, this information is often delivered in a stressful environment, where there is a concomitant concern for the mother’s health. Information concerning obstetrical outcomes must also be provided including causes of preterm birth, treatments, and prognosis. In this setting, delivery becomes an abrupt and unanticipated event which can generate an important amount of stress. High-risk pregnancies and emergency deliveries are more at risk to generate posttraumatic stress disorder than regular pregnancies (18.5% versus 4%) [ 11 ].Neonatal outcomes are deeply connected to the obstetrical path and perinatal collaboration between neonatal and maternal caregivers improves families’ experience in all aspects of preterm birth [ 12 ]. Therefore, the way in which information is delivered in the antenatal period has a major impact on the parents’ experience throughout their subsequent path.

Nowadays in France, the content and delivery of antenatal counseling is based on personal experience since there is a lack of official guidelines. Most studies evaluating antenatal counseling are focusing on extreme preterm birth [ 13 , 14 , 15 , 16 ]. However, even though preterm infants born after 26 GW are at lower risk of adverse outcomes, they represent an important population in terms of prognosis. Moreover, these studies essentially focus on parents’ role in deciding between active support and palliative care [ 17 ], overlooking all other aspects of prenatal information. Most research has also been conducted from a neonatological point of view without the obstetricians’ input.

The aim of this qualitative study is to evaluate maternal perception of antenatal information delivery in the setting of preterm birth between 26 and 34 GW. Our goal is to improve our practice by bringing some insights on how to best counsel patients at risk of preterm birth and help them understand complex information [ 18 ].

Study context

The neonatal and obstetric departments of the university hospital of Rennes offer prenatal counseling and maternal care to all patients at risk of preterm delivery. Information delivered is based on healthcare professionals’ experience. Concerning neonatal antenatal counseling, interviews are conducted by a senior neonatologist as soon as possible after patient’s hospital admission. If the situation evolves or if patient asks for an update, follow-up consultations may be conducted by the neonatal physician. The obstetric team (senior obstetricians and neonatologists, residents and midwives) informs patients on obstetrical care and prognostication. All information given is adjusted on clinical context and patient’s history.

A qualitative study was performed. We followed Consolidated Criteria for Reporting Qualitative Studies (COREQ) guidelines [ 19 ]. Then we analyzed quantitative population’s characteristics.

Participants

Mothers with a child born between 26 and 34 gestation weeks admitted to the NICU at the tertiary care university hospital of Rennes from January 2019 to April 2020 and discharged from the hospital at the time of inclusion were selected. The time lag between birth and interview ranged from 6 months post-discharge to a maximum of 18 months, in order to minimize memory bias We included in our study mothers who had been hospitalized in the level 3 high risk pregnancy unit of the University hospital of Rennes and received prenatal counseling from a neonatal attending physician. Some patients had their first medical care at another hospital and then were transferred to the hospital of Rennes before birth. Transferred patients were also included. Our exclusion criteria were children born before 26 GW, deceased children, deceased mother, patients under 18 years old, patients who did not speak fluently French, patients with cognitive disabilities, patients without contact information, patients who gave birth in another hospital and patients whose child (or one of the children in case of multiple pregnancy) was still hospitalized at the time of the study.

Setting and sample

A physician was responsible for explaining the research project to potential participants and for sending an email newsletter describing the purpose and outline of the research. Mothers were invited to participate in a semi-structured interview. Participants responded to this invitation via email. Investigators who conducted the interviews informed participants, in the letter and then orally, about the aim of the study and their right to withdraw their participation at any time without giving any reason. Reminders were then sent via emails to the participants who did not respond to the letter. Patients who did not have an email address were recruited by phone calls made by one of the investigators. All mothers gave their informed consent before participating. We planned on stopping inclusion of patients when saturation was achieved (i.e. no new themes or ideas were generated by subsequent interviews).

Considering the difficulty for patients to come to the hospital for the interview, we initially let participants choose between a face-to-face interview or over the phone according to their convenience. In the face of the Sars-CoV-2 pandemic and its associated restrictions, all interviews were then conducted over the phone.

Data collection

Semi-structured interviews were conducted in French by one or both interviewers who were a neonatal resident (DR) and an obstetrician-gynecologist (OB/GYN) resident (EF). Data collection spanned from June 2020 to March 2021. Interviews were semi-structured, with a predefined list of open-ended questions focusing first on the information received concerning the hospitalization, treatments, and prenatal counseling, and then on desired improvements, and open suggestions. The interview guide was developed by authors (DR, EF, NM, IE and KL) after a review of the literature before starting the study. If applicable, face-to-face interviews were conducted at a private office space located in the NICU.

