Throughout your pregnancy, you can expect around 14 scheduled prenatal visits, not including additional tests or ultrasounds. Your first visit, which will be the longest at about 45 minutes, begins the start of your care team relationship. It’s a great visit to bring along a partner or other support person, as you’ll be getting a lot of information and may have many initial questions! It’s okay to feel excited and nervous as you walk through those doors to meet your team for the first time this pregnancy.
Many practices will have you meet with a Nurse Practitioner (NP), Physician Assistant (PA), or Certified Nurse-Midwife (CNM) rather than an OB-GYN at your first visit. And if your long-term plan is to see a midwife, then often your appointments throughout pregnancy may be longer than the typical 15-minute visit window that is standard for OBs. During your initial visit, you’ll go through a bit of an “interview” process as your healthcare provider tries to better understand your personal and family medical history. This information will help them guide you through your pregnancy and recommend certain tests and screenings. At the first and all successive visits, the healthcare provider will usually check your weight and blood pressure and have you leave a urine sample. The urine sample will be tested for protein and glucose levels to make sure there are no indicators of preeclampsia, gestational diabetes, or infections.
The provider may also send you to the lab for other blood work, where they may test for the following:
- hCG level: Human Chorionic Gonadotropin (hCG) is the hormone released early in pregnancy. Your healthcare provider will want to make sure that your hCG level is within the recommended range. Excess hCG levels can indicate a possibility of multiples, a chromosomal difference, miscarriage, abnormally located pregnancy, or other medical conditions.
- Blood type, Rh factor: Your healthcare provider should determine whether or not a protein called Rhesus (Rh) is present in your blood. If you are Rh-negative (Rh not present) and your baby is Rh-positive, you could build antibodies that might be dangerous for them. The good news is that prevention is available, so you’ll be offered a shot called Rhogam at different points of your pregnancy and postpartum.
- Cystic fibrosis screen: You may be offered a screening test to determine if you are a carrier of cystic fibrosis (CF), a genetic disease that affects several of a baby’s organ systems, but particularly the lungs.
- CBC: Your healthcare provider will take a CBC (complete blood count) to check for infection and to check your red blood cell count to determine whether or not you are anemic (not enough red blood cells).
- Hepatitis B, rubella, syphilis, and HIV are also generally recommended because they can impact the care of your pregnancy or newborn.
Your healthcare provider may also perform a pelvic exam, breast exam, a Pap smear if indicated and vaginal cultures to test for gonorrhea and chlamydia. Lastly, if you haven’t had an ultrasound to confirm your pregnancy dating, and to make sure that everything is growing as expected – this will either take place or be scheduled.
Your doctor will discuss the upcoming appointments, tests, and symptom management plan for the next few months. You may learn about the different providers in the office and whether you can expect the same provider at most visits or a rotation to get to know everyone. It’s important to find out who you can call if the office is closed and you need support or have an emergency and if they have a list of commonly needed pregnancy-safe medications and foods to avoid.
They may also begin talking with you about genetic testing options, including noninvasive prenatal testing. This is lab testing using the pregnant person’s blood that can screen for several types of chromosomal differences and even detect gender. Each brand of noninvasive test is slightly different, so your provider can let you know specifics if you are interested in this or other genetic testing options.
Before you head home, this is your chance to ask any questions you may have and bring up medications or supplements you take regularly. Building a relationship with your care team takes time! So, your first visit starts the process of taking care of you and Baby as you develop this unique care relationship.
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Sources
- Sir John Dewhurst. Dewhurst’s Textbook of Obstetrics and Gynaecology. 8th ed. Keith Edmonds. John Wiley and Sons Ltd, 2012. Print.
- “The Rh Factor: How It Can Affect Your Pregnancy: FAQ027.” ACOG. American College of Obstetricians and Gynecologists, 9/13/2015. Web.
- “Cystic fibrosis and pregnancy.” March of Dimes. March of Dimes, 1/13/2015. Web.
- “Cystic Fibrosis – Prenatal Screening and Diagnosis: FAQ171.” ACOG. American College of Obstetricians and Gynecologists, 8/11/2015. Web.
- American College of Obstetricians and Gynecologists. “Routine Tests During Pregnancy: FAQ133.” ACOG. American College of Obstetricians and Gynecologists, 1/14/2015. Web.
- “Gestational Diabetes: FAQ177.” ACOG. American College of Obstetricians and Gynecologists, 9/13/2015. Web.
- Mayo Clinic Staff. “First trimester pregnancy: what to expect.” Mayo Clinic. Mayo Clinic, 4/22/2014. Web.
- “ACOG’s Screening Guidelines on Chromosomal Abnormalities.” ACOG. American College of Obstetricians and Gynecologists, 5/7/2007. Web.
