Pregnancy: Prenatal Care
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. In addition to medical care, prenatal care includes education on pregnancy and childbirth, plus counseling and support.
Frequent visits with your healthcare provider allow you to follow the progress of your baby’s development. Visits also give you the opportunity to ask questions. 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 the risk factors that might affect your pregnancy. It will typically be longer than future visits. The purpose of the initial visit is to:
- Determine your due date.
- Find out your health history.
- 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.
You will be asked about previous pregnancies and surgeries, medical conditions, and exposure to any contagious diseases. Also, notify your healthcare provider about any medications (prescription or over-the-counter) you have taken or are currently taking. We ask some very personal questions, but be assured that any information you give is strictly confidential.
A thorough physical exam is also 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 by your healthcare provider.
During the pelvic exam, a bimanual internal exam (with two fingers inside the vagina and one hand on the abdomen) will be performed to determine the size of your uterus and pelvis. Your healthcare provider might listen for the baby’s heartbeat with a special instrument called a doppler, which uses ultrasound (high frequency sound waves). A doppler usually cannot detect a baby’s heartbeat before the 10th to 12th week of pregnancy.
Many lab tests are ordered in the first trimester including:
- Complete blood count (CBC): screens for blood problems such as anemia (low iron).
- RPR: screens for syphilis (a sexually transmitted disease).
- Rubella: tests for immunity (protection) against German measles.
- HBSAG: tests for hepatitis B (a liver infection).
- Urinalysis: tests for kidney infection and bladder infection.
- HIV: screens for antibodies in your blood.
- Cystic Fibrosis: screens for the presence of the CF gene.
- Type and screen: determines your blood type and Rh factor* (an antigen or protein on the surface of blood cells that causes an immune system response).
- Sickle cell screen.
- Gonorrhea and chlamydia testing.
How is my expected date of delivery determined?
Normally, your due date is 280 days (40 weeks or about 10 months) from the first day of your 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 determine your due date.
A full-term pregnancy lasts 37 to 42 weeks, so your actual date of delivery can be different from your estimated date of delivery (EDD or EDC). A very small number of babies are actually born on their due dates.
How often should I see my healthcare provider during pregnancy?
The schedule of your prenatal care visits will depend on any special circumstances or risk factors you might have. Generally, it is recommended to have follow-up visits as follows:
- Every 4 weeks until 28 weeks.
- Every 2 to 3 weeks from 28 to 36 weeks.
- Weekly from 36 weeks until delivery.
During these visits, be sure to ask questions. It might help to bring a list of questions with you.
What is monitored at subsequent visits?
During prenatal care visits, your weight and blood pressure will be checked, and a urine sample will be tested for sugar and protein. Your uterus will be measured to follow the growth of the fetus. The fetus’ heartbeat will also be checked (usually beginning in the 10th to 12th week of pregnancy).
Additional tests might be required, depending on your individual condition or special needs.
During the last month, your office visits will include discussions about labor and delivery. Your office visits may include an internal examination to check your cervix (the lower end of your uterus) for thinning (called effacement) and opening (called dilation).