To ensure consistency, we used the same interview guide in every interview (Table 1 ). The interviewers received preliminary training on reformulation to carry out the in-depth interviews with qualitative method referents. They reported their involvement after each interview. Sessions were recorded with the consent of each participant and then transcribed verbatim and de-identified. The aims and rational for the research were disclosed to the participants in the newsletter. We confirmed patient’s understanding during the interview.

Throughout the session, the moderator summarized and reformulated the results and presented them back to the participants to ensure information was accurate and that their comments had been correctly understood. At the end of the session, participants completed a short quantitative questionnaire to obtain their socio-demographic characteristics. We obtained remaining socio-demographic data from the patient electronic medical record.

Data analysis

The analysis procedure was conducted byfour researchers (EF, DR, NM and IE) using an inductive approach to identify themes that emerged from the data. Each transcript was independently read several times to facilitate immersion in the data.The thematic analysis of the data promoted a logic of emergence. The interviews were first analyzed using a manual method of coding the themes and sub-themes. The researchers used open coding process to summarize participants’ views by assigning words to quotes or paragraphs. The coding of the researchers were then compared and in the event of any discrepancies or a disagreement, other physicians (MY, KL, LL and PP) adjudicated. This method enhances the validity of the assigned themes. We kept including participants in the study until saturation was achieved (i.e. no new themes or ideas were generated by subsequent interviews).

The list of themes and sub-themes was then generated and extracted in tabular form. Constant comparative analysis was used to assess overall saturation [ 20 ]. Authors selected verbatim quotes to illustrate the thematic findings. We coded data from transcripts using the Saldaña method [ 21 ] To ensure the reliability of the coding and analysis of the data, findings were discussed among the authors. At the same time we used the NVivo® 12 Plus software interface (QSR International) to support the coding tree. The software was also used to check the frequency of occurrence of themes and to ensure that our main themes were consistent. NVivo’s contribution was also to facilitate the link between the highlighted themes and the verbatim references.

Ethical considerations

The study was approved by the local Ethics Committee (reference number 20.61). Participation was on a voluntary basis. The university hospital of Rennes recorded the material in accordance with all French ethical regulations (ref: MR-003).

We conducted a total of 15 interviews, which took place between June 2020 and March 2021.We obtained data saturation after 12 interviews. Amongst the three first participants who were given the choice of the interview setting, two of them decided on a face-to-face interview, and the last one over the phone. For all remaining participants, we only conducted phone interviews.Average length of interviews is 44 min ± 11 min (minimum 25 min, maximum 66 min). Face to face interviews lasted 32 and 42 min each.

Participant’s characteristics are presented in Table 2 . On average, participating mothers were 31.4 years old (± 4.9 years). Newborns were on average 30.2 ± 2.5 weeks of gestation at birth.

Characteristics of prenatal counseling

Circumstances of prenatal counseling are reported in Table 3 . Interviews mostly took place in the patient’s hospital room, and within the first days after admission.

Thematic analysis

Seven themes were extracted from our data analysis. We subdivided each theme into sub-themes and illustrated some of them with participants’ quotes from the interview (presented in Table 4 ).

Prenatal counseling content.

Neonatal complications and care .

Information delivered during prenatal counseling was the most mentioned during the interviews. Participants recalled being told about neonatal complications. They talked about respiratory outcomes first, short and long term. Then neurological complications were evoked including specific follow-up and neurosensorial risks. Mothers also reported receiving information concerning the NICU: the rooms, the equipment, the incubator. They remembered being told about the usual medical course and the steps during hospitalization.

Parents’ role .

How participants should act with their preterm newborn is commonly addressed during antenatal consultation. Mentioning the baby’s future life makes parenthood more real. For instance, practical aspects such as transferring parents’ smell through comfort blankets and cuddly toys were greatly appreciated. Being able to spend unlimited time with their child was also reassuring. Breastfeeding is another important topic, especially knowing that it is feasible even in case of preterm delivery. This notion was carried by the obstetric team. Midwives adapted their support to patients’ need, no matter what they first wished. A participant explained that she changed her mind based on the information she received about the role of breast milk for preterm babies: ‘Midwives who listened, who taught me how to pump my milk even though I was totally reluctant to breastfeed’ (patient no 2).

