What happens at prenatal visits? As an expectant parent, you’ll undergo health evaluations, track your baby’s development, and receive guidance to ensure a healthy pregnancy and delivery. This article details each aspect of prenatal visits, from health history reviews and growth monitoring to preparing for the arrival of your newborn.
Key Takeaways
- First prenatal visits include confirmation of pregnancy, a comprehensive review of medical history, estimation of due date, and discussions on lifestyle adjustments for a healthy pregnancy.
- Regular prenatal check-ins involve tracking weight and blood pressure, listening to the baby’s heartbeat when possible, and getting routine lab tests and ultrasounds to monitor fetal development and maternal health.
- Special screenings and tests are conducted in the second and third trimesters to check for gestational conditions, genetic abnormalities, fetal growth, and to prepare both expecting mothers and healthcare providers for delivery.
Navigating Your First Prenatal Visit
Stepping into your first prenatal appointment can feel like a giant leap into the unknown. But don’t worry, it’s a well-trodden path that many have navigated successfully before. During this visit, a variety of tests and exams are conducted to confirm your pregnancy and evaluate your overall health. This appointment is when your healthcare team gets to know you and understand your medical, gynecological, obstetrical, and mental health history.
Your healthcare provider will review lifestyle factors like nutrition, exercise, work environment, medications, and dental care to facilitate a healthy pregnancy. These discussions will help tailor your prenatal care to your specific needs. Also, expect to have your vital signs measured, like:
- weight
- height
- temperature
- blood pressure
These measurements are necessary to establish the mom’s baseline health data and monitor the trend through pregnancy, delivery, and the postpartum period.
Most importantly, it’s essential to learn how to communicate with your health care providers and healthcare team. This communication is needed at the prenatal visit and between appointments for ongoing support. Don’t hesitate to ask any questions!
Confirmation with a Pregnancy Test
A positive home pregnancy test is good news, but it merely initiates the process of confirming your pregnancy. At your first prenatal appointment, pregnancy is confirmed in some manner. Up to 5 or 6 weeks in pregnancy, ultrasound evidence of normal pregnancy can be difficult. Then, lab work is useful, typically a measurement of the amount of hCG (Human Chorionic Gonadotropin). The presence of this hormone in a certain amount creates a positive or negative pregnancy test. When pregnancy is already confirmed by the qualitative test (positive or negative) but it is too early for good ultrasound evaluation, the quantitative measurement is needed through blood work. Usually, several levels will be checked with a couple of days in between lab draw to observe a trend. If the values continue to increase, ultimately the ultrasound can provide accurate information. If the first prenatal visit is after six weeks, ultrasound is usually sufficient without lab work for pregnancy confirmation.
Urine tests during routine prenatal visits are used for other reasons than confirmation of pregnancy. Urinalysis is important to evaluate proper kidney function and other conditions. Signs of dehydration, elevated protein or glucose, and possible urinary tract infections are important to diagnose and monitor or treat.
What happens after your pregnancy is confirmed by the tests? Well, it’s time to start planning the journey ahead! Now, your prenatal care visit becomes more than just a pregnancy appointment. It’s a step towards ensuring a healthy mom, healthy pregnancy, and a healthy baby.
Reviewing Your Health and Medical History
Your first prenatal appointment crucially influences the customization of your prenatal care based on your health history. Personal and biological family medical histories are discussed to tailor prenatal care to specific needs, especially regarding inherited diseases and conditions. If you’ve had previous pregnancies, that information is an important part of your medical history that can affect the approach to your current prenatal care. Details of prior deliveries and any complications are very significant for the current pregnancy. Surgical history is also vital As it may play a role in this pregnancy and/or delivery.
To improve safety during pregnancy, your healthcare provider will inquire about all medications in use, including:
- prescriptions
- over-the-counter medications
- vitamins
- supplements
Sensitive subjects such as current or past drug use should be honestly shared with your providers. Domestic abuse, whether in the past or ongoing is also an important detail. If you work, provide details of your job which may be very important to pregnancy, especially if there are hazardous conditions or chemicals in your workplace. Providers need to know if there are living conditions which may negatively affect the mother or baby during pregnancy. Remember, being open and honest about these matters can help ensure the best possible care for you and your baby.
