Your health care provider can help you have a healthy pregnancy and a healthy baby. At the beginning of your pregnancy, you should visit your health care provider every four to six weeks. After about 30 weeks, you will have visits every two to three weeks. In the last month, your health care provider will want to see you every one to two weeks or more.
You may need extra medical attention or health care advice from your health care provider if you: - Are underweight or overweight.
- Had problems with a previous pregnancy, for example, if your baby was preterm or weighed less than 2500 g (5 lb. 8 oz.)
- Have diabetes, high blood pressure, or other medical conditions.
- Are over 40 years of age.
- Are carrying more than one baby.
- Have had uterine surgery (for example cesarean birth, cone biopsy).
- Use alcohol, cigarettes, or drugs.
- Are under emotional stress or there is violence in your life.
- Are dealing with depression or other mental health issues.
Before you visit with your health care provider, write down any questions you may want to ask. Take important information when you visit your health care provider. This can be a family health history or changes in your condition. Have your partner or support person go with you. That way, they can ask questions, hear the same information, and share in the excitement of your growing baby.
Your Early Pregnancy Visits
Your early pregnancy visits are usually the longest because your health care provider will take a detailed physical history and do a physical examination.
Below are some examples of what might happen during your early pregnancy visits:
| Discussion/Procedures | Why? |
|---|---|
| pregnancy test | • to confirm your pregnancy |
| detailed medical history | • to find any risk factors you may have |
| lifestyle factors (use of alcohol, drugs and tobacco, physical activity and nutrition) | • to keep you and your baby as healthy as possible |
| prenatal supplements | • 0 .4 mg of folic acid daily reduces the risk of open neural tube defect in your baby • do not take high-dose vitamin A supplements in pregnancy • some natural herbal remedies are not safe in pregnancy |
| complete checkup that includes: • listening to your heart • taking your blood pressure • measuring your height and weight • having an abdominal examination • having a pelvic exam that includes a Pap test or vaginal swab (if not done in the last 12 months) | • to check and monitor healthy weight gain. See for more information about healthy weight gain during pregnancy on this blog • to check your cervix and to check for infections |
| blood tests | • to check complete blood count (includes hemoglobin and iron levels) • to confirm blood group, Rh type, and antibody screen • to test exposure to syphilis • to screen for HIV (recommended) • to test for hepatitis • to test for rubella (German measles) antibody |
| prenatal genetic screening blood tests and/or special ultrasounds (optional) (blood test #1 done between 10-14 weeks) | • to tell you the chance of your baby having a genetic abnormality |
| urine tests | • to check for any sugar, protein, and urinary tract infections |
Your Next Pregnancy Visits
What may happen during the visits that follow?
| Discussion/Procedures | Why? |
|---|---|
| prenatal genetic screening blood tests and/or special ultrasounds (optional), (blood test #2 done between 15-21 weeks) | • To tell you the chance of your baby having a genetic abnormality. If you miss the first blood test (between 10-14 weeks), you may still have the second blood test. It is best if you have both blood tests when possible, as having both improves the accuracy of the screen result. You will need to go back to your health care provider to talk about the results and to find out if more testing will be offered to you. |
| ultrasound test (done between 18-20 weeks) | • to check the development and position of the baby • to check your estimated due date (you may be unsure when you had your last period) |
| glucose screening (done 24-26 weeks) | • to check for gestational diabetes that may develop during pregnancy Gestational of diabetes happens during pregnancy because pregnancy hormones change the way a woman's body uses insulin . For most women, blood sugar levels can be controlled by diet, but some women may need to take insulin by injection. For most women, gestational diabetes goes away after their baby is born. |
| blood test (done at 24-28 weeks) | • a shot of Rh-immune globulin will be given to women who are Rh-negative |
| Group B Streptococcus screening (done at 35-37 weeks) | • Group B Streptococcus (GBS) is a type of bacteria found in the vagina and large bowel of 15 to 20% of healthy pregnant women Around the time of birth, GBS may be passed to the baby through the birth canal. If the baby gets a GBS infection, it can be serious. Because of the small chance of GBS infection in the newborn, all pregnant women should be offered screening between 35-37 weeks of pregnancy. A swab for GBS is taken from the vagina and anal areas. Women whose test is positive are given intravenous antibiotics, just to be safe. Often it is a brand of penicillin and is given at the time their membranes rupture or during labor. Treatment of the pregnant woman with antibiotics has been shown to decrease the chance of serious infection. However, no method has been proven to prevent all serious infections. Whether or not you need treatment in labor depends on your situation. Discuss GBS with your health care provider. |
| Discuss your emotional feelings | • Women may become depressed during or after pregnancy 10-16% of pregnant women will have depression during their pregnancy. A smaller number will also have anxiety or panic disorder. See pages 19 and 85 for more information on depression during pregnancy. |
| count fetal (baby) movements (done from 35-37 weeks and onward) | • To be aware of your baby's movements Babies have active periods and quiet periods during the day and/or night. Healthy babies may slow down slightly toward the end of pregnancy, but they do not slow down a lot. Your baby should not stop moving at a time when she is normally active. You don't need to record your baby's movement count unless you are asked to do so by your health care provider. Be aware of your baby's movement, especially in the third trimester. If you notice a drop or no movement at a time when your baby is normally active, contact your health care provider. |
| non-stress test | • tells how well your baby is doing • a painless test to check your baby's heartbeat while resting and moving • done with an electronic fetal monitor |
See your health care provider right away if you have any of the following during pregnancy
- Contact with anyone who has rubella (German measles) as there is a danger to your baby if you get sick with rubella during your pregnancy
- Rashes of any kind except the ones you often get, like eczema
- Sudden, unusual thirst
- Fever and/or coughing that isn’t getting better
- A feeling of being tired all the time
- Dizziness, headaches, dimming and/or blurring of vision
- Sudden or continuing swelling of your hands or face
- Frequent vomiting, when you are unable to keep fluids down
- Abdominal pain or if your abdomen feels hard
- bleeding from your vagina, bowel, or bladder
- A burning sensation when peeing
- Colored, frothy and/or bad-smelling vaginal discharge, or vaginal discharge causing itchiness or irritation
- A gush or trickle of water from your vagina
- Constant negative feelings or anxiety about your pregnancy and care of the baby
- Depression or periods of weeping that don’t go away
- Any violence or threatening behavior towards you in your home or workplace
- feel that your baby has moved a lot less than usual in the last 12 hours
- Signs of preterm labor
Share this information with your partner or support person so you all know what to watch for.