Prenatal Check-ups: What, when, & Why?

While there are no guarantees in life, taking good care of yourself during pregnancy is the only way to take care of your unborn baby. Regular prenatal visits help to monitor your health and ensure that your baby is growing as she should.

The usual schedule of prenatal visits to your practitioner is:

  • Monthly for the first 28 weeks
  • Every two weeks from 28 to 36 weeks
  • Weekly thereafter until delivery.

The frequency and complexity of these visits may vary, according to your practitioner’s philosophy, your previous obstetrical history, and any special needs you and your baby may have.

If you are like me, and lucky enough to be experiencing a normal, healthy pregnancy, you may think these visits are a little too frequent, bordering on obsessive. Things are going fine! What exactly is your doctor checking out and looking for?

Dr. Sears explains what’s going on at each doctors visit, tests and examinations, things to watch for, and what to discuss with your doctor throughout each exciting stage of pregnancy.

FIRST MONTH VISIT TO YOUR HEALTHCARE PROVIDER

0-4 WEEKS
On your first visit to your healthcare provider plan to have:

  • Confirmation of pregnancy
  • A general medical history and previous obstetrical history if you have one
  • A general physical exam, including an internal exam
  • Blood tests: hemoglobin and hematocrit, blood typing, rubella titer, hepatitis B screen (HIV screen, venereal disease screen, and sickle cell screen are optional)
  • Examination and possible cultures for vaginal infections
  • Pap smear
  • Possible blood test for genetic diseases if your history warrants
  • Urinalysis to test for infection, sugar, and protein
  • Weight and blood pressure check
  • Counseling on proper nutrition and avoiding environmental hazards
  • An opportunity to discuss your concerns

5-9 WEEKS
During this month’s visit you may have:

  • An examination of your abdomen
  • An examination of the size and height of uterus
  • A hemoglobin and hematocrit check for anemia
  • Nutritional counseling
  • Weight and blood pressure check
  • Urinalysis to test for infection, sugar, and protein
  • An opportunity to discuss your concerns

10-14 WEEKS
During this month’s visit you may have:

  • Examination of your abdomen to feel the top of the uterus
  • Examination of the size and height of uterus
  • Hemoglobin and hematocrit
  • Urinalysis to test for infection, sugar, and protein
  • Weight and blood pressure check
  • Possibly hearing baby’s heartbeat with a doppler device
  • Discussion of tests if needed: ultrasound, chorionic villus sampling, amniocentesis, and prenatal screening for genetic problems
  • Exam for swelling of hands and legs or fluid retention
  • An opportunity to discuss your concerns

15-19 WEEKS
During this month’s visit you may have:

  • Examination of the size and height of uterus
  • Examination for swelling varicose veins, and rashes
  • An opportunity to hear baby’s heartbeat
  • Opportunity to possibly see baby move and all the organs that are now developed on ultrasound, if indicated
  • A triple screen test for possible prenatal genetic defects
  • Weight and blood pressure check (expect a more rapid weight gain over the next three months)
  • Urinalysis to test for infection, sugar, and protein
  • Ultrasound in many practices is now a routine around 15-19 weeks to screen for possible birth defects, number of babies, placental location, and dating of baby’s age.
  • An opportunity to discuss feeling baby move, which you may have already
  • An opportunity to discuss your concerns

20-24 WEEKS
During this month’s visit you may have:

  • Examination for the size and height of uterus
  • An abdominal exam
  • Examination of your breasts and skin
  • Examination for swelling of hands, legs, and enlargement of veins
  • Weight and blood pressure
  • Urinalysis to test for infection, sugar, and protein
  • An opportunity to hear baby’s heartbeat
  • An opportunity to see baby on ultrasound, if indicated
  • An assessment of fetal activity — how often your baby moves and what it feels like
  • An opportunity to discuss your concerns

24-28 WEEKS
During this month’s visit you may have:

  • Examination of the size and height of uterus
  • Weight and blood pressure check
  • Urinalysis to test for infection, sugar, and protein
  • Oral glucose tolerance test, screening for gestational glucose intolerance, if indicated
  • Vaginal culture, screening test for beta strep infection, if indicated
  • An opportunity to hear your baby’s heart beat
  • An opportunity to see your baby growing on ultrasound, if indicated
  • An opportunity to discuss your concerns

28-32 WEEKS
During this month’s visit you may have:

  • Examination of the size and height of uterus
  • Examination of your skin for rashes, enlarging veins, and swelling
  • Weight and blood pressure check
  • Urinalysis to test for infection, sugar, and protein
  • Hemoglobin and hematocrit, if indicated
  • Review of your diet, an opportunity to discuss your weight, if necessary.
  • An opportunity to hear baby’s heartbeat
  • An opportunity to see on ultrasound how baby has grown (if indicated)
  • An opportunity to discuss your concerns

During month seven and eight your healthcare provider may want to check you twice a month.

32-36 WEEKS
During this month’s visit you may have:

  • Examination of the size and height of uterus
  • Examination of your skin for rashes, enlarging veins, and swelling
  • Weight and blood pressure check
  • Urinalysis to test for infection, sugar, and protein
  • Hemoglobin and hematocrit, if indicated
  • Review of your diet, an opportunity to discuss your weight, if necessary.
  • An opportunity to hear baby’s heartbeat
  • An opportunity to see how baby has grown on ultrasound, if indicated
  • An opportunity to discuss your concerns

During month seven and eight your healthcare provider may want to check you twice a month.

36-40 WEEKS
During this month your healthcare provider may check you weekly. During this month’s visit you may have:

  • Examination of the size and height of uterus
  • Palpation of your uterus to determine position of baby
  • An internal exam, if indicated
  • Weight and blood pressure check
  • An ultrasound exam if needed to determine the size and position of your baby
  • Urinalysis to test for infection, sugar, and protein,
  • An opportunity to discuss when to call your practitioner if labor begins
  • An opportunity to discuss the difference between Braxton-Hicks contractions and the “real” ones
  • An opportunity to discuss signs that labor has begun
  • An opportunity to discuss when to go to the hospital or birth center
  • An opportunity to discuss your birth plan, including labor assistants, avoiding episiotomy, or special birth requests
  • An opportunity to discuss other concerns

If your weekly or twice weekly visits drag on, your healthcare provider may discuss what to do when you’re “overdue”. You may have weekly ultrasound examinations to assess the volume of the amniotic fluid, a biophysical profile, or discussion of possible induction of labor at some point. If you are overdue your healthcare provider will counsel you on worrisome signs to watch for. Frequency and content of healthcare provider visits during the final month depends greatly on your particular obstetrical situation.

For more information on pregnancy, healthcare, and medical testing, visit Ask Dr. Sears!

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