Finally, participants mentioned skin to skin as a beneficial act to their child’s well-being. Mothers report highly on it, as shown by patient no 8’s quote: “they told me that I could stay close to her, that I was going to be able to touch her […] to hold her against me. When I was told that, I felt a lot better because I didn’t know I would have the opportunity to hold her.”

Use of statistics .

To participants, statistics and numbers were either not mentioned or considered irrelevant. Indeed, seven patients reported not receiving any and seven had no recall of any statistics. Only one patient was looking for statistical data in the prenatal counseling and insisted on receiving some. When asked if they wished they were given some, four participants were against, four would have appreciated it and seven had no opinion. The ones in favor explained they wanted to hear positive numbers such as survival rates. Some participants described themselves as wanting to know everything and be as informed as possible. Participants who did not wish to receive any statistics argued that it would have scared them, and made them worry about worst case scenario.

Risk of death .

Mortality of preterm children was not mentioned to every participant as four participants reported death not being talked about during antenatal counseling. Avoiding this subject was appreciated by some participants. One mentioned they felt like practitioners could sense which information was relevant to them. To other participants, not talking about death could lead parents to imagine the worst-case scenario.

Mothers’ feelings and reactions.

Announcement of a risk of preterm birth .

Participants often reported feeling paradoxically in good health while being diagnosed with a risk of preterm birth. Therefore, such a diagnosis was reported as being a shock. Another feeling commonly mentioned is fear for the child’s health. On the contrary, some participants felt optimistic.

Prenatal hospitalization experience .

When asked how their hospital stay went, participants reported as many positive aspects as negative ones. They generally appreciated the close medical attention and support which were reassuring. However, some of them also mentioned the difficulty to accept the fact that they needed to stay in the hospital. Feelings mentioned by order of frequency were stupefaction, uncertainty, hope and anxiety. The sudden change during their pregnancy brought disorientation to some participants. Another feeling described was not knowing exactly what would happen to them and when delivery would occur. Participants also mentioned developing some hope during their hospital stay, especially for participants who were hospitalized for the longest period of time. As time went by and nothing serious was happening, they found themselves hoping they would slowly escape preterm birth’s adverse outcomes. The whole experience of a risk of preterm birth generated anxiety for several participants. They continuously feared for their child’s life. Moreover, being hospitalized, away from their homes and relatives, could enhance this anxiety.

Circumstances of prenatal counseling.

Co-parent present .

Both parents being present during antenatal counseling was the most frequent situation. Having the other parent present allowed to reflect further on what had just been said. It kept the information alive and encouraged questions.

Organization of prenatal counseling .

All participants could describe how prenatal counseling went. Consultations happened in their hospital room, which participants found appropriate.

Counselor’s attitude .

Participants commented on the physician’s skills. Fourteen of them defined the neonatologist as optimistic, and showing empathy. They reported the physician using understandable language to them. According to participants, the counselor also personalized information according to the patient and the situation, as Patient no 1 mentioned: ‘I think they really understood [me] and told me what I needed to know without telling me too much.’

Support during prenatal hospitalization.

Close relatives seemed to be the most important emotional support throughout hospitalization. The other parent was the most mentioned, followed by first-degree family members, especially mothers and sisters, and for some participants, friends. Healthcare professionals were also referred as supportive. Midwives and assistant nurses were in the first line of patient’s care and mothers relied on them. The psychologist was also cited, bringing moral, psychological, and emotional support. Shared experience with other parents who went through a similar path were appreciated by participants. They mentioned feedback from relatives who had a preterm delivery, letters, and pictures from former parents of NICU’s babies, who are now doing well. One patient said she had the need to search the internet, even though it did not necessarily bring her comfort. The tour of the NICU was also appreciated by mothers and considered as a real source of support.

Delivery experience.

Participants described information on delivery as clear but mentioned the difficulty dealing with delivery’s unpredictability. They had questions on how far in their pregnancy they could possibly go, whether they were going to deliver vaginally or by cesarean, if they were going to be induced. Mothers also talked a lot about the urgency of delivery and reported a feeling of being rushed. The need for support in this difficult situation was important. The presence of the co-parent was requested by participants, although it may not always have been possible if delivery was impending. They counted on the midwives and the obstetric team to support them as well.

Additional sources of information.

The most mentioned source of information was the tour of the NICU, when the patient’s health allowed it, and delivery was not impending. Written documents were also presented to patients and appreciated. Most participants mentioned receiving paper documents, including one on breastfeeding and one explaining planned cesarean section. Some participants reported searching information on the internet.

