Medical Care During Pregnancy
Why is prenatal care important?
Regular appointments with your healthcare provider throughout your pregnancy are important to ensure the health of you and your baby.
Frequent visits with your healthcare provider allow you to follow the progress of your baby’s development. Prenatal visits also give you and your family a chance to talk to your healthcare provider about any questions or concerns you have related to your pregnancy, birth, or parenthood. Most healthcare providers welcome your partner at each visit, as well as interested family members.
What happens on my first medical visit?
The first visit is designed to determine your general health and give your healthcare provider clues to any risk factors that might affect your pregnancy. Your healthcare provider will perform a physical exam. The initial visit is meant to:
- Determine your due date.
- Find out your health history, as well as any prescription or over-the-counter medications you may be taking.
- Explore the medical history of family members.
- Determine if you have any pregnancy risk factors based on your age, health, and/or personal and family history.
- Assess your health and check for any problems.
You will be asked about previous pregnancies and surgeries, medical conditions, medications, and exposure to any contagious diseases.
What is involved in the physical exam?
A thorough physical exam is part of the first visit. You are weighed and your blood pressure, heart, lungs, and breasts are checked. The first visit also includes a pelvic exam.
During the pelvic exam, a Pap smear is taken to screen for cervical cancer, and cultures are taken to detect sexually transmitted diseases (such as gonorrhea and chlamydia). In addition, a bimanual internal exam (with two fingers inside the vagina and one hand on the abdomen) will be performed to determine the size of the uterus and pelvis. This exam will also check for any abnormalities of the uterus, ovaries, or fallopian tubes.
Your healthcare provider might listen for the baby’s heartbeat with a special instrument called a Doppler, which uses ultrasound waves (high frequency sound waves). A Doppler usually cannot detect a baby’s heartbeat before 10 to 12 weeks of pregnancy.
What questions should I ask during the prenatal visit?
Some questions you might want to ask during your first prenatal visit include:
- What is my due date?
- What is the size of my uterus?
- Are the symptoms I’m experiencing normal?
- Is it normal not to experience certain symptoms?
- What are the specific recommendations regarding weight gain, exercise, and nutrition?
- Which activities, foods, and substances should I avoid?
- Which exercises are safe? Which exercises should I avoid?
- What should I know about sex during pregnancy?
- Do you recommend certain prenatal classes?
- For which symptoms should I call my healthcare provider?
- What is the definition of a high-risk pregnancy? Is my pregnancy high-risk?
What lab tests will be performed?
Certain lab tests might be ordered at your first visit, including:
- A complete blood count (CBC): This screens for blood problems such as anemia (low blood count).
- RPR: This test screens for syphilis (a sexually transmitted disease).
- Rubella: This tests for immunity (protection) against German measles.
- HBsAg: This tests for hepatitis B (a liver infection).
- Urinalysis: This tests for kidney disease or bladder infections.
- Type and screen blood test: This determines your blood type and Rh factor, an antigen or protein on the surface of blood cells that can cause an immune system response.
- HIV screening: Current recommendations are that all pregnant patients be screened for HIV.
How is my expected date of delivery determined?
A full-term pregnancy lasts 37 to 42 weeks. Your actual date of delivery can be different from your estimated date of delivery. A very small number of babies are actually born on their due dates.
Normally, a woman's due date is 280 days (40 weeks or about 10 months) from the first day of her last period. However, if your periods are not regular or are not 28 days in cycle, your due date might be different from the "280-day rule." Your healthcare provider might order an ultrasound to help determine your due date.
If you are certain of your conception date (the date when you got pregnant), let your healthcare provider know. This information can be helpful in determining your estimated date of delivery (EDD).
What steps can I take to help ensure a healthy pregnancy?
Smoking, vaping, drinking alcohol, and/or using illegal drugs—even in small amounts—can cause health problems for the fetus. Many of these health problems result in life-long problems for the child. Healthcare providers recommend that women stop smoking, vaping, drinking alcohol and using drugs completely before they start trying to get pregnant. You should also check with your healthcare provider before taking any over the counter medications.
Women should avoid these substances throughout their pregnancies and after birth, as many of these substances can get into the baby's system through breast milk.
By eating a healthy diet, you can help ensure that your developing baby has all the nutrients it needs to grow and develop normally. In addition, it is important for pregnant women to engage in regular physical activity. Ask your healthcare provider about the level of activity that is appropriate for you during your pregnancy.
You also can help ensure that you will have a healthy pregnancy by avoiding substances that can be dangerous to the developing fetus. These substances include:
- Medicines that can affect the baby’s growth and development
- Certain herbal supplements or high doses of vitamins
- Chemicals such as pesticides, cleaning agents and certain types of paint