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Your First Prenatal Appointment

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When should I schedule my first prenatal visit? 

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What to expect at your first prenatal appointment

Your kickoff prenatal visit sets the stage for the rest of your pregnancy. Here's what to expect at this information-packed first appointment and how you can prepare.

When to schedule your first prenatal visit

When will your first appointment be, what happens at the first prenatal visit, how to prepare for your first prenatal appointment, what questions to ask at the first prenatal visit.

As soon as you get a positive result on a home pregnancy test , book an appointment with an obstetrician, family physician, or midwife . Depending on the practice, it's normal for another provider in the office, like a nurse practitioner or physician assistant, to handle your first visit.

If you haven't yet chosen a healthcare provider for your pregnancy, that's okay. It's still important to see someone now to start your prenatal care. You can always switch to another provider later. 

Many healthcare providers will schedule your first visit for when you're about 8 weeks pregnant . Some will see you sooner, particularly if you have an existing health condition, had problems with a pregnancy in the past, or are having new or severe symptoms such as vaginal bleeding or abdominal pain .

If you're taking any medications or think you may have been exposed to a hazardous substance, let your provider know as soon as possible.

The first visit will probably be the longest of your prenatal appointments (unless you have complications with your pregnancy along the way). At this and all future visits, don't be afraid to raise any questions or concerns you've been wondering about – it helps to keep a running list between appointments.

Here's what your provider will likely do during your first prenatal visit.

Take your health history. Your provider will ask questions about your gynecological health, personal medical history, and lifestyle habits. Topics commonly covered include:

• Whether your menstrual cycles are regular and how long they tend to last
• The first day of your last period (to determine your due date )
• Symptoms or problems you've noticed since your last period, whether they're related to pregnancy or not
• Current or past gynecological conditions, including sexually transmitted infections
• Details about previous pregnancies
• Current or past diseases and conditions
• Past surgeries or hospitalizations
• Mental health difficulties and diagnoses
• Whether you are being or have been abused , or have another situation that could affect your safety or emotional well-being
• Smoking, drinking, and drug use
• Medications, supplements, vitamins, and herbal drugs you take
• Drug allergies

Your healthcare provider will also ask about your family medical history. Many genetic issues and birth defects are at least partly hereditary, so learning about your family history helps your medical team keep an eye out for potential issues. Let your provider know whether a relative in your or your partner's family has a chromosomal or genetic disorder, had developmental delays, or was born with a structural birth defect.

It's also important to mention any potential exposure to toxins, especially if you live or work near toxic materials.

Check you out and run some tests. You can expect a number of standard exams and tests at your first prenatal visit. Some healthcare providers will do an ultrasound , but if you don't have any medical problems or concerns, it may not be part of the routine. Here's what's typical:

• A thorough physical exam
• A pelvic exam, including a Pap smear (unless you've had one recently) to check for infections such as chlamydia and gonorrhea or abnormal cells that could indicate cervical cancer
• A urine sample to test for urinary tract infections and other conditions

Your provider will also order blood tests to:

• Identify your blood type and Rh status
• Look for anemia
• Check for HIV, syphilis, hepatitis B and, in certain cases, hepatitis C
• Determine immunity to rubella (German measles) and chickenpox

Discuss any high-risk pregnancy concerns. Many people are considered to have high-risk pregnancies , meaning there's a higher-than-average chance of health issues during pregnancy, labor, and birth. High-risk groups include those who:

• Become pregnant for the first time at age 35 or older
• Become pregnant for the first time before age 18
• Have certain medical issues that develop during pregnancy, such as preeclampsia and gestational diabetes
• Have certain preexisting health problems, such as high blood pressure , thyroid disease , or type 1 or type 2 diabetes

High-risk pregnancies need extra care. While many potential complications are treatable or temporary, some can be dangerous to both you and your baby. Your provider will talk through the risks at your first visit and throughout your pregnancy – and don't be afraid to ask questions at any point.

Explain your options for prenatal genetic testing. Your provider will offer you various prenatal screenings that can give you information about your baby's risk for birth defects and chromosomal conditions. These tests include:

• Noninvasive prenatal testing (NIPT) , also called cell-free fetal DNA testing. Performed at 9 weeks or later, it's used to examine the little bits of your baby's DNA present in your blood.
• A first trimester screen, also called a first-trimester combined test. Typically done between weeks 11 and 13, it consists of a blood test and a type of ultrasound called a nuchal translucency .
• A carrier screening if you haven't had one already. It's a simple blood or saliva test done to see whether your baby is at risk for any of 100 genetic disorders such as cystic fibrosis, sickle cell disease, thalassemia, and Tay-Sachs disease.

Finally, if you're high-risk, there are invasive genetic diagnostic tests that can tell you for sure whether your baby has Down syndrome or certain other conditions. These tests include chorionic villus sampling (CVS) , generally performed at 10 to 13 weeks, and amniocentesis , usually done at 16 to 20 weeks.

CVS and amniocentesis are invasive and may carry a small risk of miscarriage , so women who choose to have these procedures are usually those with a higher risk for genetic and chromosomal problems. Some moms-to-be choose to wait for the results of screening tests before deciding whether to have one of these diagnostic tests.

For more information, your provider can refer you to a genetic counselor .

Give you advice and let you know what's ahead. Your healthcare provider will give you information about eating well , foods to avoid , healthy weight gain , and prenatal vitamins . They'll also give you a heads-up about the common discomforts of early pregnancy and let you know which pregnancy symptoms require immediate attention .

Your emotional health is very important. Your provider may screen you for signs of depression during pregnancy . But don't wait to be asked. If you're feeling depressed or anxious, let your provider know so they can refer you to someone who can help.

The dangers of smoking , drinking alcohol, using drugs, and taking certain medications will be a topic of discussion, as well. If you need help quitting smoking or any other substance, your provider can recommend a program or counselor.

Other topics include the do's and don'ts of exercise , travel , and sex during pregnancy ; environmental and occupational hazards that can affect your baby; and how to avoid certain infections, such as toxoplasmosis . Your provider will also discuss recommended vaccinations , like the flu shot and the COVID-19 vaccine .

To help your visit go as smoothly as possible, try taking the following steps.

Review your medical history. Brush up on your health status so you can better answer questions. This includes information about your:

• Overall physical and mental health
• Current and past diseases, conditions and other health issues
• Current medications, including prescriptions, supplements, vitamins and herbal supplements and teas
• Fertility and pregnancy history
• Family medical history
• Partner's medical history

If possible, bring documentation along, such as immunization records or a list of your medications. You may even want to bring a baggie containing the medications themselves.

Take your partner, a family member, or friend. Another person can write down notes, ask questions, and provide emotional support during this information-dense first visit.

Get there on time or a little early. This can be helpful for filling out forms and reviewing your insurance. Make sure to bring your insurance information and cash or a credit card for any necessary co-pays.

Just as your provider will ask you questions at your first prenatal visit, it's a good idea to come prepared with a list of questions for your provider. Ask anything – and don't be shy. Again, try to keep a running list in the weeks before the appointment, so nothing important slips your mind.

Here are some questions to consider if your provider doesn't bring up the topic first.

• How much weight gain is healthy for me? The first prenatal visit is a great opportunity to learn about how your body will change. It's also a good time to ask about nutrition, including which foods to prioritize in your diet.
• What are the foods I should avoid ? Raw fish and unpasteurized cheeses are long-established no-no's for pregnant people, but ask your provider for a full list of what to skip, since the accepted wisdom has changed over the years. Ask about caffeine and alcohol, too. Coffee is typically alright in limited doses, but no amount of alcohol is considered safe when you're having a baby.
• Are prenatal supplements a good choice? Your provider will likely recommend a prenatal vitamin containing folic acid and iron, both of which are needed more during pregnancy.
• Can I exercise? What about sex? With some exceptions, both are usually okay when you're pregnant. They're important to discuss, however, since certain conditions may complicate matters.
• Is it safe to keep working? If you have a physically or emotionally demanding job , you may want to ask how you can ease the effects on your body and mind.
• Is travel okay? While planes, trains, and automobiles are typically safe well into pregnancy, people with particular complications may need to limit or avoid traveling.
• Which medications are safe to take? Ask about your current prescriptions, herbal products, teas, supplements, and any over-the-counter drugs you may use, such as pain relievers and cold medicines. Non-steroidal inflammatory drugs (NSAIDs) like ibuprofen and naproxen are not recommended, for example.
• What are common symptoms of pregnancy? Your provider can tell you what to expect and how to cope. Remember to ask what symptoms are uncommon, too, and what red flags to watch for.
• What should I do in an emergency? Find out who to contact and where to go if you begin to experience new, unusual, severe, or long-lasting symptoms.
• Who will treat me over the course of my pregnancy? If your provider is part of a group practice, you may see other members of the group during appointments. They may even deliver your baby.
• Do you recommend taking prenatal classes? Whether they're in a hospital, at a university, online, or somewhere else, prenatal classes can be invaluable learning experiences for parents-to-be. On top of the usual childbirth classes you hear about, you can also find courses in everything from stress management to good nutrition and even breastfeeding.

Last but not least, ask about your next visit and schedule the appointment before leaving the office. Until your 28th week of pregnancy, you'll likely see someone every four weeks or so.

You may also want to ask whether future visits will be in-person or virtual. Certain practices offer virtual visits for low-risk patients, those whose providers aren't close by, or even higher-risk patients that need to be evaluated more often.

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Prenatal visits: What to expect and how to prepare

What happens at second trimester prenatal appointments

NIPT (Noninvasive prenatal testing)

Chorionic villus sampling (CVS)

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

March of Dimes. 2017. Prenatal Care Checkups.  https://www.marchofdimes.org/pregnancy/prenatal-care-checkups.aspx Opens a new window  [Accessed March 2024]

MedlinePlus. 2022. Prenatal care in your first trimester.  https://medlineplus.gov/ency/patientinstructions/000544.htm Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Prenatal care: 1 st  trimester visits.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044882 Opens a new window  [Accessed March 2024]

American Pregnancy Association. (2021). Your First Prenatal Visit.  https://americanpregnancy.org/healthy-pregnancy/planning/first-prenatal-visit/ Opens a new window  [Accessed March 2024]

Kids Health. 2022. Prenatal Visits: First Trimester.  https://kidshealth.org/en/parents/tests-first-trimester.html Opens a new window  [Accessed March 2024]

Mount Sinai. 2021. Prenatal care in your first trimester.  https://www.mountsinai.org/health-library/selfcare-instructions/prenatal-care-in-your-first-trimester Opens a new window  [Accessed January 2024]

Centers for Disease Control and Prevention. 2022. Recommended Clinician Timeline for Screening for Syphilis, HIV, HBV, HCV, Chlamydia, and Gonorrhea.  https://www.cdc.gov/nchhstp/pregnancy/screening/clinician-timeline.html Opens a new window  [Accessed March 2024]

Alabama Perinatal Excellence Collaborative. 2015. APEC Guidelines for Routine Prenatal Care.  http://apecguidelines.org/wp-content/uploads/2016/07/Routine-Prenatal-Care-6-30-2015.pdf Opens a new window  [Accessed March 2024]

