Your First Prenatal Visit

Missed a period? Feeling nauseous? Taken a pregnancy test that showed positive?  You’re probably feeling excited and a little anxious too, so if you want to know what to expect during the first steps of your journey through pregnancy, we can fill you in!

When to Schedule Your First Appointment

It’s best to call your doctor or midwife as soon as you find out you are pregnant.  If you’re feeling good, your caretaker probably won’t schedule a visit before you’re 8 weeks pregnant. But if you are experiencing any pain, severe nausea or vomiting, or vaginal bleeding, you need to let him/her know so they can see you right away.  If you have a medical condition, are taking any medications, or have had pregnancy-related problems in the past, they will probably want to see your sooner as well.

What to Expect at your First Appointment

The first visit is often the longest one, as your doctor wants to make sure all is well, and let you know what else

Determine your due date: This is often calculated based on the first day of your last period, so it helps if you can recall the date. The date can also be estimated using an early ultrasound of the fetus.

Take your health history: Your doctor will ask questions about your general health, chronic conditions and gynecological issues you may have, medications you take, regularity of your menstrual cycle, and details about previous pregnancies. She’ll also ask about your family’s medical history, health habits, drug allergies, surgeries, hospitalizations, and whether you have been the victim of abuse. She will also inquire about the medical history of the baby’s father and his family.

Discuss Options for Genetic Testing: There are a number of different screening tests that done to determine your baby’s risk for birth defects, chromosomal problems, and Down syndrome.

First trimester combined screening: This consists of a blood test and, if available in your area, an ultrasound called a nuchal translucency screening. It is done between 9 and 13 weeks. This screening assess your baby’s risk of having Down syndrome and some other chromosomal abnormalities as well as major congenital heart problems.

Multiple marker screening is a blood test done between 15 and 20 weeks. It screens for Down syndrome and trisomy 18, which are chromosomal abnormalities, and neural tube defects such as spina bifida.

Carrier screening: These tests are done depending on your ethnic background and medical history, in order to see if your baby is at risk for certain genetic disorders such as Tay-Sachs disease, cystic fibrosis, sickle cell disease, or thalassemia.

Genetic diagnostic tests include chorionic villus sampling (CVS), generally done at 11 to 12 weeks, and amniocentesis, usually done at 16 to 20 weeks. These tests can tell you for sure whether your baby has Down syndrome or certain other problems. These tests are usually administered only if there is a strong risk of chromosomal problems, after the results of the screening tests are known. They are invasive and carry a risk of miscarriage.

Physical exam: Your doctor may give you a thorough physical, including a pelvic exam, a Pap smear (if you haven’t had one recently), and sometimes a culture to check for chlamydia and gonorrhea.

Blood tests are done to identify your blood type, Rh status, and to check for anemia. The lab is also looking out for syphilis, hepatitis B, and immunity to rubella (German measles).  It’s also recommended that pregnant women be tested for HIV (the virus that causes AIDS) at their first prenatal visit. Being treated for AIDS during pregnancy is very important for reducing the likelihood of passing the infection to your baby.

Urine sample tests for urinary tract infections and other things.

Counsel: Your doctor should give you advice about proper nutrition, exercise, weight gain, common discomforts of early pregnancy, and symptoms that  require immediate attention.  She’ll remind you about the dangers of smoking, alcohol, drugs, and certain medications. If you are feeling anxious or depressed she can refer you to someone who can help with your emotional health.  If you have any questions or concerns don’t hesitate to share them with your doctor. Don’t worry, she’s heard and seen in all!

feature image from Rest Assured

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