Suggestions for improvement.

Additional support of information .

Participants suggested pictures and videos. A virtual tour of the NICU to show the rooms with their equipment was also mentioned. The expectation of what the photographs should describe was controversial. Pamphlets with pictures of staff members to help identify each professional’s face and tasks were suggested. Written documents about local neonatal units, from highly intensive care to current care, and how they connect to each other, would be appreciated as well. Explanations on milk collection centers (lactarium) were also requested as several participants did not have a complete understanding of their functioning.

Antenatal information .

Participants wanted the same practitioners to perform the consultation, as they sought continuity of care and commitment from healthcare professionals. Several participants also mentioned that the presence of a neonatal nurse during the neonatologist’s counseling would be beneficial. One participant suggested having the psychologist present to adjust psychological follow-up after the meeting. Sharing other parents’ experiences was also brought up. Participants wished they could have joined talk groups in the high pregnancy risks unit. Participant no 9 suggested to tell future parents confronted with a risk of preterm birth about the care of a preterm child: “And to tell them it’s a fight for the baby and it’s a fight for the parents.”

Postpartum care .

Several participants addressed postpartum mothers’ care. They expressed the need to be hospitalized in a unit without any newborn instead of the usual post-delivery maternity units, as it made the absence of their child harder to endure. Some of them even wished to be in the same room as their infant, included in the intensive care unit, such as Kangaroo Mother Care (KMC) units. Another commonly mentioned topic was breastfeeding: they wished for more help and support during the first steps of setting breastfeeding.

This study on the information related to preterm birth and its consequences, delivered during prenatal care, gives a thorough insight into the perception of mothers faced with the care of a preterm infant. The announcement of a risk ofpreterm birth came as a shock for patients, as there often was no forerunner. However, the information delivered byneonatologists was overall described as clear, adapted, and carried out with optimism and empathy. Concerning hospitalization in the high-risk pregnancy unit, participants emphasized the importance of having different sources of support to help them cope with anxiety and unpredictability. The feedback provided by participants to improve the delivery of information included the development of visual sources of information.

Providing information on a situation that cannot be predicted is a difficult task. Parents need to be aware that the ability to give an accurate prognosis before delivery remains limited [ 22 ]. Our study shows that some parents wish to have as much information as possible to be fully prepared, whereas others would like to only hear what is very necessary. Many studies on prenatal counseling have shown the importance of personalized information. Most of them focus on the field of extreme prematurity. However, Gaucher et al. demonstrated, in a preliminary qualitative study of 5 interviews [ 23 ], results comparable to our own on the content of patients’ expectations during this antenatal interview. This initial study was followed by a quantitative study [ 24 ] designed to verify their results on a larger scale using a quantitative method. This is one of the few studies which has focused on the maternal experience beyond extreme prematurity, but with a quantitative approach. Healthcare professionals must try to identify parents’ expectations and adapt their speech accordingly [ 18 ]. Culture and social background should also be taken into consideration, as well as level of understanding [ 25 ]. Personalization is probably the most important aspect and should be applied to all parts of antenatal care [ 26 , 27 ](. We also found these results in our study, but our qualitative approach, which is relevant for assessing mothers’ experiences, provided additional data on the way in which parents wish to receive this information. Learning how to identify parents’ wishes should be a part of residents’ training as it is not an easy task. Moreover, delivering unwanted information can create the wrong environment and hinder the parents and healthcare providers relationship [ 13 , 14 ]. Misunderstanding can generate miscommunication and dissatisfaction which can lead to suboptimal care [ 18 ]. What practicians think parents understood may not reflect what parents actually report being told [ 22 ].

In our findings, the wish for statistics and figures varies from one participant to another. Physicians may be confronted with the question of whether or not to share them. A study showed that some mothers, especially those with a high education level appreciated exact statistics more than general facts [ 6 ]. It brings us back to the idea of personalizing our counsel. Geurtzen et al. showed that parents’ choice on statistics was divided, and if given, these should be well explained [ 26 ]. However, a systematic review on parent communication needs during antenatal consultations found that parents wished for more than only quantitative data concerning mortality and morbidity. For instance, they expect information on their role [ 14 ]. So before giving statistical data, physicians should seek if parents want them and provide them in a way that is understandable and relevant to this individual situation.