Kids Health. 2019. Toxoplasmosis.  https://kidshealth.org/en/parents/toxoplasmosis.html Opens a new window  [Accessed March 2024]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2017. What is a high-risk pregnancy?  https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/high-risk Opens a new window  [Accessed March 2024]

Kids Health. 2022. What's a “High-Risk” Pregnancy?  https://kidshealth.org/en/parents/high-risk.html Opens a new window  [Accessed March 2024]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2018. What are some factors that make a pregnancy high risk?  https://www.nichd.nih.gov/health/topics/high-risk/conditioninfo/factors Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Prenatal Tests.  https://www.marchofdimes.org/pregnancy/prenatal-tests.aspx Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2022. Carrier Screening.  https://www.acog.org/womens-health/faqs/carrier-screening Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Chorionic Villus Sampling.  https://www.marchofdimes.org/pregnancy/chorionic-villus-sampling.aspx Opens a new window  [Accessed March 2024]

Office on Women's Health. 2021. Prenatal care and tests.  https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests Opens a new window  [Accessed March 2024]

MedlinePlus. 2021. What is noninvasive prenatal testing (NIPT) and what disorders can it screen for?  https://medlineplus.gov/genetics/understanding/testing/nipt/ Opens a new window  [Accessed March 2024]

Voyage Healthcare. 2021. Prenatal Care Overview.  https://www.voyagehealthcare.com/how-to-make-the-most-of-your-first-prenatal-visit-guide Opens a new window  [Accessed March 2024]

Gifford Health Care. Undated. Preparing for Your Appointment.  https://giffordhealthcare.org/patients/preparing-for-your-appointment/ Opens a new window  [Accessed March 2024]

Mayo Clinic. 2023. Pregnancy nutrition: Foods to avoid during pregnancy.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20043844 Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2023. Nutrition During Pregnancy.  https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Prenatal vitamins: Why they matter, how to choose.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-vitamins/art-20046945 Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2022. Exercise During Pregnancy.  https://www.acog.org/womens-health/faqs/exercise-during-pregnancy Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Sex during pregnancy: What's OK, what's not.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/sex-during-pregnancy/art-20045318 Opens a new window  [Accessed March 2024]

Kids Health. 2022. Sex During Pregnancy.  https://kidshealth.org/en/parents/sex-pregnancy.html Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2023. Travel During Pregnancy.  https://www.acog.org/womens-health/faqs/travel-during-pregnancy Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Over-the-counter medicine, supplements and herbal products during pregnancy.  https://www.marchofdimes.org/pregnancy/over-the-counter-medicine-supplements-and-herbal-products.aspx Opens a new window  [Accessed March 2024]

Where to go next

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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

When you find out you're pregnant, make 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 that you may have.

Medical history

Your health care provider might ask about:

• Your menstrual cycle, gynecological history and any past pregnancies
• Your personal and family medical history
• Exposure to anything that could be toxic
• Medications you take, including prescription and over-the-counter medications, vitamins or supplements
• Your lifestyle, including your use of tobacco, alcohol, caffeine and recreational drugs
• Travel to areas where malaria, tuberculosis, Zika virus, mpox — also called monkeypox — or other infectious diseases are common

Share information about sensitive issues, such as domestic abuse 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 have your baby. It's simply the date that you will be 40 weeks pregnant. Few people 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. Your due date also helps with scheduling tests and procedures, so they are done at the right time.

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. Typically, if the due date calculated with your last period and the due date calculated with an early ultrasound differ by more than seven days, the ultrasound is used to set the due date.

Physical exam

To find out how much weight you need to gain for a healthy pregnancy, your health care provider will measure your weight and height and calculate your body mass index.

Your health care provider might do a physical exam, including a breast exam and a pelvic exam. You might need a Pap test, depending on how long it's been since your last Pap test. Depending on your situation, you may need exams of your heart, lungs and thyroid.

At your first prenatal visit, blood tests might be done to:

• Check your blood type. This includes your Rh status. Rh factor is an inherited trait that refers to a 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. Hemoglobin also carries 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 make you feel very tired, and it 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.

Tests for fetal concerns

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. They may include ultrasound or blood tests to check for certain fetal genetic problems, such as Down syndrome.

Lifestyle issues

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.

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, called a Doppler, that bounces sound waves off your baby's heart. Your health care provider may offer a first trimester ultrasound, too.

Your prenatal appointments are an ideal time to discuss questions you have. During your first visit, find out how to reach your health care team between appointments in case concerns come up. Knowing help is available can offer peace of mind.

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• 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.

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Your First Prenatal Visit

If you did not meet with your health care provider before you were pregnant, your first prenatal visit will generally be around 8 weeks after your LMP (last menstrual period ). If this applies to you, you should schedule a prenatal visit as soon as you know you are pregnant!

Even if you are not a first-time mother, prenatal visits are still important since every pregnancy is different. This initial visit will probably be one of the longest. It will be helpful if you arrive prepared with vital dates and information. This is also a good opportunity to bring a list of questions that you and your partner have about your pregnancy, prenatal care, and birth options.

What to Expect at Your First Pregnancy Appointment

Your doctor will ask for your medical history, including:.

• Medical and/or psychosocial problems
• Blood pressure, height, and weight
• Breast and cervical exam
• Date of your last menstrual period (an accurate LMP is helpful when determining gestational age and due date)
• Birth control methods
• History of abortions and/or miscarriages
• Hospitalizations
• Medications you are taking
• Medication allergies
• Your family’s medical history

Your healthcare provider will also perform a physical exam which will include a pap smear , cervical cultures, and possibly an ultrasound if there is a question about how far along you are or if you are experiencing any bleeding or cramping .

Blood will be drawn and several laboratory tests will also be done, including:

• Hemoglobin/ hematocrit
• Rh Factor and blood type (if Rh negative, rescreen at 26-28 weeks)
• Rubella screen
• Varicella or history of chickenpox, rubella, and hepatitis vaccine
• Cystic Fibrosis screen
• Hepatitis B surface antigen
• Tay Sach’s screen
• Sickle Cell prep screen
• Hemoglobin levels
• Hematocrit levels
• Specific tests depending on the patient, such as testing for tuberculosis and Hepatitis C

Your healthcare provider will probably want to discuss:

• Recommendations concerning dental care , cats, raw meat, fish, and gardening
• Fevers and medications
• Environmental hazards
• Travel limitations
• Miscarriage precautions
• Prenatal vitamins , supplements, herbs
• Diet , exercise , nutrition , weight gain
• Physician/ midwife rotation in the office

Possible questions to ask your provider during your prenatal appointment:

• Is there a nurse line that I can call if I have questions?
• If I experience bleeding or cramping, do I call you or your nurse?
• What do you consider an emergency?
• Will I need to change my habits regarding sex, exercise, nutrition?
• When will my next prenatal visit be scheduled?
• What type of testing do you recommend and when are they to be done? (In case you want to do research the tests to decide if you want them or not.)

If you have not yet discussed labor and delivery issues with your doctor, this is a good time. This helps reduce the chance of surprises when labor arrives. Some questions to ask include:

• What are your thoughts about natural childbirth ?
• What situations would warrant a Cesarean ?
• What situations would warrant an episiotomy ?
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• First Trimester
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What to Expect at the First Prenatal Visit

You got a positive pregnancy test —congratulations are in order! Now it’s time to plan your first prenatal visit. You might be feeling nervous (or is that morning sickness already?!), and you probably have lots of questions, but not to worry—your provider will be there every step of the way. In the meantime, you might want to brush up on what to expect at your first pregnancy appointment. Ready for answers? We’ve consulted with ob-gyns on all the important info.

When Should You Schedule Your First Prenatal Visit?

After you get that positive test, you can take a day or two to soak in the news and celebrate, but it’s a good idea to book that first prenatal visit with your chosen ob-gyn or midwife pretty soon after. (If you haven’t picked a provider yet , you’ll want to get on that ASAP!)

Andrea Braden , MD, IBCLC, an ob-gyn and founder of the lactation company Lybbie , advises to “be on the safe side and give the office a call as soon as you find out you’re pregnant.”

When Will Your First Prenatal Visit Happen?

It’s ideal to schedule your first prenatal visit for when you’re around 7 to 8 weeks pregnant, says Braden. Doctors recommend this timing because that’s when an ultrasound can likely detect baby’s heartbeat . (The earliest a fetal heartbeat can be detected is around week 6, according to Cleveland Clinic .)

If you’ve had complications in an earlier pregnancy, you may want to go in earlier than 7 to 8 weeks. “Sometimes we want to watch these early pregnancies closer because with a history of complications, you have an increased risk of having complications in a subsequent pregnancy,” notes Braden.

On the other hand, if you miss the 7-to-8-week mark, Braden says the goal would be to get you in before 12 weeks, when the first trimester ends. “After that point, just get in as soon as you can because there will be some catching up to do!” she adds.

How Can You Prepare for Your First Pregnancy Appointment?

Want a handy checklist for your first prenatal appointment? Here’s what you need to prepare, according to the experts.

• The date of your last menstrual period (LMP). During your first pregnancy appointment, your ob-gyn will compare the LMP to an ultrasound to determine your due date , says Braden. “If the last period was irregular or unpredictable, sometimes you need to know the first day of the period before that one,” she adds.
• Your medications and medical history. Gather a list of medications and dosages to bring to your provider to discuss their safety during pregnancy, advises Michael Platt-Faulkner , DO, an ob-gyn at St. Elizabeth Physicians in Northern Kentucky. “Writing down any significant personal medical or surgical history and family history of genetic diseases is also helpful information for your visit,” he adds.
• Your pharmacy information. Your doc might prescribe prenatal vitamins or other medications, depending on your medical history, so make sure you have a convenient pharmacy in mind.
• Any questions about symptoms or other concerns. Those first-trimester symptoms—nausea, fatigue, peeing all the time—can cause anxiety. Plus, figuring out what to eat (and not to eat) and questions like “ Can I have coffee while pregnant? ” can be confusing. Platt-Faulker suggests writing all your questions and concerns down for your provider, so you don’t forget them in the heat of the moment.
• Somewhere to track the rest of your pregnancy appointments. “There will be a lot of information coming at you,” says Braden. “You want to have a place to write down future appointments and take any notes.”

What Happens at Your First Prenatal Visit?

What happens at your first prenatal visit can vary widely depending on your state and the type of practice you’re visiting, says Braden. In some practices, you get both an ultrasound and a consultation during your first pregnancy appointment, while other providers’ offices split up these to-dos.

Here’s generally what to expect at your first prenatal appointment.

Your provider may perform an ultrasound to confirm the pregnancy, help determine your due date, check baby’s heart rate and check for any complications, according to Cleveland Clinic . “Oftentimes, an early-pregnancy ultrasound may use a vaginal probe and can be mildly uncomfortable—which can be helpful to know in order to be best prepared for your visit,” says Platt-Faulkner. By about 12 to 14 weeks of pregnancy, your provider will be able to hear baby’s heartbeat with a small device called a Doppler ultrasound, according to Mayo Clinic .

Medical history

“Your provider will review your pregnancy, medical and surgical histories in detail,” says Platt-Faulkner. “Your ob-gyn will [also] review how any medical diagnoses, pregnancy complications or surgical history may affect your pregnancy.” Your provider will also take a look at your medication list and discuss any pregnancy-related safety concerns with the medications you’re taking. Omoikhefe Akhigbe , MD, an ob-gyn at Pediatrix Medical Group in Maryland, adds that your provider may also discuss whether there are any specialty doctors you should start seeing or continue to see.

