The patient and their care provider will discuss the following during the first visit:
- Medical History - Includes details about the patient's personal and family medical history, menstrual cycle, past pregnancies, and use of medications
- Lab Tests - Includes blood type, screening for infections, and checking for anemia
- Establish Due Date - An informal ultrasound may be done to measure the size of the baby
- Lifestyle Issues - Includes nutrition, exercise, work, use of medications, and smoking
- Genetic Screening Tests - After talking with the doctor or midwife and reading the educational material on the First Trimester Screen and Multiple Marker Screen, these tests will be scheduled after the first visit, should the patient choose.
Subsequent visits are often scheduled about every four weeks and tend to be shorter than the first visit. Each visit with the provider will include:
- Physical Exam - Includes a pelvic exam and pap smear, if indicated
- Weight check
- Blood pressure check
- Listening to the baby's heart beat - this is usually heard with a Doppler between 10-14 weeks
- Discussion of any questions or concerns
Precaution: If there is any bleeding, the patient should contact their provider as soon as possible. If the patient's blood type is Rh Negative, they may require an earlier dose of Rhogam.
Patients will continue to visit their provider about every four weeks. During these visits, the provider will:
- Check weight and blood pressure
- Listen to the baby's heartbeat
- Discuss the baby's movement - patients can usually feel flutters at 20 weeks
- Discuss any questions or concerns
- Screen for Gestational Diabetes (24-48 weeks) - This test takes one hour and requires that the patient cease eating and drinking anything other than water for 2 hours prior to the test. Food and drinks that are high in sugar should be avoided.
- Discuss recommended immunizations - Includes Flu and TDap
- Patients with Rh Negative blood will receive an injection of Rhogam around 28 weeks
Precaution: If the patient experiences bleeding, the leaking of fluid and/or change in discharge from the vagina, or more than 4 contractions per hour, they should contact their care provider.
During the last month of pregnancy, expect weekly checkups. The care provider will continue to:
- Monitor blood pressure and weight
- Monitor the baby's heartbeat and movements
- Screening Test for Group B Streptococcus (GBS) at 35-37 weeks - GBS is a common bacterium that is usually harmless in adults. Babies born to mothers not treated with antibiotics prior to delivery, however, can become seriously ill. If the patient tests positve for GBS, the provider will administer intravenous antibiotics during labor to help protect the baby from the bacteria.
- Pelvic exams towards the end of pregnancy - To check the baby's position and detect cervical changes
Precaution: Patients should continue to keep watch for any bleeding, leaking of fluid and/or change in discharge from the vagina, or more than 4 contractions per hour. It is also important to monitor for at least 10 movements of the baby during the patient's waking hours.
These checkups occur 6 weeks after delivery and will include:
- Blood pressure and weight check
- Checking of the vagina, cervix, and uterus to ensure proper healing is occurring
- Discuss resuming sexual activity, birth control, breastfeeding, and adjusting to life with a new baby
Precaution: Patients should abstain from sexual intercourse 2 weeks prior to this visit if they desire long-acting birth control (LARC), such as an IUD, Nexplanon, or Depo-Provera. If patients do not abstain, they may be scheduled for a different appointment for the placement of birth control.