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
As soon as you think you’re pregnant, schedule 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.
Your health care provider might ask about:
- Your menstrual cycle, gynecological history and any past pregnancies
- Your personal and family medical history
- Exposure to potentially toxic substances
- Medication use, including prescription and over-the-counter medications or supplements
- Your lifestyle, including your use of tobacco, alcohol and caffeine
- Travel to areas where malaria, tuberculosis, the Zika virus or other infectious diseases are common
Share information about sensitive issues, such as domestic abuse, abortion 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 deliver. It’s simply the date that you will be 40 weeks pregnant. Few women 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, as well as schedule tests or procedures at the most appropriate times.
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.
Your health care provider will typically check your blood pressure, measure your weight and height, and calculate your body mass index to determine the recommended weight gain you need for a healthy pregnancy.
Your health care provider might do a physical exam, including a breast exam, pelvic exam, and screening exams of your heart, lungs and thyroid. You might need a Pap test to screen for cervical cancer as well, depending on how long it’s been since your last screening.
At your first prenatal visit, blood tests might be done to:
- Check your blood type. This includes your Rh status. Rhesus (Rh) factor is an inherited trait that refers to a specific 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, and to carry 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 cause you to feel very tired and 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.
Screening tests for fetal abnormalities
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, which may include ultrasound or blood tests to screen for certain fetal genetic abnormalities, such as Down syndrome.
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.
Normal 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 that bounces sound waves off your baby’s heart (Doppler).
Your prenatal appointments are an ideal time to discuss questions or concerns. Also find out how to reach your health care provider between appointments. Knowing help is available can offer peace of mind.Nov. 10, 2018
- 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.