Establishing the Timeline: Calculating Your Due Date
One of the most exciting parts of your first prenatal visit is establishing the timeline for your pregnancy. The estimated due date is calculated starting from the first day of your last menstrual period, adding seven days, and then counting back three months. This date, however, is an estimation. It’s confirmed or adjusted with a prenatal ultrasound, providing a more accurate measurement of the baby’s size and approximate age.
An accurate due date permits your healthcare provider to track your baby’s growth, regulate your pregnancy’s progress, and appropriately arrange relevant tests and procedures. So, now that you’ve got an estimated due date, let’s look at what follows in your prenatal care visits.
Regular Check-Ins: Following Up After the First Prenatal Appointment
After your first prenatal visit, you’ll start to have regular appointments. These visits typically include weight and blood pressure monitoring, urine testing, measurement of the growth of the uterus, and fetal heartrate checks. How often you have these visits can vary. The typical schedule is monthly up to from 28 weeks, every 2 weeks from 28 to 36 weeks, then weekly from 36 weeks until birth. However, this schedule may be individualized based upon the surveillance of the mother’s or baby’s health.
Why do these regular check-ins hold such importance? Prenatal care is critical since serious complications are possible should gestational diabetes or high blood pressure conditions during pregnancy. Without proper prenatal care, there is a significant increase in the risk of giving birth to a baby with low birth weight. Routine check-ups involve a review of the mother’s physical and mental well-being. If a change has occurred or new symptoms developed, timely response can happen.
Tracking Progress: Weight and Blood Pressure Monitoring
During your prenatal visits, weight gain and blood pressure are tracked. Keeping an eye on reasonable weight gain helps assess the likely fetal growth with appropriate maternal nutrition. Excessive weight gain may increase the potential for pregnancy complications as gestational diabetes and hypertension. Typical weight gain varies from 25 to 35 pounds over the course of a normal pregnancy with one baby. Twin pregnancy weight gain is not double the anticipated weight gain with one baby inside, but approximately 40 to 50 pounds is reasonable.
Routine blood pressure checks during each prenatal visit are vital for the early identification of pregnancy-related hypertension, a condition that can pose serious health risks to both mother and baby. Some women may have a pre-existing diagnosis of high blood pressure. Chronically high blood pressure can risk the development of preeclampsia, a serious maternal condition that can have various impacts on the mother and the baby.
Listening to Baby’s Heartbeat
The baby’s heart develops with motion that is visible by ultrasound at 5 to 6 weeks. Most ultrasound equipment has a Doppler mode which can pick up the baby’s heartbeat at that early time. This ultrasound use of Doppler is more powerful than the portable devices used throughout the pregnancy and is not used except for appropriate evaluation of the baby’s health.
Hearing your baby’s heartbeat for the first time is a magical moment that many expectant parents anticipate. The baby’s heart rate is faster than that of a healthy adult. These heartbeats are usually detected using a handheld Doppler device from around 14 weeks of pregnancy. But it’s not just an emotional experience. Listening to the baby’s heartbeat during your prenatal visits provides both emotional and medical benefits. Sometimes it may be hard to immediately locate the baby to find the heart sounds. Remember that they are small, so the heart is even smaller. Listening to the baby’s heart sounds are reassuring to parents. It is important for the pregnancy care team, too. They measure the rate and consider the rhythm.
Lab Tests and Ultrasounds: Keeping an Eye on Health
Beyond weight and blood pressure monitoring, lab tests are part of routine pregnancy evaluation. Ultrasound can be beneficial for specific reasons in the beginning of pregnancy. It is unusual to require an ultrasound evaluation at every prenatal visit.
Blood tests are also needed. Information is collected as your blood type, Rh status, complete blood count, and tests for immunity to certain conditions like rubella and chickenpox. Other information is also a standard public health assessment as sexually transmitted disease and HIV status.
Urine tests are necessary and easy samples to obtain. Prenatal visits will always check a urinalysis with a panel of results which can detect for a possible bladder infection and signs of other conditions by noting if there is too much protein or glucose in the urine sample.
