Maybe you’ve been trying to have a baby for months and have grown accustomed to squinting at negative pregnancy tests, hoping to see that elusive second line. Maybe pregnancy was the farthest thing from your mind, until you got queasy brushing your teeth last week. Either way, you’re expecting! Now the only trouble is, you have absolutely no idea what comes next—and it’s starting to make you panic.
The earliest days of pregnancy are a rollercoaster of emotion—thrill and joy at the thought of your soon-to-arrive little one, and fear and doubt over all of the changes your body is going through. For first-timers, that uncertainty can be especially hard to handle. Every woman, and every pregnancy, is unique, but knowing what to expect beforehand can make those first eight weeks a lot easier, and give you the peace of mind you’ll need to start planning for the next chapter of your life.
Visiting the Doctor
Once the reality of a positive home pregnancy test has started to settle in, your first thought will probably be, “Call the doctor!” It’s easy to be impatient in those early days, but getting in to see your doctor immediately may not be in the cards. Many newly pregnant women are surprised to discover that a first prenatal visit is commonly scheduled at eight weeks or later. (If there is reason for your pregnancy to be considered high risk, you can expect to see your doctor around the six-week mark.) The reason for this is simple: There just isn’t much to see before then.
“The earliest you could expect to see a heartbeat on an ultrasound is six weeks,” explains Dr. Robin Kalish, MD, an OB-GYN who practices at Weill Cornell Medical College in New York, New York. “Still, a pregnancy can be perfectly healthy and not have a visible heartbeat at six weeks. Many doctors are hesitant to bring a patient in that early, because if no heartbeat can be found it can worry her unnecessarily. By eight weeks though, there should definitely be a nice, strong heartbeat. So [this is] the optimal time for a first appointment by many doctors.”
It’s also worth noting that while a heartbeat should be visible on an ultrasound by eight weeks, the heartbeat won’t be audible until farther along in the pregnancy. Some doctors opt not to do an early ultrasound at all, waiting until around 12 weeks to listen for the heartbeat with a device called a Doppler, and doing an ultrasound around 18 weeks to check on the overall development of the fetus. If this is the case at your doctor’s office, you may not get an initial appointment until you’re closer to 12 weeks along. If an early ultrasound is done, your doctor will be looking for confirmation that the pregnancy is developing in the uterus—not in the fallopian tubes, as it would in an ectopic pregnancy—and checking to see if you’re carrying one baby or multiples.
If you haven’t seen your doctor in a while and are due for a Pap smear, your doctor will perform one as well as a pelvic exam and a breast exam. Blood will be drawn to look for things like anemia, and in some cases an STD screen may be done. (State law may mandate tests for HIV and other diseases.) Says Dr. Kalish, “At this first appointment, I’ll ask the patient about her family background to see if she should have any genetic testing done; for example, if she is from an Eastern European or Ashkenazi Jewish background I may test for Tay-Sachs disease. I’ll also do some initial counseling—what to expect during pregnancy, how my office works, how often she can reach me.”