Lifestyle discussion

Your provider will discuss the lifestyle choices you plan to make during pregnancy. (Remember that, for starters, that means no smoking or alcohol .) “You’ll learn about foods that are safe to eat in pregnancy and the way to keep yourself healthy,” says Braden. “They will answer questions about exercise, diet, nutrition, rest, common symptoms and how to treat them and what to do if you do have discomfort in pregnancy.”

Genetic testing

At your first pregnancy appointment, your provider might perform or discuss future genetic testing. “There are genetic tests that are time-sensitive and can be done as early as 10 weeks,” says Braden. “There are some that are done with an ultrasound around 12 or 13 weeks pregnant, and some that are done in the second trimester. Depending on your history and what you desire, that’ll likely be brought up.” There are some specific tests your provider may offer based on your age or family history too, she adds.

Blood testing

You’ll likely get blood drawn during your first prenatal visit. You’ll be tested for a variety of conditions, including anemia, hepatitis B, syphilis and HIV, as well as for your blood type and Rh factor .

Urine testing

For starters, your provider might test a urine sample to confirm your pregnancy, as well as to test kidney function and screen for the presence of protein, as noted by the Cleveland Clinic .

Physical exam

You can expect a full physical exam at your first prenatal visit, which may include a pelvic examination and a breast exam. “If you’re due for a pap smear and you’re over 21 years of age, then you can expect that you’ll have a pap smear screening test done for cervical cancer along with an HPV test if indicated,” says Braden. “Typically, we also test for sexually transmitted infections at the time of the first prenatal visit.”

Questions to Ask at Your First Prenatal Visit

You’re likely full of questions—and that’s completely normal! Make sure to write them down—and bring this list to your first prenatal appointment in case you feel like you’re forgetting something.

• Questions about symptoms. Of course, you should bring any questions about symptoms to your appointment. Akhigbe says it’s also important to ask “when and where to call for an urgent question, what constitutes an emergency, what is an urgent question and what is a routine question that could probably wait for normal business hours.”
• Questions about testing. Which tests will you need during pregnancy? What will your insurance pay for? “Ask about common resources to use and where you can find the evidence-based information about your pregnancy and guidelines and information about tests,” advises Braden. A lot of people also want to know when they’ll find out baby’s sex , she adds. (Spoiler alert: With non-invasive prenatal testing (NIPT) , you can find out as early as 10 weeks.)
• Questions about your ultrasound plan. How many ultrasounds will you get? “Sometimes it depends on insurance, sometimes it depends on your medical history and sometimes it depends on your provider. Do they do them in-house or at a different center?” says Braden.
• Questions about lifestyle choices. Your doctor will review information about how to eat a healthy pregnancy diet with you, but if you have any specific concerns—such as about drinking alcohol or eating sushi—be sure to let them know.
• Questions about logistics. You’ve got a long journey ahead of you! Your provider will likely “review their practice structure, visit schedule and confirm the hospital where you’ll deliver,” says Platt-Faulkner. But if they’ve missed anything, Akhigbe recommends asking follow-up logistical questions, like how many providers you’ll see and which doctor is most likely to deliver baby. (Remember, there are no guarantees!)

There’s a lot of information to take in at your first prenatal visit. It might seem overwhelming, so make sure to bring questions, take notes and do whatever else you need to feel comfortable. Bringing your partner or a good friend along for the ride can help ease some nerves too. “If you have a support person that will be going along this journey with you, it’s always great to bring them to this visit if that’s allowed,” says Braden.

While it might feel like a lot to take in, know that your provider is there to make sure you and baby are healthy during your first prenatal visit and throughout your whole pregnancy—and that you’re making a wonderful first step in your pregnancy journey.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Plus, more from The Bump:

15 Early Signs of Pregnancy

Pregnancy Checklist: Your First Trimester To-Dos

When Do You Start Showing in Pregnancy?

Omoikhefe Akhigbe , MD, is an ob-gyn and medical director at Pediatrix Medical Group in Maryland. She earned her medical degree from Meharry Medical College School of Medicine in Nashville, Tennessee.

Andrea Braden , MD, IBCLC, is an ob-gyn, board-certified lactation consultant and founder of the lactation company Lybbie . She earned her medical degree from the University of South Alabama School of Medicine.

Michael Platt-Faulkner , DO, is an ob-gyn at St. Elizabeth Physicians in Northern Kentucky. He earned his medical degree from the Heritage College of Osteopathic Medicine at Ohio University.

Cleveland Clinic, Fetal Development , March 2023

Cleveland Clinic, Ultrasound in Pregnancy , September 2022

Mayo Clinic, Prenatal Care: 1st Trimester Visits , August 2022

Nemours KidsHealth, Prenatal Tests: First Trimester , July 2022

Cleveland Clinic, NIPT Test , October 2022

Cleveland Clinic, Your First Prenatal Appointment: What to Expect , December 2022

Learn how we ensure the accuracy of our content through our editorial and medical review process .

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Your first prenatal appointment: What to expect

The first prenatal visit is one of the longest appointments a woman will have during pregnancy, with several tests and a lot of important information conveyed..

During pregnancy, you need regular prenatal visits to keep yourself and the pregnancy healthy. These visits are called prenatal care appointments. In these visits, you might meet with an OB/Gyn, a midwife or a nurse practitioner.

During pregnancy, you'll meet with your prenatal care provider every four weeks until you are about 28 weeks (7 months) pregnant. After that, you'll come every two weeks. Then, in your last month of pregnancy, we'll want to see you weekly.

Your first appointment will likely be the longest of the many prenatal visits to come. At that visit, we will discuss your overall health, answer your first round of questions and help you prepare for the next nine months.

Most women make an appointment after they get a positive result from a home pregnancy test. Often, this is one or two weeks after a missed period. Call us at 505-272-2245 , and we will schedule your first prenatal appointment between six and eight weeks of pregnancy.

What to Expect

Confirming the pregnancy.

Sometimes, home pregnancy tests give false positives—it says you are pregnant, but you aren't. And unfortunately, approximately one in four pregnancies ends in miscarriage , often early in pregnancy. Before we do any other tests, we'll first confirm your pregnancy with a urine test and blood draw.

Estimating Your Due Date

We’ll also ask about your periods:

• How old you were when they started
• How regular they are
• When your last period started

This information helps us estimate your due date—when we expect the baby to come. The due date is approximately nine months from the first day of your last period.

We’ll also discuss whether you want to continue with the pregnancy. Nearly half of all pregnancies in the U.S. are unplanned. It’s OK to not immediately know how you feel about being pregnant, or what you want to do. At your first prenatal visit, we  can talk you through your options . We will support you in whatever you decide.  

Personal and Family Medical History

Be prepared to discuss your personal and family medical history. This information helps us determine whether the embryo might be at risk for health problems.

Some of the topics we'll discuss include:

• Alcohol, tobacco and caffeine use
• Chronic conditions, such as diabetes and high blood pressure
• Exposure to potentially toxic substances
• Genetic disorders
• Medications, including supplements and over-the-counter drugs
• Past surgeries
• Pregnancy complications
• Travel to countries where infectious diseases—such as Zika virus or malaria—are common

At your first visit, we'll also discuss social concerns, such as whether you feel safe at home and at work. Your employer is required to give you accommodations if your job is unsafe for pregnancy. If you don’t feel safe, we can discuss options to manage that situation.

You’ll also get a battery of tests to examine the health of you and your baby. These can include blood and urine tests to look for:

• Blood type and Rh status to determine if you are Rh negative, which can affect the pregnancy
• Glucose levels
• Immunity to measles and chickenpox
• Infections such as rubella, hepatitis B and C, syphilis and HIV
• Urinary tract infections, gonorrhea and chlamydia

Depending on your age and health history, your may also be offered an optional blood test called noninvasive prenatal testing (NIPT) . This screening can be done as early as nine weeks and can determine whether the embryo may be at risk for genetic conditions such as:

• Down syndrome (trisomy 21)
• Edward’s syndrome (trisomy 18)
• Patau syndrome (trisomy 13)

Physical Exam

We’ll check your vitals such as blood pressure and calculate your body mass index to determine how much weight you should gain during pregnancy. We’ll also do a head-to-toe physical exam that may include a breast exam, pelvic exam and screenings of your heart, lungs and thyroid. If you’re due for a Pap smear to check for cervical cancer, we can also do that test at the first visit. We may also try to find out how big your uterus is and if this corresponds to how many weeks pregnant you think you are. We can usually hear fetal heart tones with a doppler after 10 weeks.

Getting an ultrasound at your first prenatal appointment is not required. But we do them more often than not. The ultrasound helps narrow down your due date and confirms that the pregnancy is in the uterus. We also may be able to hear the heartbeat at this time and see if you’re having than one baby.

However, if you’re hoping to learn whether you’re having a boy or girl, you'll have to wait a bit longer! The baby won't be that apparent on ultrasound until approximately 20 weeks.

Education and Resources

Education is a big part of prenatal care. All patients who deliver at UNM Hospital get access to:

• Managing pregnancy symptoms: Some early pregnancy body changes are weird, but normal. These include tender, swollen breasts, fatigue or nausea and vomiting. We can discuss how to manage these symptoms and when to see your doctor.
• Prenatal vitamins: It’s important to take prenatal vitamins with folic acid to prevent neural tube defects and walk you through some foods to avoid—such as alcohol, unpasteurized cheeses, deli meats, and raw fish. We also can suggest exercises that are safe to do during pregnancy .
• Drug and alcohol support: During pregnancy, it's important to quit drinking, smoking and using drugs. If you need help to quit, we can recommend pregnancy-safe medications and options. For example, our Milagro Clinic is designed specifically to give pregnant patients safe, respectful addiction care.
• Prenatal classes: From new parent classes to childbirth classes , we offer a range of in-person and Zoom classes to help you prepare for parenting.
• Financial assistance: There are financial programs at UNM Hospital and in the community to help families with no or limited health insurance.
• Home visits: We can connect you to programs for first time moms that offer home visits at no charge to families with new babies. At these visits, we'll answer your questions and help troubleshoot feeding concerns.

Your first prenatal appointment might seem a bit overwhelming. But we are here for you. We will give you all the information you need to have a healthy pregnancy. And we’ll be by your side, all the way.

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What to Expect at Your First Prenatal Visit

March 26, 2024

Maternal Health , OB-GYN

When you find out you’re pregnant, your to-do list instantly becomes much longer. There are people to tell, nurseries to decorate and names to consider. You also need to establish where you’ll receive your prenatal care.

Your first prenatal appointment should be scheduled seven to nine weeks after your last menstrual period.

“Early prenatal care is important because it gives your provider an opportunity to review your health history and identify risk factors we need to be proactive about,” says UNC Health certified nurse-midwife Rebeca Moretto . “It’s also an opportunity for you to ask questions about the process of pregnancy so that we address your concerns.”

Moretto and UNC Health obstetrician-gynecologist Kimberly Malloy, MD , talk about what to expect at the first prenatal visit.