Lab results and ultrasound information are crucial in building a medical record of the pregnancy. Individual results may not be enough to interpret. Always ask for the opinion of your pregnancy care provider. Most information needs to be considered in context of other data as the pregnancy care team works with mom for a healthy pregnancy.
Specialized Screening During the Second Trimester
As you move into your second trimester, your prenatal care will include more specialized screenings. These tests include prenatal genetic tests, fetal ultrasounds, and blood tests for blood count, and gestational diabetes screening.
Prenatal genetic testing is complex. The decision to pursue specific evaluation must include your pregnancy care team after a discussion of options. Early prenatal genetic screening may involve maternal blood work for various lab results such as alpha-fetoprotein (AFP), and other serum findings that can indicate a fetal problem. Sometimes an ultrasound is added to view the baby for a specific assessment called nuchal translucency. Another screening evaluation is known as cell-free DNA screening.
Later in the second trimester of pregnancy, the are other screening options. The quadruple screen (also known as the “quad screen”) is a blood test that may be performed after 15 weeks and up to 23 weeks in pregnancy.
Diagnostic genetic testing may be offered based upon screening results or history. Chorionic villus sampling and amniocentesis are the options. These evaluations are performed with ultrasound.
Anatomy Scan: A Detailed Look at Your Baby’s Development
One of the key screenings offered during the second trimester is the anatomy scan. This scan, typically offered between 18 to 22 weeks of pregnancy, assesses the baby’s development and can detect birth defects such as spina bifida and heart conditions.
An anatomy scan can sometimes determine the baby’s sex, although accuracy may be affected by the baby’s position. If an anomaly is detected during the anatomy scan, an appointment with a fetal medicine specialist may be offered to the expectant parent. Diagnostic tests like amniocentesis or chorionic villus sampling (CVS) may be recommended to confirm a diagnosis if the anatomy scan suggests potential concerns.
Genetic Testing: Understanding Risks and Preparing for the Future
Prenatal genetic screening tests, including ultrasound and blood tests, are offered early in the pregnancy to check for fetal genetic issues like:
- Down syndrome
- Cystic fibrosis
- Duchenne muscular dystrophy
- Sickle cell disease
- Trisomy
These conditions can be diagnosed prenatally through genetic screening methods, such as prenatal tests.
Apart from blood marker tests, second-trimester prenatal genetic screens may also include:
- Noninvasive prenatal testing (NIPT)
- Quad screen
- Chorionic villus sampling (CVS)
- Amniocentesis
For women with high-risk pregnancies, diagnostic genetic testing may be conducted.
Preparing for Delivery: Third Trimester Prenatal Visits
As you progress into the third trimester of pregnancy, you can expect your prenatal check-ups are more frequent to ensure the well-being of you and your baby. During these visits in the later weeks of pregnancy, healthcare providers conduct routine physical examinations, measure weight and blood pressure, and monitor the baby’s size and heartrate. Cervical exam may also be included.
Group B Strep test is also performed in the latter part of pregnancy. A positive test is important to know so that antibiotic prophylaxis can be given during labor. The pregnancy care team will usually perform pelvic exams starting around the 36th week and weekly until the baby is born. These exam provide information as the baby’s position (vertex or otherwise), the baby’s station (how low or high in the pelvis), and maternal cervical dilation and effacement.
If pregnancy lasts beyond 40 weeks, additional recommendations are possible. Non-stress tests may be included to monitor the baby’s heart rate and activity.
Monitoring for Gestational Diabetes and Pregnancy Complications
As you progress through your pregnancy, monitoring for potential complications becomes vital. One such condition is gestational diabetes. Glucose tolerance screening is typically conducted between the 24th and 28th weeks of pregnancy. If the results are not ideal with the screening test, a more definitive glucose tolerance test is arranged to evaluate for gestational diabetes.
Prenatal visits provide surveillance of the wellbeing for the mother and baby. These appointments also serve as preventive measures for identifying and managing pregnancy complications such as high blood pressure and gestational diabetes. Please ensure that you keep all your appointments and follow your healthcare provider’s advice. You also have the option and right to ask questions and get answers.