In our study, physician’s skills and attitude are well remembered by mothers, suggesting the idea that if parents feel in a safe and trusting environment, they will be more willing to listen, understand and ask questions. Other studies found that in order to improve pedagogy, the speaker should be compassionate, empathic, honest, and caring [ 10 ]. Nevertheless, parents also expect truth and real outcomes and importantly, in words they can understand [ 14 ]. Our study shows that participants had a positive experience with well conducted antenatal counseling, even though the risk of neonatal death was brought up by the physician. As pointed in previous research work, truthful information, even when difficult, can be expected from physicians regarding prenatal information. Some hope should also be provided, however some physicians may fear giving false hope [ 16 ]. The timing of the information delivery is another aspect of prenatal counseling that also needs to be personalized. Too soon can be stressful if the patient is still accommodating to their new situation [ 18 ]. On the contrary, too late may increase mother’s stress. Uncertainty of the prognosis and the possible threat of sudden emergency delivery add difficulty to the timing of antenatal counseling.

Several participants from our study brought up the positive impact of a nurse being present during counseling, which illustrates the importance of multidisciplinarity. Indeed, it has been shown that nurses can rephrase and check parents’ understanding [ 14 ]. Moreover, in the Netherlands, guidelines mention antenatal counseling should be performed with both an obstetrician and aneonatologist [ 15 ]. An American study supports the idea that optimal communication between the obstetric and neonatal teams improves outcomes and safety during the peripartum period [ 28 ]. When combined with an obstetric expertise, neonatal information can be more accurate and adapted to the degree of emergency. .

The use of multiple means of information delivery was supported by our participants including written, oral and visual. A study on the use of a decision aid in antenatal counseling showed that written information was often too complicated and understanding relied on parents’ educational level. Consequently, written information should be completed by oral explanations from a professional [ 18 ]. This has proven its efficacy in the obstetric field [ 25 ]. Such documents should be preferably personalized and adjusted to parents’ needs [ 26 ]. A visual support can decrease mothers’ anxiety [ 7 ]. Indeed, the time between antenatal counseling and the actual day of delivery can be long and mothers’ memory of the information delivered may fade. Visual aid can help parents remember information, even more so in a stressful environment [ 29 ]. A. D. Muthusamy et al. [ 30 ] found that submission of the medium before or while the information is being delivered improved recall of the information and decreased anxiety. However, providing this support after the information has been delivered is not very effective. Written information may not improve factual recall after verbal counseling of mothers in preterm labor [ 31 ]. Concerning the support of written information, Nicole M Rau and al provided that a paper handout and multimedia tablet were equally effective in the labor unit to supplement verbal preterm birth counseling and decrease parental anxiety [ 32 ]. This approach could be used in the setting of antenatal counseling. Alongside official documents provided by the hospital, the use of the Internet as a means of information has become increasingly important for pregnant women over the years [ 28 ]. In our study, the internet was depicted as negative because mothers mostly reported on their “worst case scenario” findings. However, other research show that even though internet findings may generate anxiety, they can also reassure mothers-to-be and be a rich and accessible source of support [ 33 ].

Strengths and limitations

Our study is novel as it explores the obstetric side, and the research team was multidisciplinary, including neonatologists, obstetricians, and a psychologist. Moreover, the fact that we did not focus on periviable terms enabled us to study several aspects of prenatal counseling other than decision-making. Even though our interviews were conducted over the phone for the most part due to the sanitary conditions, the interview durations were satisfactory which shows participants’ trust towards researchers. Furthermore, we included patients who gave birth at least 6 months before the interview, and whose child was discharged which gave participants time to process what happened, allowing them to tell their experience. Another asset of this study is that it reflects real world experience and not a simulation like many previous studies [ 34 ].

One of the limitations of our study is that our results are impacted by some mothers’ characteristics: our participants mostly had preeclampsia. In consequence, we cannot generalize our results to all high-risk pregnancy hospitalizations, in particular spontaneous preterm labor. However, preeclampsia causes longer hospital stays and thus allows deeper insights on the hospital experience. Patients who present with spontaneous preterm labor sometimes don’t have time to receive antenatal counseling before delivery. Other biases to consider are gestational age at admission and delivery, and pathology of the newborns, as they may have influenced participants’ experiences. We also did not include mothers who had lost their child. They probably have a very different insight that is important to consider. This stems from the fact that we decided to not include very extreme preterm children, therefore mortality was less important in our population. In order to explore mothers’ point of view after the loss of their child, the research team would have to be well prepared to deal with grief and bring emotional support during the study. Another population that was not included was mothers who had gotten prenatal counseling but ended up delivering at full term. We did not explore the impact of such information on preterm birth and the stress generated on those patients. Fish et al. showed that prenatal counseling improved parental knowledge and satisfaction without increasing anxiety [ 35 ]. Finally, in this study we focused on mothers’ experiences. It would be interesting to compare them with the coparents’ point of views, as there could be differences in psychosocial perceptions between them.