Selecting Prenatal Care

“I always encourage patients to have established OB-GYN care and to have a preconception counseling appointment,” Dr. Malloy says. “We discuss your medical history and any medications you’re taking so you can prepare for a healthy pregnancy.”

You may already have a relationship with a practice that delivers babies, and your provider might know that you were preparing for pregnancy. If you don’t have a provider, Dr. Malloy recommends starting by identifying where you want to deliver .

“Patients typically choose the facility that’s closest to them, but if you have a complicated medical or obstetric history, you may want to travel farther if it means you can have access to more accommodations of care, such as a NICU [neonatal intensive care unit] or a maternal-fetal medicine department,” Dr. Malloy says.

Also, think about the people you want to be involved in your prenatal care and delivery, considering these factors:

• You may be able to see a family medicine provider for part of your prenatal care.
• Maybe you prefer a practice with nurse-midwives .
• You might not be able to identify specific providers to be in the room for your delivery, as they rotate hospital shifts.
• At an academic institution, medical students, residents and fellows could be part of your care team.

“With a team-based approach , you’ll be able to see a variety of wonderful providers, and a team ensures there are multiple eyes identifying issues,” Dr. Malloy says.

Be sure to confirm with your insurance provider that your selected healthcare practice is included in your coverage.

Preparing for Your First Prenatal Visit

Once you’ve scheduled your first appointment, there are a few things you can do to prepare and help your provider. If you are a new patient to the practice or health system, arrange to have your prior records sent to your new team or obtain copies so you can bring them to the first appointment.

“If you have a record of your most recent Pap test, or any information about prior pregnancies or complications, bring that to the appointment,” Moretto says. “If you’ve had a cesarean section , an operative report is important, especially if you want to pursue a vaginal birth after cesarean.”

Also, bring a list of any medications you take—better yet, bring the packaging or pictures of the prescription labels —so your provider can review them and make adjustments as necessary.

Start a written list of questions you have about your pregnancy, so you don’t forget to ask them when you see your provider. Talk to your family and your partner’s family about hereditary medical issues that could affect your baby so that you can share those details with your doctor.

While you’re waiting for your initial appointment date, know that you can reach out to your care team with questions or concerns.

“Vaginal bleeding and spotting are common in early pregnancy,” Dr. Malloy says. “If it’s a persistent problem, call the provider so they can assess whether you need to be seen sooner.”

Testing at the First Prenatal Visit

The first prenatal visit probably will be the longest of your pregnancy. It will include a complete physical exam, including pelvic and breast exams. Your blood pressure and weight will be recorded at this and future visits.

A urine sample will be taken so that your provider can check for signs of infection and dehydration and levels of protein and glucose.

You’ll also have your blood drawn for a variety of labs, including anemia, immunity to certain infections, blood type and Rh factor .

At this appointment you might have your first ultrasound, depending on the practice. Some providers schedule the first one beforehand so that the images can be reviewed at this visit. You may also be able to see or hear fetal heart tones.

All of this testing helps your provider identify and monitor potential risk factors and issues that could arise during pregnancy, such as hypertension, diabetes and preeclampsia .

In addition to this testing, you’ll have a consultation with your provider, who will review your entire health history, including medications, surgeries and prior pregnancies. If you have concerns about genetic issues, your provider can identify additional screenings or tests you might wish to pursue.

The care team will also give you guidance on how to make your pregnancy as healthy as possible and to prepare for the rest of pregnancy , childbirth and lactation .

“We’ll go over nutrition issues , such as anticipated weight gain and additional caloric intake,” Dr. Malloy says. “We’ll review vaccines that may be necessary during pregnancy, make recommendations for any medications you may need and discuss precautions you may need to take.”

Moretto adds, “It’s also a time to talk about mental health resources. Pregnancy is impactful on mental health , so we can help make connections for therapy and other relevant resources if needed.”

Your due date will be set at your first prenatal visit, but you won’t find out the sex until the second trimester. Finally, your provider will review the schedule for the rest of your prenatal care, dependent on your individual needs and risks.

If you’re pregnant or thinking about becoming pregnant, you should talk to your doctor. Need a doctor? Find one near you .

What to Expect at Your First Prenatal Appointment

Heidi Butler

In this article, you will find:

General health check.

Congratulations, you are expecting! For first time moms, this is an extremely exciting, and overwhelming, time. There are suddenly so many things to do and your body is about to change drastically. The good news is that we are here to walk you through what to expect at your first prenatal visit. This will allow you to address any and all concerns that you may have about this amazing journey into motherhood.

Your first appointment normally occurs between weeks six and eight of pregnancy. However, it can sometimes be scheduled at ten weeks. The timing of this appointment will determine what types of tests will occur and how long the appointment takes, but plan for it to last at least an hour.

1. An Initial Health Assessment

The doctor will usually begin the appointment by establishing a baseline of your vitals. They will take your blood pressure, determine your weight, and check your oxygen levels. If your appointment is after the six week mark, then they will also take the time to listen to your baby’s heartbeat. This will become a regular occurrence throughout your many prenatal checkups in the coming months.

2. Blood & Urine Tests

Next, you will provide your doctor with a urine sample and have blood tests done. These will give your OB-GYN an overall view of your health and indicate if you have certain health conditions, such as anemia, clotting disorders, diabetes, or a urinary tract infection , that may require treatment.

They will also determine your blood type as well as you and your baby’s rH factors . This refers to a protein that is or is not present on the surface of your red blood cells. It is signified by the plus or minus sign attached to your blood type. This is an important piece of information because if you are rH negative and your baby is rH positive, your body will begin to reject the fetus, unless medical interventions are taken during early pregnancy.

Finally, they will check for sexually transmitted infections since many of these conditions can impact your developing baby in utero. Thankfully, bacterial infections like syphilis , chlamydia, and gonorrhea can be treated with antibiotics. Conversely, if you have a viral STI such as hepatitis B, HIV, or genital herpes, these conditions cannot be cured. Instead, your doctor can prescribe antivirals to help prevent the spread of these infections to your baby.

3. Due Date Determination

Your doctor will determine your due date at your first prenatal appointment using the first day of your last period as the start of your gestational window. This will give you a general idea of when to plan for your little one’s arrival, but it is also crucial for your physician as well, because it allows them to properly monitor your baby’s growth and ensure that they are reaching the proper milestones throughout your 40 weeks of pregnancy.

It is important to remember that this is an estimated time of arrival, not a guarantee. In fact, most first time moms tend to deliver at 41 weeks or later if they are given the chance to progress naturally. In contrast, if you are expecting multiples or if you used in vitro fertilization to conceive, this time frame will actually be shortened.

4. A Possible Ultrasound

Some doctors will choose to do an ultrasound during this visit. First trimester ultrasounds will simply confirm the pregnancy, determine that the implantation occurred correctly (the fertilized egg implants incorrectly in the case of an ectopic pregnancy), and show the number of fetuses present. Conversely, if you know the exact date of your last period and you don’t have a history of ectopic pregnancy , your doctor may choose to forgo this diagnostic procedure until the second trimester.

5. Prenatal Testing

For the ladies who pushed their appointment until their tenth week or later, you may have the opportunity to partake in a genetic screening test called cell-free DNA testing. According to The American College of Obstetricians and Gynecologists ( ACOG ), “the cell-free DNA in a sample of a woman’s blood can be screened for Down syndrome, Patau syndrome (trisomy 13), Edwards syndrome, and problems with the number of sex chromosomes.”

This simple blood test can be performed as early as 10 weeks of pregnancy and it can even let you know the sex of your baby. However, if you are having multiples and they are not identical, you may still have to wait until your ultrasound in order to determine the sex of all of the babies . This test looks for a Y chromosome. A positive test result indicates a male chromosome is present. Thus, if it is absent, then you are only having girls. In contrast, if it is present, then you could be having all boys or a mix of both genders.

6. Pelvic Exam

Finally, depending on when you had your last pap smear and your family medical history, your healthcare provider may decide to do a pelvic exam. This allows them to check for abnormal tissue and infections that could impact the pregnancy. Not all physicians will deem this physical exam necessary though, so don’t be surprised if they skip this procedure.

Topics You Should Discuss

1. Health History

During your visit, your doctor will want to get a comprehensive rundown of you and your partner’s family medical history in order to determine if you have any health problems that could impact your pregnancy. These can include conditions such as diabetes, hypertension, thyroid disease, autoimmune disorders, and genetic disorders that you could pass onto your unborn child (e.g. Down syndrome, Cystic fibrosis, or Tay-Sachs disease ).

Additionally, they will inquire about any allergies, previous surgeries, and if you have a history of miscarriages or ectopic pregnancies. These risk factors can help your physician determine if you are prone to having a high risk pregnancy and how to best care for you throughout the next nine months. Remember that you want to provide your doctor with as many details of your overall health information as possible. This will allow them to better care for you and your baby.

2. Weight Gain

The recommended amount of weight that a woman should gain throughout her pregnancy is dependent on what pre-pregnancy weight category she falls under — underweight, normal, overweight, or obese . For those ladies who are in the normal category, you should be gaining a total of 25 to 35 pounds. Underweight women should put on as much as 40 pounds and obese women should only aim to put on a maximum of 20 pounds.

These guidelines are important because gaining too much weight puts you at a higher risk of developing conditions like gestational diabetes and preeclampsia as well as having complications during delivery. You can lessen your risk of these conditions by simply eating well, exercising, taking a prenatal vitamin with at least 400 micrograms of folic acid daily, and drinking plenty of water.

3. Medications

As mentioned, a proper diet and low to moderate activity are important throughout pregnancy. However, there are a lot of things that you need to avoid over the next nine months as well. Make a point to speak with your doctor about the specific medications and supplements that you take regularly and if they are safe to continue throughout pregnancy. This should also include over the counter pills and herbal teas.

Furthermore, inquire about prenatal classes that are available to you through your hospital system. This can help you to be better prepared for what is to come throughout pregnancy, labor and delivery, and beyond!

4. Vaccinations

Another important topic to discuss is what vaccinations you should be receiving throughout the next 40 weeks. The Centers for Disease Control and Prevention recommends that all moms-to-be receive a flu shot and a Tdap vaccine. While you may be wondering why you are required to get a tetanus shot every time you get pregnant, the answer is actually quite logical.

The “p” in Tdap stands for pertussis, otherwise known as whooping cough. By getting this vaccine, you are giving your baby antibodies that will keep them protected during their first few months of life, before they are eligible to receive vaccinations. Additionally, the CDC now also states that the COVID-19 vaccine is also safe for expectant mothers.

Just remember to speak with your physician prior to getting any of these vaccines as the timing is key for ensuring optimal protection for you and your little one. More specifically, the TDap should be administered during the third trimester to guarantee the most antibodies are transferred to your child whereas the flu vaccine should be given just before the peak of flu season, which can vary from year to year.

Lastly, there are a handful of vaccines that are not safe for your unborn child. Some of these include the chickenpox vaccine, the MMR (measles, mumps, and rubella) vaccine, the human papillomavirus (HPV) vaccine, and travel inoculations to protect against yellow and typhoid fever.

Your Specific Concerns

At the end of your first visit, you will have a chance to discuss any questions or concerns that you may have regarding you and your baby. Therefore, have a list of questions ready! This is a brand new experience and every pregnancy is different so don’t be afraid to ask what is on your mind.

