Your First Prenatal Doctor's VisitBeth M. Iovinelli, RN, BSN, IBCLC
That very first meeting with the doctor you’ve chosen for your pregnancy can be a little nerve-wracking for some. Most women want to bring their own stenographers to take down every detail!
The Medical History Interview
During this visit, your nurse and/or the doctor will take an extensive look at your medical history. (If you are already established with the doctor for regular gynecological visits, she will have much of this information already available.) Your doctor will then start your antenatal paperwork, which will be a record of your pregnancy—including your upcoming visits and your past medical history.
Your doctor will go over the following topics with you:
- Review of medical history
- Date of last menstrual period or LMP (this will help to calculate your due date)
- Contraceptive history
- Family history of major disease or genetic issues
- General health
- Allergy history (drug or food)
- Use of medications and/or herbs
- Any history of previous pregnancies or miscarriages
First Visit Tests
Other tests which you may have at this visit include:
- Blood work (includes checking: hCG levels—pregnancy test, hemoglobin (to test for anemia), blood type and RH factor, Hepatitis B screening, HIV testing, Rubella titer, syphilis screening)
- Pap smear (to check for abnormal cervical cells)
- Gonorrhea and chlamydia cultures
- Heart, lung, and thyroid assessment by your doctor
Chances are, your doctor will also perform an internal (pelvic) exam to check your cervix and uterus. He or she will also do a measurement of your pelvis to see how roomy it is to accommodate delivering your baby. (Generally, there won’t be more internal exams until much later in your pregnancy.)
Your monthly checkups will include:
- Urine check
- Weight check
- Blood pressure
- Check hands, feet, and face for excessive swelling
- Hemoglobin check (to make sure you are not anemic)
- Measurement of your abdomen to assess fetal growth (fundal height)
- Check baby’s position (determined by your doctor feeling your belly)
- Fetal heart rate check (listening for your baby’s heart beat; this can be done between week nine and week 12
Other tests you’ll receive in the coming months include:
- Blood glucose screening (glucose tolerance test) to check for pregnancy-related diabetes. This is done between 24 weeks and 28 weeks.
- Ultrasound at around 20 weeks. However, this can be done sooner if your doctor feels it is necessary.
- Group B streptococcus culture, done between 32 weeks and 36 weeks (if you are positive you will be treated with antibiotics in labor to prevent spread to your baby)
- Exam of your breasts and discussion of preparing to breastfeed
- AFP or MSAFP (maternal serum alpha fetal protein) test to screen for Down syndrome and neural tube defects—this test, recommended by the (ACOG (American College of Obstetricians and Gynecologists) will only tell you if you are at risk, it is not a positive confirmation. If the test is positive your doctor will recommend further testing and screening.
Making the Most of Your Appointments
Be sure to ask your doctor or midwife to explain any diagnostic tests that are suggested to you.
Each of your visits provides an opportunity for you to discuss how you are feeling and for your doctor to answer your questions or concerns. If your provider is part of a group, you’ll have appointments with a different practitioner each time so you visit. (Your primary doctor may not be the one to be on call when you deliver, so meeting other doctors can help make you more comfortable.)
While all this testing may seem overwhelming, it is done to make sure you and your baby have a safe, healthy pregnancy and delivery.