To improve the delivery of information related to preterm births, several leads could be explored. Using simulation to personalize the information in prenatal counseling remains interesting and has been widely described in the literature, but an evaluation of the clinical implementation after this simulation training is essential. Furthermore, multidisciplinarity could be developed by training different specialists to perform prenatal counseling. Written documents and videos may be elaborated to improve patients’ understanding.

The risk of preterm birth is a complex situation and all involved healthcare professionals should reflect on the best way to inform and support patients. Providing some general guidelines on how to respond to mothers’ expectations could be relevant, however personalization is the most fundamental aspect to keep in mind when delivering information on preterm birth. Hence the skills associated with information delivery in preterm births could benefit from the development and improvement of tools like: healthcare professionals’ training, interview guide for physicians that integrates parents’ expectations, and multidisciplinary counseling including all actors involved in the care of the mother and the child.

Data availability

All authors had full access to the data and materials. Data is available from Nadia Mazille-Orfanos ([email protected]) upon reasonable request.

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Doriane Randriamboarison, Elisa Fustec Contributed equally.

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Department of Neonatology, University Hospital of Rennes, Rennes, 35000, France

Doriane Randriamboarison, Mathilde Yverneau, Karine Le Breton, Nadia Mazille-Orfanos & Patrick Pladys

Department of Obstetrics and Gynecology, University Hospital of Rennes, Rennes, 35000, France

Elisa Fustec, Isabelle Enderlé, Karine Le Breton & Linda Lassel

Faculty of Medicine Rennes 1 University, Rennes, France

Isabelle Enderlé, Mathilde Yverneau & Patrick Pladys

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Contributions

DR, EF, IE, KL, NM participated in the study design, collection and analysis of the data and the writing of the report. NM, IE and MY participated in the study design, trained the interviewers, guaranteed the expertise of the qualitative method and participated in the analysis of the data through N Vivo software. LL and PP participated in study design, data collection, writing and the interpretation of the data. DR and EF participated in organisation of the interviews and collection of the data. All authors revised this article critically, approved the final manuscript and agreed to its being submitted for publication. DR, EF, IE, KL, MY, LL, NM, and PP had complete access to the study data that support the publication.

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Correspondence to Nadia Mazille-Orfanos .

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The study was reviewed and approved by the Rennes University Hospital Ethics Committee (reference number 20.61). The University Hospital of Rennes recorded the material in accordance with all French ethical regulations (ref: MR-003). All methods were carried out in accordance with relevant guidelines and regulations. Participation was on a voluntary basis. All participants provided written informed consent to participate in this study.

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Randriamboarison, D., Fustec, E., Enderlé, I. et al. Qualitative analysis of mothers’ perception related to the delivery of information regarding preterm births. BMC Pregnancy Childbirth 24 , 272 (2024). https://doi.org/10.1186/s12884-024-06404-3

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PHOTO: In this May 14, 2022, file photo, a medical doctor participates in an abortion rights demonstration in Atlanta, following the leaked Supreme Court opinion suggesting the possibility of overturning the Roe v. Wade abortion rights decision.

Brown is unsure if she would come back to Indiana after completing her residency.

"I would find it very, very, very difficult to go back, as much as I want to. It would be really a tragedy for me to not be able to provide the full scope of reproductive care and have to go day by day and send people up to Chicago, or wherever, and not be able to do it myself," Brown said. "My goal was to end up in Indiana, or at least around Indiana, but I don't know if that's going to be a safe or realistic option anymore."

She is not alone.

Residency programs in states with bans in place saw a drop in the number of OB-GYN residency applications, according to recent data from the Association of American Medical Colleges. While there was an overall decrease in the number of all residency applications submitted in 2023, the decrease was sharper in states with complete bans compared to states without restrictions, according to the data.

MORE: Texas abortion law means woman has to continue pregnancy despite fatal anomaly

There was a 10.5% decrease in OB-GYN applicants in states with complete bans in 2023 compared to 2022 residency applications. In states without restrictions, the decrease was only 5.3%, data shows.