Two of the top subjects to discuss are what symptoms are normal (and what are not) as well as your doctor's stance on certain procedures like episiotomies, inductions, scheduled c-sections, and delayed cord clamping. While it may seem like a long way off, if their views do not align with your own, you will want to find a different OB-GYN in your region sooner rather than later.

Lastly, take the time to ask if they have an after hours number that you can call if you notice irregular symptoms or have pressing concerns at an odd hour. This can save you the headache of a potentially unnecessary hospital visit.

Prenatal Care Matters

Most women find out that they are pregnant a few days or weeks after their missed period. For those ladies who have irregular periods and go for longer amounts of time before discovering their big news, remember that it is never too late to receive prenatal care.

What you may not realize is that for the first seven months of pregnancy, women’s health experts advise that expectant moms only visit their doctor once a month, unless they are placed in the high risk category based on specific test results. In other words , even if you waited until 12 weeks to see your physician, you will likely go on to have a healthy pregnancy without any complications.

Nonetheless, in order to achieve the best health outcomes for you and your baby, it is crucial that you receive prenatal care throughout these 40 weeks. While the cost can be high, there are lots of affordable solutions available and most appointments and testing are covered with regular insurance. If you are concerned, speak with your physician about skipping unnecessary check-ups. First time moms normally see their OB-GYN more frequently since this is uncharted territory.

Take Precautions Before Conception

Lastly, if you are a woman of reproductive age and you are sexually active, one of the best ways to protect yourself and your future little one is to simply take prenatal vitamins daily, whether or not you intend to conceive . This better guarantees that if you were to become pregnant unexpectedly, that your baby is getting the majority of the essential nutrients that they need to thrive and grow.

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Pregnancy · July 8, 2023

First Prenatal Visit: What to Expect and How to Prepare

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Congrats on your pregnancy, mama! Did you already schedule your first prenatal visit?!

I know the wait between a positive pregnancy test and your first prenatal visit can feel like foreveeer …

And a bit surreal too.

Then you FINALLY get to go to your first prenatal appointment and BAM— the reality of your pregnancy really hits you!

After all, that’s when your pregnancy will be confirmed!

But in the meantime, while you’re waiting, you may be thinking a lot about your first pregnancy appointment.

What should I expect? How do I prepare? What should I wear? What questions should I ask?

So to shed some light on what may be the longest prenatal appointment you’ll ever have, let’s get into your first prenatal visit: what to expect and how to prepare !

In this post

When to make your first prenatal appointment

Before you call to make a prenatal appointment, make sure you have this info ready:, an example of what to say when scheduling your first prenatal appointment:, urine sample, confirmation of your pregnancy, calculation of your estimated due date, blood pressure check, weight check, review of you and your family’s medical history, surgical history, reproductive history, gynecological history, medication history, review of previous or current substance use, review of lifestyle habits, review of social and mental health history, assessment for domestic violence, full physical exam including pelvic exam and pap smear, fetal heart check, schedule next prenatal appointment, what is the normal schedule of routine prenatal care, how to prepare for your first prenatal visit, what questions to ask at your first prenatal visit, 7 tips and hacks to help you make the most of your prenatal appointments, now you’re totally ready for your first prenatal visit.

So when should you make your first prenatal appointment?

My BEST answer is to call to schedule a prenatal appointment as soon as you get a big fat positive (BFP) on your pregnancy test .

Even though you won’t get seen until you’re about about 8-10 weeks pregnant.

Why? Because prenatal appointments are booked pretty quickly. And the longer you wait, the further into the future your first prenatal appointment will be scheduled.

It’s bad enough that waiting for your first prenatal visit can feel like an eternity. So spare yourself those extra days (or weeks) of anxious waiting…

And call, like right now, if you haven’t already.

What to say when scheduling your first prenatal visit

I totally get it. This may be your first pregnancy, you might be nervous, shy or have social anxiety. It’s possible you never made a call to schedule an appointment before.

So I’m going to give you a script of what to say when scheduling your first prenatal appointment!

But before doing that, I want to give you some tips on how to prepare for the call. This is REALLY important!

• Name and date of birth (DOB): Yep, have your name and DOB ready LOL. Trust me, nervousness can make you forget your name, age, DOB, the reason why you’re calling in the first place, etc.
• First day of your LMP: They might ask, so they can get an idea of how far along you are in your pregnancy.
• Insurance cards: You’ll most likely be asked to provide your insurance name (e.g., Aetna) and your policy number (i.e., member ID number). Remember to ask about any co-payments!
• Your (& maybe your partner’s) schedule: Know when you’ll be free to make it to your appointment. You might be asked if you prefer an AM/PM time slot. If your partner is going, make sure you know his schedule and when he might be available to go with you.
• Calendar: Have a calendar in front of you. You can check your phone’s calendar, but you’ll have to put the call on speaker. So it might be better to have a physical calendar. This will help you see the day (e.g., Monday) a prospective appointment falls on and make it easier for you to schedule your appointment.
• Pen and paper/notebook: Have this in hand to write down any info you might be given (e.g., date, time, what you’re required to bring to your first appointment, any other specific instructions, etc.). I absolutely LOVE using pocket planners/calendars (like this ) to keep my scheduled appointments and other info all in one place. They usually have a notes section for you to write down any questions you may have .

Seriously, all of this preparation is 100% WORTHWHILE!

Okay, so now that you know how to prep for the call, here is…

“Hi, good [morning, afternoon]. My name is [your name]. I just found out I’m pregnant, so I’m calling to schedule my first prenatal appointment. Are you accepting new patients and do you take [name of your health insurance] insurance?”

Filled out version of the example above:

“Hi good morning. My name is Olivia Williams. I just found out I’m pregnant, so I’m calling to schedule my first prenatal appointment. Are you accepting new patients and do you take Aetna insurance?”

Note: If new patients are being accepted, the receptionist will ask for your name, DOB and health insurance information to register you into their system and set up your appointment.

What to expect at your first prenatal visit

Here is a quick glance at what to expect at your first pregnancy appointment:

• Review of previous and current substance use

Here’s a deeper look at what to expect at your first prenatal appointment:

One of the first things you’ll be asked to do is go to the bathroom to collect a urine sample.

You’ll be given a specimen bag with a specimen cup and a few packs of pre-moistened wipes to clean yourself beforehand.

Make sure to clean front to back and it’s better to collect a midstream catch (i.e., pee a little bit into the toilet then fill the cup with the rest of your urine).

If the outside of the cup gets soaked with pee, don’t panic. Just use some tissue to wipe the OUTSIDE of the cup dry and make sure you secure the top before placing into the specimen bag.

Give it to the nurse, or drop it off at the place you were directed to leave it.

Your urine will be checked for excess protein, sugar and other substances that may indicate an infection or pregnancy complication such as gestational diabetes.

Even though you got a positive home pregnancy test, your pregnancy still has to be confirmed at your first prenatal appointment.

They have to do their own pregnancy test so they can enter it into their system.

The urine sample you provided can be used to confirm your pregnancy, but it can also be confirmed with a blood test and/or ultrasound.

They will ask you for the first day of your last menstrual period. This helps them to give you an estimated due date by calculating 40 weeks from that date.

Don’t worry if you can’t remember the date of your LMP because an ultrasound can be done to predict your baby’s estimated due date (EDD).

Your EDD can also be calculated based on the date of your conception, if you happen to know it.

Your blood pressure will most likely be checked after you give them your urine sample.

It’s normal for your blood pressure to decrease when you’re pregnant due to the increase in blood volume, but sometimes it can be abnormally high.

Monitoring your blood pressure is an important part of prenatal care, so you’ll be checked at each prenatal visit.

Regular blood pressure checks are an easy way to detect and treat pregnancy complications like gestational hypertension (i.e., high blood pressure during pregnancy) early.

Your weight will be checked at every prenatal visit—starting with your first. This initial weigh-in will be used as a baseline for all future weigh-ins.

And based on your BMI, you’ll be expected to gain a certain amount of weight during your pregnancy.

Regular weigh-ins can check for sudden fluctuations in your weight and help your provider to see how your pregnancy is progressing.

You’ll be asked a lot of questions about you and your immediate family’s medical history (e.g., diabetes, high blood pressure, asthma, heart disease, allergies etc.).

You might also be asked about your partner’s medical history, as well as the medical history of your partner’s immediate family.

All of this information will help your provider to determine if you’re at risk for certain pregnancy complications and conditions.

If there are any concerns or an increased risk for genetic conditions, you’ll be given the opportunity to receive genetic counseling and genetic testing.

Any prior surgeries? They’ll want to know this because this info can shape your prenatal care.

For example, letting your provider know you’ve had a prior c-section can help them set up a TOLAC (trial of labor after c-section) if your goal is to have a VBAC (vaginal birth after c-section).

Any prior pregnancies, including miscarriages and abortions? They’ll need to know this too.

They will assess you for GTPAL to get a complete reproductive history:

• Gravida: Number of pregnancies you’ve had
• Term: Number of babies delivered after 37 weeks gestation
• Preterm: Number of babies delivered between 20- 36 weeks gestation
• Abortion/miscarriage: Number of losses before 20 weeks gestation
• Living: Number of living children you have

Your provider will want to know any current or past gynecological issues.

This is to determine if you have any potential or actual risks for birth defects and other pregnancy complications.

What’s your STD history? (e.g., herpes, HIV, chlamydia, gonorrhea, syphilis, genital warts, trichomoniasis and more).

It’s BEST to be honest here, so you and your partner can be treated if necessary!

Plus, untreated STDs during pregnancy can be really dangerous for your developing baby.

Your provider will want to know what medications you take (prescribed and over the counter) to assess whether or not it’s safe for you to take during pregnancy.

For any medications that aren’t safe, an alternative one may be provided. But usually the pros and cons of continuing that specific medication during pregnancy are weighed against each other. Meaning—do the benefits outweigh the risks? And vice-versa.

Your OB/midwife will also need to know if you’re allergic to any medications, so it can be entered into your patient record.

Your provider will want to know if you have any previous or current use of alcohol and/or drugs. This includes cigarettes, marijuana and other illicit drugs.

Being transparent can make it easier to get whatever help you may need.

For example: If you smoke cigarettes, but want to stop now that you’re pregnant, your provider can offer a smoking cessation program and other helpful resources to help you.

You will be asked about your lifestyle habits (e.g., exercise, diet, career, hobbies, etc.).

It’s important to be honest, so your provider can give you the best recommendations based on your situation.

Your provider can also let you know what things are safe vs unsafe for you to continue to do while you’re pregnant.

Tips may also be shared about how you can improve the health of your pregnancy.

You’ll be asked about your social history (e.g., emotional support system) and mental health history (e.g., depression, anxiety, prior mental health counseling, etc.).

These questions are asked to get a better idea of how your provider can best support you during your pregnancy.

Domestic violence tends to start or spike during pregnancy ( source ), so you’ll be asked if you’re experiencing any kind of abuse.