Finalizing Birth Plans and Hospital Preparations
Preparing for delivery is more than just waiting for your due date. It involves communicating your delivery preferences, considering pain management options, and preparing for your hospital stay. A birth plan can cover aspects such as who will be in the delivery room, desired positions for labor and delivery, and interventions you prefer to avoid. Please be flexible with your requests as unusual circumstances may change the priority of your goals.
Part of your preparation also includes packing for your hospital stay. This includes:
- Personal items (pillow, toiletries)
- Clothing for you and the baby
- Necessary documents and insurance information
- Phone and charging cable
- Car seat to bring baby home (required by law)
Ensuring all these are packed ahead of time can help make your hospital stay more comfortable and less stressful.
Essential Postpartum Follow-Up
Prenatal care extends beyond the arrival of your baby, and postpartum care holds equal importance! The American College of Obstetricians and Gynecologists recommends that new mothers have multiple postpartum checkups, with the initial visit typically happening around 3 weeks after giving birth. These visits assess your overall health, ensuring your physical, mental, and emotional well-being. Stork Advisor® suggests that the year after the baby is born is critical to monitor the mom and baby so that families will thrive.
A postpartum physical exam includes vital signs, occasional lab work, and a physical exam of the breast, abdomen and pelvis.
Common postpartum issues that are addressed include:
- Depression
- Anxiety
- Breastfeeding challenges
- Pain
- Fatigue
- Bleeding
- Hypertension
Sexual health and birth control may also be discussed. Pregnancy spacing is also discussed. For added convenience, some ob-gyns may offer telehealth options for postpartum visits.
Prenatal Care for High-Risk Pregnancies
Certain pregnancies are considered high-risk due to factors like being above 35 years of age, having pre-existing health conditions such as diabetes or high blood pressure, or multiple gestations as twins. If pregnancy is categorized as high-risk, more frequent prenatal visits and additional monitoring to ensure necessary care will be recommended for closer surveillance.
The need for delivery by C-section may be unpredictable. Some pregnant women may require this type of delivery for various indications:
- Abnormal position of the baby as breech
- Twin or multiple gestation with the presenting baby in position other than vertex
- Placental position problems as placenta previa or placenta accreta
- Prior C-section, especially with a classical incision
- Cardiovascular problems that contraindicate pushing with labor
Summary
Navigating prenatal visits can seem daunting, but with the right information, it can become a more manageable and less overwhelming process. Remember, these visits are not just about conducting tests and monitoring. They’re about providing care, support, and guidance throughout your journey to motherhood.
From your first prenatal visit to your postpartum care, remember that these visits are critical checkpoints in your pregnancy journey. They ensure both your and your baby’s health and well-being. So, no matter where you are in your journey, know that you’re not alone, and there’s always help and guidance available to ensure you and your baby are on the path to good health.
Frequently Asked Questions
What happens during the first prenatal visit?
During the first prenatal visit, various tests and exams are conducted to confirm your pregnancy and evaluate your overall health, including discussions about your medical history, lifestyle, nutrition, and exercise.
How often should I have prenatal visits?
You should have prenatal visits monthly from weeks 4 to 28, bi-weekly from weeks 28 to 36, and weekly from weeks 36 until birth, but the schedule can be adjusted based on your individual health and needs.
What is the importance of listening to the baby’s heartbeat during prenatal visits?
Listening to the baby’s heartrate and rhythm during prenatal visits is important as it provides both emotional reassurance and medical confirmation of the baby’s development.
What does a second trimester prenatal visit involve?
During the second trimester prenatal visit, you can expect specialized screenings like prenatal genetic tests, fetal ultrasounds, and blood tests for various factors such as blood count, iron level, and gestational diabetes. These screenings are important for monitoring the health of both the mother and the baby.
What is considered a high-risk pregnancy?
A high-risk pregnancy is typically associated with factors such as advanced maternal age (over 35), pre-existing health conditions like diabetes or high blood pressure, and carrying multiples like twins. These factors may require additional monitoring and care during pregnancy.