States that Have Restricted Abortion Rights Since Roe v. Wade was Overturned

Fifteen states have ceased nearly all abortion services since the U.S. Supreme Court overturned Roe v. Wade , ending federal protections for abortion rights.

Adriana Traub, a medical student at Emory University in Georgia, said the state's so-called heartbeat ban "definitely impacted" where she plans on applying for residency in a year and a half.

"Personally, I want to receive an education, if I go into OB-GYN, where I can learn how to provide abortion care services, and be able to also provide all options to my patients without being worried about losing my medical license -- without being worried about having to tell a patient 'no,'" Traub said.

Traub said the abortion bans have pushed her more toward specializing in OB-GYN.

"There is such a great need for it," Traub said.

Percent Change in U.S. MD Senior OB/GYN Applicants from the Previous Application Cycle by State Abortion-Ban Status

Marisa Giglio, a first-year resident at Rutgers University in New Jersey -- whose family lives in North Carolina and Alabama -- was very careful about where she applied, knowing the Supreme Court was hearing an abortion case. Months before Roe was overturned, she was in a "scramble" to find which states were planning to restrict abortion care and avoid them. But some of her classmates didn't do the same.

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"They ended up in states, now, that they won't be able to train on these [skills] and they're kind of scrambling to figure out ways that they can gain this training so that in the future they'll be able to provide that care for their patients," Giglio said.

Natalie Dicenzo, a third-year resident at Rutgers, is now applying for a complex family planning fellowship to provide complex contraception and abortion care. As she is applying, Dicenzo is prioritizing her safety and being able to provide that care, she told ABC News.

"I don't envy the providers who already live in these states and are facing this on a daily basis," Dicenzo said. "I'm not really itching to put myself in that position either. So I also would probably steer away from providing care in those states."

PHOTO: Protesters gather inside the South Carolina House as members debate a new near-total ban on abortion with no exceptions for pregnancies caused by rape or incest at the state legislature in Columbia, South Carolina, August 30, 2022.

There are 56 OB-GYN residency programs and over 1,100 residents in states with the most restrictive abortion bans in the country as of April 1, according to the Ryan Program , a subspecialty program that trains physicians on complex family planning -- which includes complex contraceptive and abortion care -- at Oregon Health & Science University.

Several residents from states with bans or restrictions in place who sought training at the Ryan Program are considering moving, Alyssa Colwill, the director of the program, told ABC News.

"A lot of them have seen patients, get unnecessarily sick, that have had hysterectomies, lost their fertility, because they've had pregnancy complications that could have been resolved with a safe and timely abortion, but instead had to wait until their life was at risk for intervention to happen," Colwill said.

PHOTO: In this May 3, 2022, file photo, a group of doctors and medical workers join protesters gathering in front of the State House to show support and rally for abortion rights in Boston.

Abortion training and state legislation were among the top questions future residents had for programs in Ohio and Indiana where Dr. Katie McHugh works, she told ABC News. This is starkly different than what McHugh was prioritizing when she was in their shoes; she was worried about the quality of training and proximity to her family, she said.

"Now, [abortion laws] is all these medical students and residents are considering," she said.

Dr. Beverly Gray, the director of Duke University's residency program in North Carolina, told ABC News she has had more conversations with applicants about the political landscape in the last application cycle than ever before. But this is an issue that could stretch beyond just residents, she said.

MORE: Republicans will 'lose huge' without finding 'middle ground' on abortion, Nancy Mace says

"I have colleagues in Tennessee who have already left the state, who were providing family planning care and decided to leave the state. And so you have residents training there who may not have faculty with the expertise to train them; they're having exposure to fewer clinical situations and procedures where they would get the training that they need to be competent," Gray said.

"They may have less training and then they decide to stay in the state and then that's this snowball effect that over time we have fewer and fewer people who have the requisite skills to provide second-trimester abortion care," Gray said. "And there are certain emergencies that come up where we need that skill set to be able to intervene and save a life."

