Your first prenatal visit

Your first prenatal visit

When should I have my first prenatal visit?

As soon as you get a positive home pregnancy test, call to schedule an appointment with your obstetrician, family physician, or midwife.

If you haven't yet chosen a doctor or midwife to care for you during your pregnancy, it's still important to see a pregnancy caregiver now and get started on your prenatal care. You can always switch to another caregiver when you find the one you want to stick with.

Many healthcare providers will schedule your first visit for when you're about 8 weeks pregnant. Some will see you sooner, particularly if you have a medical condition, have had problems with a pregnancy in the past, or are having symptoms such as vaginal bleeding, abdominal pain, or severe nausea and vomiting.

If you're taking any medications or think you may have been exposed to a hazardous substance, ask to speak to your provider about it as soon as possible.

Your first visit will probably be the longest unless you encounter problems along the way. At this and all future prenatal checkups, don't be afraid to raise any issues you've been wondering about. If questions come up between appointments, it may help to keep a running list.

Read on to see what you can expect your healthcare provider to do on your first visit.

Take your health history

Here's what your provider is likely to ask about:

Gynecological health details

  • Whether your menstrual cycles are regular and how long they tend to last
  • When the first day of your last period was (to determine your due date)
  • Any symptoms or problems you've noticed since your last period (related to pregnancy or not)
  • Any gynecological problems you have now or have had in the past (including sexually transmitted infections)
  • Details about any previous pregnancies

Other aspects of your medical history

  • Chronic conditions and medications used to treat them
  • Drug allergies
  • Psychiatric problems
  • Past surgeries or hospitalizations

Habits that could affect your pregnancy

  • Smoking
  • Drinking
  • Drug use
  • Whether you are (or have been) a victim of abuse or have any other problems that could affect your safety or emotional well-being

Your family's medical history

  • Whether any of your relatives have had any chronic or serious diseases.

(Many health problems are at least partly hereditary, so learning about your family's medical history helps your healthcare provider keep an eye out for potential problems.)

Do a genetic and birth defect history

Your provider will ask:

  • Whether you, the baby's father, or anyone in either family has a chromosomal or genetic disorder, had developmental delays, or was born with a structural birth defect.
  • About any medications and nutritional supplements you've taken since your last period, and whether you've used alcohol or drugs. Take some time to think about any exposure you might have had to other potential toxins (bring a list of any concerns, especially if you live or work near toxic materials).

Let your provider know if you've recently had any rashes, viruses, or other infections.

Explain your options for prenatal genetic testing

Your provider will offer you various screening tests that can give you some information about your baby's risk for Down syndrome as well as other chromosomal problems and birth defects.

During your first trimester, you may be offered a blood test that's performed between 9 and 13 weeks. If it's available in your area, you'll also be offered a nuchal translucency screening (a type of ultrasound done at 11 to 13 weeks). Together, the blood test and the ultrasound are known as the first-trimester combined screening.

First-trimester screening may be done in conjunction with the quadruple screen, a blood test done between 15 and 20 weeks.

If you're at high risk for having a baby with a genetic condition, you'll likely be offered noninvasive prenatal testing (NIPT) in your first trimester. This is a blood test that can detect Down syndrome and some other chromosomal conditions at 10 weeks of pregnancy or later.

If you haven't had it already, you may also want to have carrier screening. It's a simple blood or saliva test done to see whether your baby is at risk for any of 100 genetic disorders, such as cystic fibrosis, sickle cell disease, thalassemia, and Tay-Sachs disease.

Finally, you'll be offered genetic diagnostic tests that can tell you for sure whether your baby has Down syndrome or certain other problems. These tests include chorionic villus sampling (CVS), generally performed at 10 to 12 weeks, and amniocentesis, usually done at 16 to 20 weeks.

CVS and amniocentesis are invasive and carry a small risk of miscarriage, so women who choose to have these procedures are usually those with a higher risk for genetic and chromosomal problems. Some moms-to-be choose to wait for the results of screening tests before deciding whether to have one of these diagnostic tests.

If you need more information, your provider can refer you to a genetic counselor.

Check you out and run some tests

Some healthcare providers will do an ultrasound at your first prenatal visit. But if you don't have any medical problems or concerns, it may not be part of the routine. Here's what's typical:

  • A thorough physical
  • A pelvic exam, including a Pap smear (unless you've had one recently) to check for abnormal cells, which could indicate cervical cancer
  • Possibly a culture to check for chlamydia and gonorrhea
  • A urine sample to test for urinary tract infections and other conditions

Your provider will also order blood tests to:

  • Identify your blood type and Rh status
  • Check for anemia
  • Test for syphilis, hepatitis B, and immunity to rubella (German measles)
  • Test for immunity to chicken pox unless you've definitely already had it or have received two doses of the vaccine against the virus that causes it

You may also request a screening to see if you have antibodies to cytomegalovirus (CMV). Read our article about how CMV can be dangerous to your unborn baby and what you can do to avoid contracting this mild virus during pregnancy if you haven't already been infected. This is especially important if you have a child in daycare since it would be easy for your child to pick up CMV there and pass it to you.

The U.S. Public Health Service and a host of other organizations now recommend that all pregnant women be tested for HIV, the virus that causes AIDS, at their first prenatal visit. If your provider doesn't offer you an HIV test, be sure to ask about it. If you have the virus, being treated during pregnancy can dramatically reduce your chances of passing the infection to your baby.

If you're at high risk for gestational diabetes, a glucose challenge test might be done at your first visit.

In some cases, your provider will also do a skin test to see whether you've been exposed to tuberculosis.

Counsel you and let you know what's ahead

Your provider should give you advice about eating well, foods to avoid, weight gain, and prenatal vitamins. You'll hear about the common discomforts of early pregnancy and be warned about symptoms that require immediate attention.

Your emotional health is very important. Your provider 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 provider know so you can be referred to someone who can help.

Your provider will talk to you about the dangers of smoking, drinking alcohol, using drugs, and taking certain medications. If you need help quitting smoking or any other addiction, ask for a referral to a program or counselor.

Your provider will also go over some do's and don'ts of exercise, travel, and sex during pregnancy; environmental and occupational hazards that can affect your baby; and how to avoid certain infections, such as toxoplasmosis.

If it's flu season (or flu season is near), your provider will probably talk to you about getting a flu shot.

Finally, you'll schedule your next appointment, which should be in about four weeks. See our articles on second-trimester prenatal visits and third-trimester prenatal visits for details on what's ahead.

Watch the video: What to Expect at your First MidwifeGPAntenatal Appointment: Pregnancy Advice (January 2022).