During your first prenatal visit, you will be screened for potential medical issues or other concerns that could affect your pregnancy. Ideally, you will make an appointment for your first prenatal visit as soon as your pregnancy has been confirmed.
Your doctor will likely schedule the appointment around 6 to 8 weeks into your pregnancy. However, they may see you sooner if you:
- have an existing medical condition
- have had prior problems with pregnancy
- have certain symptoms, such as vaginal bleeding, abdominal pain, and severe nausea or vomiting
At your first visit, your doctor will check your vital signs and take your medical history. They may perform certain examinations and tests, including blood and urine tests.
It’s important to ask your doctor questions and to address any concerns you may have about your pregnancy.
They will also describe the importance of eating a balanced diet, exercising, and taking certain prenatal vitamins during pregnancy. Make sure to ask your doctor about any over-the-counter medicines or supplements you might want to take while you’re pregnant. They can advise you whether they are safe to use during pregnancy.
Your vital signs indicate the status of essential body functions, such as heartbeat, breathing rate, and blood pressure. These signs will be closely monitored throughout pregnancy for any changes that could indicate underlying problems.
While taking your vital signs, your doctor will ask you for the date of your last menstrual period. This will help them calculate your due date.
Your doctor will also want to know about your menstrual history.
They may ask you for details regarding the types of birth control methods you’ve recently used, the length and regularity of your menstrual periods, and the severity of your premenstrual symptoms.
Your doctor will also need to know about any previous pregnancies, including miscarriages and abortions. Important details include:
- the length of pregnancy, including the number of weeks at which the baby was delivered
- the method of delivery
- the birth weight of the baby
- the type of anesthesia or analgesia used
- the occurrence of any infections, blood pressure problems, or bleeding complications
Past reproductive experiences may help predict future pregnancy outcomes. They can also assist your doctor in developing a pregnancy or birth plan tailored to your particular circumstances.
Your gynecologic history is particularly important. Your doctor needs to be aware of any current or past gynecological problems that could potentially lead to birth defects or complications in your baby.
Tell your doctor if you currently have or have ever had sexually transmitted infections, such as:
It’s also important to tell your doctor if you have ever had abnormal Pap smear results.
Your doctor should also know about any and all diseases that have affected you. Many conditions can potentially lead to complications during pregnancy. These include:
If you currently have any of these conditions, your doctor will monitor you very closely throughout your pregnancy to make sure your particular condition doesn’t get worse. They may also run certain tests to evaluate the severity of your condition.
It’s also vital to tell your doctor if you have a history of:
- psychiatric disorders
- trauma or violence
- blood transfusions
- allergic reactions to certain medications
Once you and your doctor have thoroughly covered your medical history, they will ask about your family history and ethnic heritage, as well as that of the other parent. This can help them evaluate your risk for certain genetic or inherited conditions.
Ethnic heritage is important because some medical conditions occur more frequently among certain populations. It’s important for your doctor to know if you have a family history of diabetes or high blood pressure.
A family history of diabetes puts you at an increased risk of developing the condition during pregnancy or at some other point in your life. If are at risk for diabetes, your doctor may want to perform a screening test sooner rather than later.
Diabetes that occurs during pregnancy is known as gestational diabetes, and it can increase your risk for a large baby, the need for cesarean section, and delivery complications.
Similarly, if you have a family history of high blood pressure, one of the problems that can develop during pregnancy can be preeclampsia, and it can be life threatening when left untreated.
If you are at risk for high blood pressure, your doctor will monitor your blood pressure very closely throughout your pregnancy.
Your family’s obstetrical history may be important. Your doctor might ask you if you have a family history of twins, recurrent miscarriages, and stillbirths.
What if you have a high risk for certain genetic diseases?
Genetic counseling can be beneficial if you are at risk for certain genetic diseases. This type of counseling involves taking an extensive medical history and assessing the health of you, your partner, and your respective families.
Your counselor may recommend that you, your partner, or certain family members undergo blood testing for inheritable diseases.