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COMMENTS

Prenatal care: 1st trimester visits
Prenatal care: 1st trimester visits. Pregnancy and prenatal care go hand in hand. During the first trimester, prenatal care includes blood tests, a physical exam, conversations about lifestyle and more. By Mayo Clinic Staff. Prenatal care is an important part of a healthy pregnancy. Whether you choose a family physician, obstetrician, midwife ...
Pregnancy appointment timeline: How often to see your OB
There are also complications that may show up after you become pregnant, like pregnancy-related high blood pressure, which can require more frequent visits. Pregnancy appointments timeline example. Visit #1: 6-10 weeks. Visit #2: 10-12 weeks. Visit #3: 16-18 weeks. Visit #4: 20-22 weeks. Visit #5: 24-28 weeks. Visit #6: 32 weeks. Visit #7: 36 weeks
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 ...
Your Guide to Prenatal Appointments
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 ...
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 ...
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.
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 ...
What To Expect at Your First Prenatal Visit
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 ...
Prenatal visit schedule, plus how to prepare
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.
Prenatal care and tests
Prenatal care and tests. 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 ...
What Happens at a Prenatal Care Check-Up Appointment?
During prenatal care visits, your doctor, nurse, or midwife may: update your medical history. check your urine. check your weight and blood pressure. check for swelling. feel your belly to check the position of your fetus. measure the growth of your belly. listen to the fetal heartbeat. give you any genetic testing you decide to do.
15 Questions to Ask Your OB/GYN at a Prenatal Visit
Currently, the Institute of Medicine recommends the following for moms of multiples based on BMI: A BMI between 18.5 and 24.9: 37 to 54 pounds. A BMI between 26 and 30: 31 to 50 pounds. A BMI greater than 30: gain 25 to 42 pounds. That said, everyone's pregnancy will look different and that includes pregnancy weight gain.
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.
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 ...
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.
Prenatal Care
Download transcript. Your first prenatal care appointment will most likely be between weeks 7 and 12. After that, as long as your pregnancy is going normally, you'll have prenatal visits — either in person, online, or by phone — at about: 16 to 20 weeks. 21 to 27 weeks. 28 to 31 weeks.
Third trimester: What happens at your prenatal appointments
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Prenatal Visit Week 38. Your baby could be born any day now! In fact, 85% of babies are born in the two weeks before their due date. At this stage, you are probably feeling pretty uncomfortable ...
Prenatal Visit Schedule: What To Expect During Each Appointment
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 ...
Prenatal Visit Week 37
Ask Your Doctor: 3 min read. You'll pass a milestone at the end of your 37th week -- your baby will become "early term." Most women have their 11th prenatal visit during this week. At this week's ...
Here's What These Black OB-GYNs Want You To Know Before ...
Maternity care begins at preconception, and three Black OB-GYNs sat down with ESSENCE to discuss what they want you to know before starting your pregnancy journey.. For Black women, the statistics ...
do ob claim to your insurance every routine prenatal visit?
I am a bit confused. For prenatal care, I thought the first prenatal visit was a special visit. And then the rest of the prenatal care routine visit will be bundled in one charged. My Ob submitted a claim to my insurance company for my 23 week routine visit as an office visit, which I don't understand.
Five things women should ask their OB-GYN about their heart
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PDF Prenatal Care and Routinely Recommended Vaccinations-February 21, 2024
Prenatal Care and Routinely Recommended Vaccinations Vaccine product: Any Tdap vaccine product may be administered. Schedule: Administer a dose of Tdap, preferably during the early part of gestational weeks 27 through 36, during each pregnancy irrespective of the patient's prior Tdap vaccination history. Tdap Vaccine. Influenza Vaccine
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A visit to the OB/GYN can leave you feeling vulnerable. Everyone should have a doctor who puts them at ease. But if you're a transgender man or nonbinary person who's pregnant or trying to be ...
Custodial and perinatal care patterns of women who received prenatal
In a recent systemic review and meta-analysis of prenatal care and pregnancy outcomes among women who were incarcerated while pregnant in the U.S., Hessami and colleagues ... The great majority (85.2%) were seen for their first prison-based prenatal visit within 14 days of prison intake, and all but 1 woman was seen within 30 days of prison ...
Qualitative analysis of mothers' perception related to the delivery of
According to the latest French National Prenatal Survey (NPS), the rate of preterm birth was 7% in 2021, which represents about 46,000 newborns [].This rate has remained stable since 2016.Most of preterm deliveries happen between 32 and 36 GW (5.3%), and1.7% occurbetween 22 and 31 GW [].Preterm birth has long term effects and even though survival without neuromotor or sensory disabilities has ...
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MORE: Texas abortion law means woman has to continue pregnancy despite fatal anomaly There was a 10.5% decrease in OB-GYN applicants in states with complete bans in 2023 compared to 2022 residency ...