A massive to-do list builds following the appearance of two lines on a home pregnancy test. (Congrats, by the way!) There’s soooo much to do over the next nine months — but few things will be as important as prenatal care.
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Expect to become a regular at your healthcare provider’s office as you advance through pregnancy. These appointments begin just a few weeks after you become pregnant and continue right up until the big day.
For a healthy pregnancy, your doctor will probably want to see you on the following recommended schedule:
- Weeks 4 to 28 — One prenatal visit every four weeks.
- Weeks 28 to 36 — One prenatal visit every two weeks.
- Weeks 36 to 40 — One prenatal visit every week.
Each scheduled visit on the timeline comes with a checklist of sorts to help you progress toward a healthy outcome for you and your baby. They provide opportunities for assessment, education and support.
Let’s break down a typical appointment schedule with ob/gyn Stacie Jhaveri, MD, so you get an idea of what to expect.
Weeks 4 to 28
How often you’ll visit: Once every four weeks
Expect your first visit to be a longer one as your healthcare provider gathers information to help guide your pregnancy. For starters, you’ll be asked detailed questions about your and your family’s health history.
This assessment lays the foundation for prenatal care visits throughout your pregnancy.
“We’re looking for health issues that could bring any sort of increased risk,” says Dr. Jhaveri. “If you’re on a medication, do you still need to be? If you have diabetes, is it under control? We talk about lifestyle, stress, diet, exercise. The list goes on and on.”
A thorough physical exam — including a pelvic exam — is also part of your initial visit. There’ll also be an evaluation (typically an ultrasound) to make sure your baby is growing well within your uterus.
You’ll also walk out of that first appointment with an exciting piece of information: A due date. (Or as many medical professionals call it, an EDC — estimated date of confinement.)
Regular tests at appointments
Visits will be shorter at the monthly check-ins that follow up to week 28. You can expect the following to take place at every appointment:
- Blood pressure reading.
- Weight check.
- Urine test.
- Measurement of your belly bump to monitor your baby’s growth.
“This is all part of your ongoing assessment,” says Dr. Jhaveri. “Every one of these tests gives information that can be used to make sure you and your rapidly growing baby are as healthy as possible.”
Magical moments start popping up in this stretch, too. Fetal Doppler devices typically start picking up your baby’s heartbeat around 10 weeks, and will become a regular soundtrack to your prenatal visits.
Screenings on the early schedule
Common tests during pregnancy also include a series of screenings that can provide information on your baby’s health. These include:
- Noninvasive prenatal testing (NIPT) is typically available after 10 weeks of pregnancy. This blood test screens for genetic conditions such as Down syndrome, Trisomy 13 or Trisomy 18.
- A quad screen is a blood test offered between weeks 15 and 20 to assess potential risks and development complications involving your baby’s brain, spinal cord and neural tissues.
- A test for gestational diabetes is usually provided around weeks 24 to 28 to see if hormonal changes are pushing up blood sugar levels.
Weeks 28 to 36
How often you’ll visit: Once every two weeks
As your third trimester begins, expect to begin spending much more time with your healthcare provider. The regular tests done in previous appointments will continue to monitor for any changes.
“Blood pressure can be normal, normal, normal … then all of a sudden it’s sky-high,” notes Dr. Jhaveri. “The closer we get to the end of your pregnancy, there’s more need for evaluation.”
A Tdap vaccine is typically encouraged in this period, too, to protect you and your baby from pertussis (whooping cough), as well as tetanus and diphtheria. Ditto for the Rh0 immune globulin shot to treat possible blood protein incompatibility.
Education also continues, with new information that fits the moment: “We tailor our counseling to where you are in your pregnancy, focusing on what you can expect and any warning signs to look for at that particular time period,” says Dr. Jhaveri.
Weeks 36 to delivery
How often you’ll visit: Once a week
You’re in the home stretch now. Visits to your doctor’s office are more frequent, as preparations for the big day come into sharper focus.
Your baby’s position will be checked to determine what direction they’re facing and your cervix will be checked for dilation. Expect questions and discussions about contractions, leaking fluid and bleeding, says Dr. Jhaveri.
A test for group B strep (GBS) is also routine at this point in the process. GBS can be passed on from parent to baby and cause life-threatening infections in newborns. If found, antibiotics given during labor can help prevent GBS from spreading to your baby.
Reasons why the schedule might change
Here’s the thing with the prenatal schedule above: It can change, especially if you’re pregnancy or health situation is one that demands additional monitoring, says Dr. Jhaveri. This could apply to you if:
- You’re in your teens or age 35 or older. At both ends of the age spectrum, the chance of preeclampsia and gestational diabetes grows higher.
- Twins (or triplets or quadruplets or…) are on the way. Multiples increase the risk of complications during pregnancy — including the likelihood of premature labor and preterm birth.
- Existing health conditions need a careful eye. Pregnancy risk factors rise if you have high blood pressure, diabetes or are HIV-positive. Being overweight can also increase your risk of complications.
How to get the most out of your prenatal visits
If you’re pregnant, you’ve probably got a lot of questions. Ask them, says Dr. Jhaveri.
“Feel empowered when you walk into every appointment,” she says. “We’re here to help you take care of yourself and your baby.”
So, come to your visits with a list of questions and talk openly about any concerns. “Having a baby can be an emotional and scary process,” says Dr. Jhaveri. “But going to regularly scheduled prenatal visits can really help minimize a lot of your fears. You’re coming to a supportive environment. Use that to your advantage.”