You may also be offered early pregnancy screening tests, such as ultrasound and amniocentesis, to assess your pregnancy for the presence of a genetic disease.
During your first prenatal exam, your doctor will complete a checkup, which usually includes a physical examination as well as blood and urine tests.
Your doctor may also complete a pelvic exam during your first prenatal visit.
Depending on how far along you are in your pregnancy, your doctor will listen for your baby’s heartbeat. Oftentimes, the heartbeat can’t be heard or seen on an ultrasound until at least 6 or 7 weeks.
Check your height and weight
Your doctor will check your height and weight to determine how much weight is ideal for gaining during pregnancy. Your first prenatal exam will serve as a baseline for measuring changes during your pregnancy.
Certain lab tests are routinely performed in pregnant people to identify conditions that may affect the outcome of the pregnancy, for the parent or the fetus.
At your first prenatal exam, your doctor will perform a blood test to determine if you have sexually transmitted infections like syphilis, hepatitis, or HIV.
Your doctor will also administer a complete blood count test (CBC), which will count your red and white blood cells. This test can help diagnose conditions ranging from anemia to cancer and autoimmune disorders.
A rubella blood test will be administered to detect antibodies that help kill the rubella virus. If you’re infected with rubella (also called German measles) during pregnancy, you can transmit the disease to your baby.
If this happens, serious birth defects, miscarriage, or stillbirth could occur.
If you have rubella antibodies or have been vaccinated, you are immune to the disease.
Your doctor will administer a blood test to determine your blood type and Rh factor. Rh factor is a protein that is found on the surface of red blood cells. If you don’t have this protein, you are Rh-negative. If you do have it, you are Rh-positive.
If you are Rh-negative and your baby is Rh-positive, serious health problems, like anemia, and even death can occur for a fetus or newborn.
Fortunately, treatment during pregnancy can help prevent bad health outcomes.
Your doctor will administer a urine test, also called a urinalysis, to detect if you have a urinary tract disease, kidney or bladder infection, or diabetes. While the presence of sugar in the urine is normal in pregnancy, high levels could be a sign of diabetes.
Your doctor may also order a urine culture, another test that detects bacteria in your urine. If the test shows bacteria in your urine, you will be treated with antibiotics.
Depending on your risk factors and how far along you are in your pregnancy, your doctor may use a urine test to check for a condition called preeclampsia — a type of high blood pressure that can occur during pregnancy.
Depending on how far along you are in your pregnancy, your doctor may perform an ultrasound to measure the embryo or fetus to establish or confirm gestational age.
Ultrasounds to confirm gestational age are the most accurate during the first trimester.
Pelvic exam and Pap smear
Your physical exam may include a pelvic exam, where your provider will check your pelvis and uterus to make sure they are healthy.
A pelvic exam is a physical examination of your pelvic organs, including your external genitals (vulva) and internal organs, including the vagina, cervix, and uterus.
Your doctor may also administer a Pap smear, where they will collect cells from your cervix using a swab and a tool called a speculum. Pap smears are used to find changes in the cells of your cervix that could lead to cancer.
At the end of your first prenatal visit, your doctor will explain any additional testing that may be needed. You may consider having additional testing done if you are at high risk of having a baby with a genetic or chromosomal condition, like Down syndrome or cystic fibrosis.
Your doctor may also recommend or prescribe a prenatal vitamin, which is a multivitamin made specifically for pregnant people. These vitamins have folic acid in them, a vitamin that can protect your baby from certain birth defects.
Your doctor will also tell you about the discomforts you may experience during pregnancy and warn you about the symptoms that require immediate medical treatment.
At the end of your appointment, your doctor will instruct you to schedule follow-up prenatal care checkups to ensure the health of you and your baby throughout your pregnancy.
In your first trimester, you will have a prenatal visit every month. In your second and third trimesters, these appointments will increase in frequency.
If you have or are at risk of complications during pregnancy, your doctor may want to see you more frequently.