Studies have associated domestic violence (aka intimate partner violence) during pregnancy with:

• Poor maternal nutrition and inadequate weight gain
• A negative impact on a woman’s ability to receive regular prenatal care.
• Prenatal and postpartum depression
• A higher risk of substance use
• Adverse neonatal outcomes like low birth weight and premature birth
• An increased risk of miscarriage, stillborn death and induced abortion

If you’re experiencing abuse during pregnancy, your provider can give you all the resources and help that you need.

This includes connecting you with a domestic violence specialist to help you set up a safety plan .

You will also get the proper advice on how to get out of your abusive situation in the SAFEST way possible.

But, of course, you will NOT be forced or coerced to leave your situation if you don’t feel ready to.

You’ll get a full physical exam after you’re done answering questions and asking questions of your own . This usually involves a breast and pelvic exam.

A pap smear with cultures might also be done, especially if you’re due for one.

All of these exams check for infections, STDs and other abnormalities that may complicate your pregnancy.

Your provider will ask you to lie down and expose your abdomen, so a fetal doppler can be used to listen to your baby’s heartbeat.

Just so know, it’s not always possible to detect a fetal heart beat with a doppler in the very early weeks of pregnancy.

Your blood will be drawn at the end of your appointment to check for things like your blood type, Rh factor, blood count, HIV status and immunities.

Lastly, you’ll be told to make your next prenatal appointment.

This is usually done at the front desk, but your provider may set up your next appointment while you’re still in the exam room.

Here is the typical prenatal care schedule for a normal (i.e., uncomplicated) pregnancy:

• Weeks 4-28: every four weeks
• Weeks 28-36: every two weeks
• Weeks 36-birth: every week

The standard schedule is only a general guideline and might look different for you.

Your prenatal care schedule can increase in frequency if you:

• Have a medical history that requires extra monitoring
• Have a high risk pregnancy
• Experience a complication anytime during your pregnancy

The best way to prepare for your first prenatal visit is by gathering all the information you would need to answer all of their questions.

Before heading to your first prenatal visit, make sure you prepare all of the following information:

• Your insurance cards and ID: If a co-payment is required, make sure to have the money together.
• The first day of your last menstrual period: If you don’t know the first day of your LMP, you can give a rough estimate. Or let them know your conception date if you’ve been tracking your fertility. An ultrasound can be used to calculate an estimated due date.
• Your medical history: This includes your gynecological, reproductive, surgical and mental health history
• The medical history of you and your partner’s immediate family: It would be beneficial to have your partner with you, if possible.
• All of the medications you are currently taking: Including prescription, OTC, vitamins, supplements and herbal supplements (e.g., teas, pills, powders, liquids, patches, topical creams, etc) It’s BEST to put all of your medications into a large ziplock bag to bring with you. It will be easier for your provider to know what’s safe or unsafe for you to take during pregnancy.
• Previous or current substance use: This includes tobacco, cannabis, alcohol, vaping products and other illegal or recreational drugs.
• Social history and lifestyle habits: Your career, hobbies, diet, exercise, emotional support system, housing situation, domestic violence history, etc.
• Any questions you may have: Find out all the essential to ask at your first prenatal visit here .

There are 50+ questions you can ask at your first prenatal appointment , but here are a few to get you started:

• How often will I have my prenatal appointments?
• How much weight in total should I gain during my entire pregnancy? How much weight should I be gaining each week?
• How can I help support my baby’s development?
• What lifestyle changes do I need to make during my pregnancy?
• Is there a nurse line to call if I have questions or concerns?
• When should I go straight to the emergency room? (e.g., heavy bleeding, severe cramping, fainting, etc.)
• Are my prescribed and OTC medications safe for me to use during my pregnancy?
• What changes do I need to make to my diet during my pregnancy?

How to make the most of your prenatal appointments

Did you know that getting regular prenatal care from the start of your pregnancy increases health outcomes for you and your baby ( source )?

Prenatal care is SO IMPORTANT for managing the health of your pregnancy, reducing your risks for complications, early detection and treatment of complications and much more!

• Go to all of your prenatal visits: Don’t skip your appointments even if you have a normal, low-risk pregnancy. If you can’t make it to your appointment, call to reschedule but try your best to make it to each appointment.
• Prepare to give a urine sample at each appointment: I would drink water before each of my prenatal visits to make sure I had urine to collect.
• Prepare to have your blood pressure taken at each visit: You might be having your BP taken outside of the exam room, so wear something that will make it easy for you to expose your arm to get a proper BP measurement.
• Wear clothes that allow easy access to your belly: Fetal dopplers, fundal height measurements and checking for baby’s position all require easy access to your belly. I’d skip the maxi dresses, rompers, jumpers and go for T-shirts instead.
• Keep important info within easy reach: This includes your provider’s name and number, other emergency contact info, signs and symptoms to report ASAP and other helpful reminders on your fridge, mirror or anywhere else you think would be good for you
• Prepare your questions beforehand: Write down all of your questions, as they come up, in a notes app on your phone or in a notebook you won’t forget to put in your purse. That way you don’t leave your appointment to then realize you forgot to ask the question(s) you wanted to ask.
• Have your partner or support person go with you, if possible: Especially during the first prenatal visit when questions are being asked about past medical history and family medical history. If they can’t make it, ask if you are able to do a video call. Another tip: if your partner has to take off of work to make it to your prenatal visit, ask the receptionist for a letter for your partner to have proof for their employer. Also, the BIG VISITS to attend are the first prenatal visit, 12 week visit, 20 week anatomy scan (where you can find out the gender!) and one or two late pregnancy appointments nearing your due date.
• Have your insurance cards and ID ready to present to the receptionist when checking in to your appointment. And know beforehand if you have any co-pays to make because if you do, you’ll be expected to pay the day of your visit.

There you have it, mama! Now you know what to expect at your first prenatal visit, how to prepare, what questions to ask and how to make the most of your prenatal appointments. And then some!

I hope you found this post to be really helpful to you and, if so, I hope you share this post with all of your friends!

Seriously—knowing just what to expect, how to prepare and even what questions to ask at your first prenatal visit can really help to get rid of some of those jitters.

Your turn! When is your first prenatal visit and what have you been doing to prepare for it? What tips or info did you find the most surprising or helpful in this post? Let me know in the comments!

Enjoy your first prenatal visit, mama!

Pin to share!

• Alhusen, J. L., Ray, E., Sharps, P., & Bullock, L. (2015). Intimate partner violence during pregnancy: maternal and neonatal outcomes . Journal of women’s health (2002), 24(1), 100–106. https://doi.org/10.1089/jwh.2014.4872
• https://americanpregnancy.org/resources/pregnancy-calculator/
• https://www.thehotline.org/plan-for-safety/create-a-safety-plan/
• https://www.marchofdimes.org/find-support/topics/pregnancy/abuse-during-pregnancy

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What To Expect at Your First Ultrasound During Pregnancy

When do you get an initial glimpse of the fetus? Here’s when you get your first pregnancy ultrasound and what happens during it.

When Should You Get Your First Ultrasound?

What should i expect at my first ultrasound, what your provider is looking for at your first ultrasound, how to prepare for a pregnancy ultrasound.

Getty Images/7postman

That first ultrasound during pregnancy can cause various emotions. No matter what you're feeling, you can typically expect it sometime in the first trimester . A first ultrasound can confirm pregnancy, help determine the fetus' gestational age, and estimate a due date. But for others, the first pregnancy ultrasound is the anatomy scan, which is performed around 20 weeks.

Many parents-to-be are understandably filled with questions about their first pregnancy ultrasound. For starters, an ultrasound is a painless diagnostic test that most people receive at least once during routine prenatal care. High-frequency sound waves travel into the uterus, then bounce back off the embryo or fetus as vibrations. The echoes are translated into electrical signals that are projected as black-and-white pictures on a monitor. The images display the fetus's soft tissues and organs. A pregnancy ultrasound is considered a safe procedure for you and the fetus.

You may also be wondering when you should get your first ultrasound, how it will feel, and what providers are looking for. Experts break down your most pressing questions.

The timing of your first pregnancy ultrasound will depend on things like your age, your medical history, your cycle regularity and last menstrual period (LMP), your health care provider's preference, and any risks they feel you may be facing during the pregnancy. For many people, a first ultrasound is performed at around 8 weeks. But it may also be performed later on.

An early scan (6 to 8 weeks)

Many providers schedule their patients' first ultrasound around 6 to 8 weeks into the pregnancy, which could be during the first prenatal visit. Others will only arrange for an ultrasound that early if the pregnancy is considered high-risk, whether because of age, current medical symptoms (bleeding, abdominal pain), or a history of miscarriage , congenital abnormalities, or pregnancy complications.

At this time, the embryo is tiny , and your uterus and fallopian tubes would be closer to your birth canal than to your abdomen, so a transvaginal ultrasound is clearest. Your provider will typically look for cardiac activity, forecast a due date, check for multiples, and viability. An ultrasound at this time can also be used to screen for an ectopic pregnancy, a rare condition in which the fetus grows in the fallopian tube instead of the uterus.

The dating ultrasound (10 to 13 weeks)

Ultrasounds conducted around 10 weeks capture the baby's growth. The ultrasound technician will measure the length of their body from crown to rump, which serves as a marker of gestational age (and better predicts a due date).

"This helps us determine if the size of the fetus matches up with the size it should be based on the patient's last menstrual period," says Michele Hakakha, MD, an OB-GYN in Beverly Hills and the co-author of Expecting 411. "A smaller crown-rump length may signal an embryo that is not developing normally and may have a chromosomal problem ." It could also mean your estimated due date based on your last menstrual period was off, which is common for people with irregular cycles .

During this period, you may be offered a nuchal translucency (NT) test, which evaluates your child's risk of chromosomal abnormalities and certain congenital heart disorders. This two-part exam includes a blood test that measures the level of specific hormones and proteins in your body and an ultrasound that assesses thickness at the back of the baby's neck (increased thickness indicates that they may be at risk for Down syndrome, trisomy 18, and other genetic disorders). The NT ultrasound is a personal choice. It’s always best to discuss the pros and cons with your health care provider.

The anatomical survey (18 to 20 weeks)

By 20 weeks, most pregnant people will have already had their first ultrasound, but in some cases, the 20-week ultrasound, also known as the anatomy scan, is the first. This routine ultrasound is fairly comprehensive. "We look at about 35 elements, including the brain, heart, kidneys, limbs, face, sex, and more," says Jane Chueh, MD, director of prenatal diagnosis at Lucile Packard Children's Hospital Stanford in Palo Alto, California.

The fetus will have measurements taken of the diameter and circumference of their head, the circumference of their abdomen, and the length of their femur bone. Ultrasounds can't detect all medical and genetic issues, but they can highlight physical characteristics that are suggestive of potential disorders.

Additional ultrasounds

There are instances where a person may need extra ultrasounds, such as if there are issues with the cervix, amniotic fluid, or the placenta location or size. You may also need growth ultrasounds to ensure the fetus is staying on its growth curve if you are a pregnant person with diabetes, preeclampsia , hypertension, or placenta or uterus issues.

Most people will have their first ultrasound in their prenatal care provider's office or a local hospital, though there are also freestanding facilities that offer them. There are two types of pelvic ultrasounds that a pregnant person can have: a transvaginal ultrasound or a transabdominal ultrasound. Which method is used will depend on how far along the pregnancy is.

