Regular prenatal visits are an important part of your pregnancy, making sure that both you and your baby are healthy.
During your visits your caregiver will be alert for potential problems, planning to stop them before they become serious. This could even be something as simple as making sure that you are getting enough iron to prevent anemia or an ultrasound scan to ensure that your baby is developing normally. Routine prenatal visits will give you the tremendous reassurance that your pregnancy is going exactly as you planned.
After your first prenatal visit, which occurs sometime between week eight and week twelve, your caregiver will schedule a visit every four weeks until week twenty eight. After that it is recommended that you see your caregiver every other week until week thirty six. You will then have a routine visit every week until your baby is born.
If your pregnancy is high risk, you are carrying multiple fetuses or there is some other complication, your doctor will schedule more frequent visits to ensure that everything is progressing normally. There are no set dates on which to visit your caregiver. The schedule you and your doctor develop will depend on your medical history and your pregnancy.
During the weeks that pass between your visits you will probably think of many questions that you want to ask your caregiver. Develop the habit of making notes, so that when you go in for your appointment you can be prepared to ask questions. Websites such as BabyPartner can help you with answers to many of your questions, but much of pregnancy will depend on your own personal circumstances, and you will still need to seek professional advice.
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Encourage your partner to accompany you on your visits if it is possible. As your pregnancy progresses he will be preparing for his role during labor and delivery. He may have some questions of his own that will need to be answered by your doctor.
Your caregiver will probably want a urine sample at each prenatal visit. Many doctors prefer a morning sample, which is usually much more concentrated and can provide more accurate test results. If possible collect a urine sample when you go to the bathroom first thing after getting up in the morning and take it with you to your visit.
Be sure to drink plenty of water so that if you need to provide a urine sample during your visit you will be ready. It is also easier to give blood, if necessary, when you are well hydrated. An abdominal ultrasound benefits from a full bladder, and drinking plenty of fluid will save you drinking water in your doctor's office and waiting for your bladder to fill!
Although your routine prenatal visits will not last as long as your first prenatal visit, you will undergo a simple physical examination and tests. The goal of the visit is to ensure that your pregnancy is progressing as expected for the age and size of the fetus and that no complications are developing.
Your caregiver, or nurses, will ask you for a urine test. If you brought a sample of morning urine with you there is no need for another unless specifically requested. You will also be measured and weighed, and the size of your uterus will be recorded. Your blood pressure will be checked and your abdomen will be measured to monitor the growth and position of the fetus.
The way you gain weight during your pregnancy can indicate how your baby is growing. Your doctor will want to weigh you at every visit, but you may find this constant attention about your weight difficult to handle. It is important that your doctor understands what bothers you during your visits, so make it clear you only want to know if something is wrong. If everything is normal, then it can be recorded silently in your medical record!
Your prenatal visits are a time for you, too, to share your concerns with your caregiver. Although a quick visit simply means that everything is going well, you should ask your caregiver to spend time answering your questions if you have any. Both you and your baby deserve the attention of your caregiver during your pregnancy. But bear in mind that others may be waiting for their visits too. Bring along a list of questions you have prepared so that both of you can make the most of any time you have. And save simpler questions for a nurse or midwife who can spend more time with you.
The second trimester is an exciting stage in the development of your baby. You will have increased energy, and will feel and hear your baby for the first time. In addition to the routine physical exam and urine test that will form part of every prenatal visit, your caregiver may choose to perform some specialized tests, depending on your age, or if there are potential complications in your pregnancy.
Although we have described a typical schedule of routine visits below, they represent the minimum number of prenatal visits during pregnancy. Your actual visits may not correspond to the schedule we have created.
One of the earliest and most exciting developments in the progression of your pregnancy will be the first time you hear your baby's heart beating. This test is usually performed during your second or third prenatal visit, sometime after week twelve. Although the heartbeat may be heard as early as week ten using a Doppler scan, it can be difficult to hear, especially if the baby is in the wrong position.
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During your third or fourth prenatal exam, sometime between week fifteen and week eighteen, you will be offered an alphafetoprotein triple screen, or AFP3. This test, sometimes called DownScreen Plus, or a multiple marker test, helps identify possible neural tube defects or chromosomal problems such as Down's syndrome.
If you are over the age of thirty five, the risk of Down's syndrome rises, and you may be offered an amniocentesis during this visit instead. An amniocentesis is also used if the results of the AFP3 test requires further investigation. Ask your caregiver to recommend a genetic counselor if you need more information about these potential problems and the tests themselves.
Sometime during your fourth or fifth visit, between week sixteen and week twenty an ultrasound will be requested. The ultrasound will provide you with your first look at your baby, and give your caregiver and opportunity to check for any abnormalities. The size of your baby will also be compared to the expected size and age to verify your baby's due date.
Between week twenty four and week twenty eight, you will have your fifth or sixth prenatal visit. During this visit you will be given a glucose tolerance test so that you can be screened for gestational diabetes. Gestational diabetes is a common occurrence during pregnancy and can often be controlled by diet alone. Women who are Rh-negative can also expect to receive a RhoGAM injection by this stage of their pregnancy, to make sure that a future Rh-positive baby will not cause problems.
Your ninth visit will probably take place between week thirty five and week thirty seven. During this visit your caregiver will test for Group B B-streptococcus infection. By this stage of your pregnancy you will be visiting your doctor weekly. If your due date passes a nonstress test and biophysical profile will be performed at week forty two to check fetal wellbeing. Labor will be induced if your pregnancy lasts beyond week forty two.
At every prenatal visit your weight will be recorded and during the second half of your pregnancy, your doctor will start looking for signs of preeclampsia. An increase of more than two pounds per week will raise a red flag, as will an increase in blood pressure. The fetal heart rate will also be checked using the Doppler scan as well as the height of the fundus. To do this, your caregiver will start measuring the vertical growth of your abdomen. Starting at the pubic bone, the size in centimeters to the top of your uterus is recorded. This length is approximately equal to the number of weeks pregnant you are. Your hands and feet will be examined for swelling, a sign of water retention, and the varicose veins that often result from this edema.
By the third trimester your caregiver may ask you to keep track of your baby's movements. A fetal kick chart may be recommended as a way of ensuring your baby's wellbeing.
Your ninth visit, between week thirty five and week thirty seven is a busy one. In addition to the Group B B-streptococcus screen, you will also undergo an abdominal exam to check the position of the baby's head in the uterus. Your cervix will also be checked for effacement, the first sign that labor may start soon. You will be told what to look out for so that you know when it's time to go to the hospital.
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