Prenatal care, or the medical care you receive during pregnancy, should begin early on in your pregnancy. The first step will be to choose what type of provider you want to see for your prenatal care. Your options are:
- an obstetrician (OB): A doctor who specializes in caring for pregnant women and delivering babies. Obstetricians are the best choice for high-risk pregnancies.
- a family practice doctor: A doctor who cares for patients of all ages. A family practice doctor can care for you before, during, and after your pregnancy. They can also be the regular provider for your baby once it is born.
- a midwife: A healthcare provider trained to care for women, especially during pregnancy. There are several different types of midwives, including certified nurse midwives (CNMs) and certified professional midwives (CPMs). If you are interested in seeing a midwife during your pregnancy, you should choose one who is certified by either the American Midwifery Certification Board (AMCB) or the North American Registry of Midwives (NARM).
- a nurse practitioner: A nurse who is trained to care for patients of all ages, including pregnant women. This can be either a family nurse practitioner (FNP) or a women’s health nurse practitioner.
No matter what type of provider you choose, you will be visiting your prenatal care provider regularly throughout your pregnancy. These visits will typically include a physical exam, a weight check, and various tests. Regular prenatal care will reduce the chance of complications during your pregnancy and can protect both your health and your infant’s.
You should schedule your first visit as soon as you know you are pregnant. Generally, the first prenatal visit will be scheduled for after your 8th week of pregnancy. If you have another medical condition that could affect your pregnancy or have had difficult pregnancies in the past, your provider might want to see you earlier than that.
Because this is likely to be the first time you meet your prenatal provider, the first appointment is usually one of the longest. Among the topics you and your provider will discuss are:
- medical history: You and your provider will discuss any past medical or psychological problems you have had in the past. Of particular interest are any previous pregnancies, what medications you are taking, your family medical history, any prior abortions or miscarriages, and your menstrual cycle.
- due date: Your provider will try to determine your estimated due date based on the date of your last period. While most women do not end up giving birth precisely on their due date, it is still an important way to plan and monitor progress.
- lifestyle: You may need to make some lifestyle changes in order to maximize your chances of having a healthy pregnancy. Proper nutrition is very important for fetal development. Your provider will recommend that you start taking prenatal vitamins, and may also discuss exercise, sex, and environmental toxins to avoid.
Your provider will also perform a comprehensive physical exam. This will include taking vital signs, like height, weight, and blood pressure, a pelvic exam, and blood tests. Depending how far along you are in your pregnancy, your provider may or may not do an ultrasound.
There are a number of different tests that are typically run at the first prenatal visit. Some tests you can expect include:
- confirmatory pregnancy test: Even if you have already taken an at-home pregnancy test, your provider will likely request a urine sample in order to run a test to confirm that you are pregnant.
- blood typing test: Blood typing is important during pregnancy because of the Rhesus (Rh) factor, a protein on the surface of red blood cells in some people. If you are Rh-negative and your baby is Rh-positive, it can cause problems. As long as your provider is aware of this, he or she can take precautions to prevent any complications.
- screen for infections: Your provider will want to check whether you have any infections, including sexually transmitted infections (STIs). This is likely to include HIV, chlamydia, gonorrhea, syphilis, and hepatitis B. It is important to know whether you might be carrying any infections, as some infections can be transmitted to your baby during pregnancy or delivery.
- check for immunity: Unless you have well-documented proof of immunization against certain infections (such as rubella and chickenpox), your provider will run a blood test to see whether you are immune. This is because certain diseases, like chickenpox, can be very dangerous to your baby if you contract them during pregnancy.
- hemoglobin and hematocrit measurement: Hemoglobin is a protein in your red blood cells that allows them to carry oxygen throughout your body. Hematocrit is a measurement of the number of red blood cells in your blood. If either your hemoglobin or hematocrit is low, it is an indication that you could be anemic, which means that you do not have enough healthy blood cells. Anemia is common among pregnant women.
Your provider may also discuss genetic screening with you. Screening tests are used to diagnose genetic disorders, including Down’s syndrome, Tay-Sach’s disease, and trisomy 18. These tests will typically be performed later on in your pregnancy — usually between weeks 15 and 18.