Transvaginal ultrasound

Given early in pregnancy, transvaginal ultrasounds use a wand-shaped probe (a transducer covered with a latex sheath and lubricant) that is inserted inside the vagina. It offers a very detailed look at the embryo and helps health care providers assess how far along a pregnancy is. To get a good picture, the ultrasound technician may move the device, but any discomfort should be minimal. At this point, the embryo is very small and located deep in the pregnant person's pelvis; since sound waves can't pass through bones, a technician may approach the uterus through the cervix. This exam may also be used later in pregnancy if the person expecting develops placenta previa (a condition in which the placenta covers the cervical opening) or the provider needs to measure the cervix itself.

Transabdominal ultrasound

A transabdominal ultrasound is a non-invasive type of ultrasound that tends to be more common after 11 to 12 weeks of pregnancy . The technician moves the transducer along a pregnant person's abdomen, applying a small amount of pressure as they go. The transducer transmits sound waves that create a picture of the fetus inside the body, and it may be rotated at different angles to get a complete picture. If you're ticklish, you might find yourself challenged by this procedure. Breathe deeply and try to relax!

Early ultrasounds are typically looking for the following:

• Pregnancy viability 
• Number of fetuses
• Size of the fetus
• Due date confirmation

After you make an ultrasound appointment, your health care provider may give you an instruction sheet telling you what to do next. People who are less than 14 weeks pregnant are usually asked to fill their bladders to capacity before the exam. Sound waves travel better through liquid, and a full bladder improves the quality of the ultrasound. As the pregnancy progresses, this is not as essential because the uterus and fetus become so large—but even then, some providers still ask patients to come to the ultrasound appointment with bladders full.

Otherwise, if you'll be having an abdominal rather than a transvaginal ultrasound, you might consider wearing a two-piece outfit that provides easy access to your tummy—and one that you won't mind getting a little ultrasound gel on (Don't worry: It'll come out in the wash).

Benefits and risks of ultrasound in pregnancy . Semin Perinatol . 2013.

Sonography 1st Trimester Assessment, Protocols, and Interpretation . StatPearls . 2022.

Ectopic Pregnancy, Ultrasound . StatPearls . 2023.

The role of ultrasound in the diagnosis of fetal genetic syndromes . Best Pract Res Clin Obstet Gynaecol . 2014.

Role of ultrasound in the evaluation of first-trimester pregnancies in the acute setting . Ultrasonography . 2020.

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Pregnancy: first prenatal visit.

Your first prenatal visit will probably be the longest visit you'll have. Your doctor or midwife will take your medical history and do a complete physical exam. You may also have some tests. This will provide information that can be used to check for any problems as your pregnancy progresses.

Medical history

Your doctor or midwife will ask about your medical history. This helps your care provider plan the best possible care for your pregnancy and childbirth. Things you'll be asked about include:

• Your menstrual history. This will include your age when you had your first period, whether your cycles are regular, and the date of your last period. Information about your last period is used to estimate your due date .
• Any previous pregnancies, abortions, miscarriages, or stillbirths.
• Problems with previous pregnancies.
• Any problems with your reproductive organs .
• Health problems in your family, such as heart disease or genetic conditions .
• Your general health. This includes vaccinations, surgeries, and serious illnesses you have had. It also includes any current or past mental health issues, such as depression.
• Any medicines you take regularly. This includes prescription and over-the-counter medicines, vitamins, and supplements.
• Any habits that could affect your pregnancy, such as tobacco, alcohol, or drug use.

Physical exam

A complete physical exam may include:

• Checking your weight and blood pressure.
• A pelvic exam .
• A Pap test (if you haven't had one recently).
• A breast exam.

This may be used to confirm your pregnancy and to:

• Estimate the due date.
• Make sure the pregnancy is located in your uterus.
• Check the number of embryos in your uterus.

A urine test may be done to check for:

• Sugar in your urine. This is a sign of gestational diabetes.
• Protein in your urine. This may be a sign of kidney disease.
• Bacteria in your urine. This is a sign of a urinary tract infection (UTI). UTIs are common during pregnancy, and they may not cause symptoms. If not treated, a UTI may lead to a kidney infection.

Blood tests

You may have blood tests to check for:

• Blood type . If your blood is Rh-negative and the father's blood is Rh-positive, the fetus may have Rh-positive blood. That can lead to problems with Rh sensitization.
• Iron deficiency anemia.
• Immunity to German measles (rubella).
• HIV infection.
• Hepatitis B infection. If you are infected, your baby will be treated within 12 hours of birth. You may also be tested for hepatitis C infection.
• Gestational diabetes.

Other tests

You may have other tests to look for some conditions, such as:

• Genetic conditions that can be passed down through families. These include cystic fibrosis, sickle cell disease, and Tay-Sachs disease.
• Sexually transmitted infections (STIs) such as gonorrhea and chlamydia. STIs during pregnancy have been linked to serious problems, including miscarriage and premature birth.
• Thyroid disease. You may have thyroid tests if you have a personal or family history of thyroid problems.
• Diabetes. You may have an early blood sugar test (glucose tolerance test) if you have risk factors for having gestational diabetes.

Current as of: July 10, 2023

Author: Healthwise Staff

Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . Learn how we develop our content .

To learn more about Healthwise, visit Healthwise.org .

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First Prenatal Visit At the first prenatal visit, take a careful history, looking for factors that might increase the risk for the pregnant woman.

Many providers use a questionnaire, filled out by the patient, as a starting point for this evaluation. A sample Prenatal Registration and Obstetrical Questionnaire form can be used for this purpose.

One important aspect of prenatal care is education of the pregnant woman about her pregnancy, danger signs, things she should do and things she should not do.

Many providers find it useful to give the woman printed material covering these issues that she can take with her. This allows her to read the material at a later time and to refer to it whenever she has questions. A sample Prenatal Information form can be printed and used.

• Confirm intrauterine pregnancy placement
• Confirm fetal viability
• Confirm the number of fetuses
• Provide a highly reliable estimate of gestational age

EDC Based on the history, physical exam and ultrasound scan (if done), it is important to establish a gestational age and estimated date of confinement (EDC, or "Due Date").

You may use the last menstrual period, if known, reliable, and the patient has a history of regular periods. Add 280 days (40 0/7 weeks) to the LMP and this will give you her EDC. This assumes that she ovulated on day #14 of her last menstrual cycle. To assist you in making this calculation, I'm enclosing a LMP to EDC conversion chart here:

You may take the LMP, add 7 days and subtract 3 months. This is a rough but usable adaptation of the 280 day rule. It has the same limitations.

You may measure the fundal height (distance from the symphysis to the top of the uterus). That distance in centimeters is roughly equal to the weeks gestation of the patient.

• Hemoglobin and hematocrit (HGB/HCT)
• White blood cell count (WBC)
• Urinalysis (UA)
• Blood type and Rh
• Hepatitis B Screen
• Rubella Titer
• Atypical antibody screen
• Thyroid Stimulating Hormone (TSH)
• Serologic test for syphilis (RPR or VDRL)
• Other lab tests as indicated by individual circumstances. For example, Sickle screening for black patients, Tay-Sachs screening for Ashkenazi Jewish patients, and thalassemia screening for patient's of Mediterranean extraction.

Subsequent Lab Tests

• Serum AFP at 15-18 weeks
• Targeted (Level II) ultrasound scan for women at high risk at 16-20 weeks
• Hbg / Hct at about 28 weeks
• Glucose screening at about 28 weeks (50 g oral load with 1-hour glucose test)
• Antibody screen and Rhogam for Rh negative women at 28 weeks
• Vaginal/rectal culture for Group B Strep at about 36 weeks

Subsequent Visit s

• every 4 weeks until 28 weeks' gestation
• every 2-3 weeks until 36 weeks' gestation
• every week from 36 weeks to delivery

At these visits, you will want to ask the patient about any interval changes. You'll also want to know about any vaginal discharge or bleeding, fetal movements, and uterine contractions.

Weight gain is usually slow during the first 20 weeks. Then, there is usually rapid weight gain from 20 to 32 weeks. After that, weight gain generally slows and there may be little, if any weight gain during the last few weeks.

Too little weight gain (below 13 pounds) leads to concerns that the baby may not be getting enough nutrition.

Too much weight gain leads to concerns about soft tissue distocia during labor and difficulty with restoring normal weight after delivery.

Blood Pressure Measure the blood pressure at each prenatal visit. Significant cardiovascular changes occur during pregnancy, including a 50% increase in blood volume, 50% increase in cardiac output, significant reduction in peripheral resistance, and a mild, sustained tachycardia. While these changes are taking place, I would make the following generalizations about blood pressure:

If the measurements are too small, consider:

• Your estimate of gestational age may be incorrect
• There may be very little amniotic fluid (oligohydramnios) .
• The baby may be small for gestational age (or growth retarded)
• The baby may be normal, but simply constitutionally small.

If the measurements are too big, consider:

• There may be too much amniotic fluid (polyhydramnios)
• The baby may be large for gestational age (as is seen in gestational diabetes)
• The baby may be normal, but constitutionally large.

Listen for the heartbeat The normal rate is generally considered to be between 120 and 160 beats per minute.

Use a coupling agent (eg, Ultrasound jel, surgical lubricant, or even water) to make a good acoustical connection between the transducer and the skin.

Doppler fetal heartbeat detectors are moderately directional, so unless you happen to aim it directly at the fetal heart initially, you will need to move it or angle it to find the heartbeat.

Check for edema Swelling of the feet, ankles and hands is common during pregnancy. If mild, and in the absence of hypertension, the patient can be reassured that:

Facial edema, severe pedal edema, or any sudden increase in edema can be a sign of developing pre-eclampsia , so the BP should be checked. Usually, rapid accumulation of extracellular fluid is accompanied by a significant weight gain in a very short time.

It is not necessary to treat simple edema, in the absence of pre-eclampsia . However, some patients are so uncomfortable or their edema is so substantial that you may feel compelled to treat the patient. One effective treatment for edema is bed rest for 2-3 days, while drinking plenty of plain water and avoiding excessive salt. This technique:

• Mobilizes the extracellular salt and fluids
• Increases urine output
• Will lead to a loss of several pounds through urination.

Check urine protein and glucose A urine dipstick test for protein is generally negative or trace during pregnancy. If 1+ (30 mg/dl) or more, it is considered significant.

Ask about fetal activity Although fetal movement can be documented by ultrasound as early as 7-8 weeks of pregnancy, fetal movement is not usually felt by the mother until the 16th week (for women who have delivered a baby) to the 20th week (for women pregnant for the first time).

Once they positively identify fetal movement, most women will acknowledge that they have been feeling the baby move for a week or two, but didn't realize that the sensation (fluttery movements) was from the baby.

Movements generally increase in strength and frequency through pregnancy, particularly at night, when the woman is at rest. At the end of pregnancy (36 weeks and beyond), there is normally a slow change in movements, with fewer violent kicks and more rolling and stretching fetal movements. A sudden decrease in fetal movement is a danger sign that needs to be reported and investigated immediately.

• An ultrasound scan will confirm the presentation and position any time it is needed.
• An x-ray of the abdomen can provide nearly as much information as the ultrasound scan, but exposes both the mother and fetus to radiation and thus is rarely used.
• Clinical examination of the abdomen (Leopold's Maneuvers) can provide very reliable information, although the more experienced the examiner, the more reliable the information. Patient habitus also makes this exam easier or more difficult.

