Prenatal care: 1st trimester visits

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.

Prenatal care: The first visit

As soon as you think you're pregnant, schedule your first prenatal appointment. Set aside ample time for the visit. You and your health care provider have plenty to discuss! You might want to include your partner in the appointment as well.

Medical history
Your health care provider will ask many questions, including details about:

• Your menstrual cycle
• Use of birth control
• Past pregnancies
• Your personal medical history
• Your family medical history
• Medication use, including prescription and over-the-counter medications or supplements

Be sure to mention even sensitive issues, such as domestic abuse, abortion or past drug use. Remember, the information you share will help your health care provider take the best care of you — and your baby.

If there's any part of your medical history that you don't want to share with your partner or other loved ones, mention it to your health care provider privately.

Due date
Few women actually give birth on their due dates. Still, establishing your due date — or estimated date of delivery — is important. An accurate due date allows your health care provider to monitor your baby's growth and the progress of your pregnancy, as well as schedule certain tests or procedures at the most appropriate time.

To estimate your due date, your health care provider will likely count ahead 40 weeks from the start of your last period — or add seven days to the first day of your last period and then subtract three months.

If there's any question about your due date — if you don't know the date of your last period or your periods are irregular, for example — your health care provider might recommend an early ultrasound to help confirm the date.

Physical exam
Your health care provider will check your weight, height and blood pressure. He or she will listen to your heart and assess your overall health.

Your health care provider might examine your vagina and the opening to your uterus (cervix) for any infections or abnormalities. Changes in the cervix and in the size of your uterus can help confirm the stage of your pregnancy.

You might need a Pap test to screen for cervical cancer as well, depending on how long it's been since your last screening.

Lab tests
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 needs 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 is a sign of anemia — a lack of healthy red blood cells.
• 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 might suggest blood tests to detect various other infections, such as hepatitis B, toxoplasmosis, syphilis, gonorrhea or chlamydia. You might also be offered a test to check for HIV, the virus that causes AIDS.

A urine sample might be tested for signs of a bladder, urinary tract or kidney infection.

Lifestyle issues
Your health care provider will discuss the importance of proper nutrition and prenatal vitamins. Your first prenatal visit is a good time to discuss exercise, sex during pregnancy and other lifestyle issues. You might also discuss your work environment and the use of medications during pregnancy.

If you smoke, ask your health care provider for suggestions to help you quit.

Screening tests for fetal abnormalities
Prenatal tests can provide valuable information about your baby's health. Your health care provider might offer ultrasound, blood tests or other screening tests to detect fetal abnormalities.

Prenatal care: Other first trimester visits

Subsequent prenatal visits — often scheduled about every four weeks during the first trimester — will probably be shorter than the first. Your health care provider will check your weight and blood pressure, and you'll discuss your signs and symptoms.

Near the end of the first trimester — by about nine to 12 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).

You probably won't need another pelvic exam until later in your pregnancy.

Remember, your health care provider is there to support you throughout your pregnancy. Your prenatal appointments are an ideal time to discuss any questions or concerns — including things that might be uncomfortable or embarrassing.

Also find out how to reach your health care provider between appointments. Knowing help is available when you need it can offer precious peace of mind.

Related

• Chorionic villus sampling
• Slide show: Pregnancy stretches
• First trimester screening
• Slide show: Pregnancy exercises
• Fetal ultrasound
• Rh factor blood test
• Down syndrome blood test: How does it work?
• Birth control pills: Harmful in early pregnancy?
• Implantation bleeding: Normal in early pregnancy?
• Nausea during pregnancy: A good thing?
• First trimester pregnancy: What to expect
• Fetal development: The first trimester