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When to Visit the Doctor to Confirm Pregnancy

Missing a period or developing odd symptoms when you’re not ill can quickly lead to questions about whether or not you’re pregnant. Your first thought may be to rush and take a pregnancy test, especially if you’ve been experiencing nausea, vomiting, fatigue, breast tenderness, frequent urination, or food and smell aversions. There’s nothing wrong with doing so. Peace of mind is important.

However, you should still see a doctor if these symptoms occur around the time of a missed period or after a store-bought pregnancy test confirms your suspicions. The sooner you know that your symptoms are pregnancy-related, the earlier you can start taking measures to give your baby the best start in life.

What to Expect at Your First Doctor’s Visit to Confirm Pregnancy

The first prenatal appointment is important. In most cases, it takes place at least 6 to 12 weeks after a missed period. There are some situations where the first doctor’s visit to confirm pregnancy may take place a bit sooner or later. Every woman’s body and pregnancy is different. Much of what happens at the first appointment and afterward, is dependent on your choice of provider.

To prepare for the first appointment, write down any concerns you may have about your situation so you can bring them up when you talk to the doctor. Upon your arrival, you’ll need to complete patient paperwork and provide insurance information if applicable.

Prior to seeing the doctor, a medical assistant or obstetric nurse will take your vitals and weight and review your medical history. Depending on your situation, a urine or blood test and additional lab tests may be necessary to determine if you are pregnant and how far along you may be. If there are any special concerns about your possible condition, an ultrasound may also take place during that time as well.

The first appointment is a great opportunity for you to get to know your doctor or OB/GYN and discuss any concerns you may have about your condition. If you have diabetes, high blood pressure, or other medical issues, your physician will inform you of special considerations that you may need to take. No matter how far along you may be by the date of your first appointment, prenatal care is beneficial.

Why Is Prenatal Care Important?

It is important not to overlook the importance of prenatal care. Pregnancy is a wonderful thing. However, it’s also a delicate and risky time for both mom and baby. According to the Office on Women’s Health, part of the U.S. Department of Health and Human Services, low birth weight and high infant mortality rates are 30 to 50 percent higher in women who forgo prenatal care during their pregnancies. Medical care during pregnancy is one of the most effective ways to minimize complications and adverse outcomes.

As exciting as the thought of having a healthy baby is, prenatal care is a critical part of the journey to ensure both mom and baby are healthy. Pregnancy causes many expected and unexpected changes to the body. It is also a time of rapid growth development for the unborn child and new mother.

The benefits of prenatal care include:

• Guidance and clarity on how to care for self and the growing unborn baby
• Peace of mind and anxiety relief against the uncertainties
• Increases the chances of a healthy pregnancy
• Fewer complications risks during labor and delivery

Prenatal care is necessary to help catch and treat potential issues early. It’s also crucial, so preventative measures can be taken when needed as well. Seeing a doctor all throughout pregnancy is essential for the best outcome.

Prenatal appointments are scheduled in intervals all throughout pregnancy so the doctor can routinely assess the health, growth, and progress of the mother and baby. Appointments are usually initially scheduled at least four weeks apart. However, expectant mothers with certain conditions or who are considered high risk often end up seeing their OB/GYN care team more often. Also, appointments become more frequent during the later stages of pregnancy.

What Is Preconception Care?

If you’re thinking about becoming pregnant and growing your family, you should start by seeing your doctor for a preconception visit, in other words, a doctor’s visit before you even get pregnant. An OB/GYN can help guide you throughout this process by performing tests to determine any preexisting conditions or issues that may impact your ability to get pregnant and carry your child safely to term.

Benefits of preconception care include:

• Preventing nutritional deficiencies
• Detection of potential genetic risk factors
• Update immunizations
• Weight and dietary guidance
• Smoking, alcohol, and recreational drug cessation support

Getting proactive about pregnancy before it occurs is one of the most important things you can do for yourself and your family. It’s never too early for you to start taking measures to ensure your health to increase the chances of a healthy pregnancy and baby.

In addition to seeing a specialist about preconception care, here are some actions you can take to prepare.

Lose excess weight. Pregnancy is a time of rapid weight gain for expecting women. Being overweight before pregnancy significantly increases the likelihood of obesity, diabetes, low birth weight, and other complications during and after pregnancy.

Take a prenatal vitamin. The body works much harder during pregnancy. Therefore it requires more vitamins and nutrients. If these levels are low prior to and during pregnancy, there’s an elevated risk of birth defects and developmental problems for the developing baby.

Exercise to stay active. Pregnancy can be tiring, and hormone surges can lead to food cravings and fatigue, which also contribute to maternal weight changes. Exercise can help you maintain a healthy weight during and after pregnancy. It helps to counteract poor moods as well.

Learn More About the East Los Angeles Doctors Hospital Family Birthplace

East Los Angeles Doctors Hospital Family Birthplace is committed to providing families with the exceptional and compassionate care they need before, during and after pregnancy. Our services include special bonding time exclusively for new parents and their newborns, breastfeeding support, narcotic and pharmacology-free pain relief options and more. Our experienced obstetricians and staff are here to help ensure positive outcomes for all.

Whether you’re thinking about getting pregnant, suspect that you might be, or are in need of a birthplace, look no further than East Los Angeles Hospital Family Birthplace .

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news Public Health

As congenital syphilis cases soar in U.S., doctors group urges more screening in pregnancy

The american college of obstetricians and gynecologists recommends screenings be done at the first prenatal visit, during the third trimester and at birth..

By The Associated Press

3:05 PM on Apr 18, 2024 CDT

With syphilis cases in U.S. newborns skyrocketing, a doctors group now recommends that all pregnant patients be screened three times for the sexually transmitted infection.

The American College of Obstetricians and Gynecologists issued new guidance on Thursday sayinghe tscreening should be done at the first prenatal visit, during the third trimester and at birth. Though the screening isn’t required, health professionals generally follow the group’s recommendations.

Related: Feds eye Texas as cases of syphilis surge in newborns

“The cases of congenital syphilis are definitely climbing, and they’ve been climbing over the last 10 years. And it’s completely preventable ... It’s unacceptable,” said Dr. Laura Riley, who chairs the Department of Obstetrics and Gynecology at Weill Cornell Medicine and helped with the guidance. “We need to be able to do better diagnostics and treatment.”

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Previously, the group recommended one test in the third trimester — but only for women considered at risk of getting syphilis during pregnancy or those living in communities with high rates of the disease. But this risk-based approach is “how we get into trouble because we’re missing cases,” Riley said.

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Earlier this year, the Centers for Disease Control and Prevention said more than 3,700 babies were born with congenital syphilis in 2022, the most in more than 30 years. U.S. health officials called for stepping up prevention, including screening which is done with a blood test.

In its advisory, the OB-GYN group said CDC statistics show nearly 9 in 10 congenital syphilis cases that year “could have been prevented with timely screening and treatment.”

Related: ‘Worse than COVID’: 41% fewer Texas students completed FAFSA this year

Infections during pregnancy are generally treated with at least two doses of penicillin. Babies born to women with untreated syphilis may be stillborn or die shortly after birth. The disease can also cause other problems in newborns, such as deformed bones, severe anemia, blindness or deafness.

“I hope that everyone takes it seriously,” Riley said. Kids with congenital syphilis may have birth defects that can be devastating — “which is incredibly sad.”

The Associated Press

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Amid syphilis surge, doctors call for more testing during pregnancy

The nation’s largest coalition of obstetricians issued an urgent warning Thursday calling on doctors to expand testing for syphilis during pregnancy amid a surge of cases in recent years.

The American College of Obstetricians and Gynecologists updated its recommendations, advising a routine blood screening at the first prenatal visit and screenings in the third trimester of pregnancy and at birth. This contrasts with previous recommendations, which called for testing in the third trimester exclusively for individuals living in communities with high syphilis rates and for those at risk of syphilis exposure during pregnancy.

“We’re always trying to create healthier families, and some of the diseases that we can easily diagnose and treat are things that we should prioritize, especially when they can be devastating to a baby,” said Laura E. Riley, chair of the obstetrician coalition’s immunization work group. Riley helped write the guidance.

“Sometimes, it’s difficult to know that you’ve been exposed to syphilis, and it’s not like you can raise your hand and say, ‘I have this, please give me treatment,’ because you may not even know you have it,” said Riley, chair of obstetrics and gynecology at Weill Cornell Medicine in New York.

Rates of syphilis have been skyrocketing, with cases hitting their highest level since the 1950s. Reported syphilis cases increased 80 percent from 2018 to 2022 in the United States, soaring from about 115,000 cases to more than 207,000, according to the Centers for Disease Control and Prevention .

In 2022, more than 3,700 babies were born with syphilis, with 231 stillbirths and 51 infant deaths attributed to transmission of syphilis from pregnant people to their babies.

Experts say these rising numbers reflect decreased condom use and an uptick in substance use, The Washington Post reported.

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. When a pregnant person is infected with syphilis, the infection can pose severe consequences for the pregnant individual and the unborn baby. Left untreated, syphilis can progress to advanced stages and damage organs and nerves.

It can also be transmitted to the fetus during pregnancy or at childbirth, resulting in congenital syphilis, which can lead to severe health problems for the baby, including premature birth, low birth weight, stillbirth, developmental delays and other complications.

Nicole Smith, medical director of maternal-fetal medicine at Brigham and Women’s Hospital in Boston, said that by calling for routine syphilis testing, the guidelines should prove to be a useful tool for physicians, especially when stigma surrounding sexually transmitted infections persists.

“Some populations are less likely to be either screened or treated … due to the locations where they’re receiving care or because there’s a concern among that population that they’re being stigmatized because they’re being tested,” Smith said.

“So if we say, ‘No, this is nothing about you in particular, this is something that we’re doing for every single pregnant person in this country … we’re treating everyone the same way,’ and therefore some of the barriers to appropriate treatment should be diminished or ideally removed,” she said.

A single injection of a long-acting dose of penicillin can cure early-stage syphilis.

If a person has late-latent syphilis or does not know how long they had the infection, the CDC suggests three doses of long-acting benzathine penicillin G, given weekly. While the treatment can eliminate the infection and stop more harm, it can’t undo damage that has already occurred.

Hurdles exist for syphilis patients, including getting access to testing and medication. Drug shortages — a long-standing issue for many medications — have contributed to rising syphilis cases, experts say.

In April 2023, the Food and Drug Administration announced a shortage of penicillin in the United States attributed to increased demand.

To combat the ongoing shortages, the FDA granted temporary approval for a French drug, Extencilline, which is used for syphilis treatment but is not FDA-approved. While the Food, Drug, and Cosmetic Act prohibits importing unapproved drugs into the United States, the secretary of Health and Human Services can authorize temporary importation and distribution of such drugs to address shortages until domestic production returns to normal levels.

Riley said the updated guidance from the obstetricians group is essential because it makes physicians aware of the alternative treatment for syphilis amid the shortage.

In June 2023, the maker of penicillin, Pfizer, said it would prioritize making the drug available, with the shortage expected to be relieved within the next few months of this year.

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