what to expect at the first prenatal appointment
One of the most exciting milestones in your pregnancy is getting to see your baby’s heartbeat for the first time. However, there are many other things that you and your provider will do at this appointment, too. And while they aren’t quite as fun as hearing a baby’s heartbeat or watching their movements on an ultrasound screen, they ensure that both you and your baby are healthy during this important time in your life.
You may have a Pap smear.
Your doctor may do a Pap test, which is a screening for cervical cancer. During this test, your doctor will take a sample from your cervix (the opening of the uterus) to test for abnormal cells.
This is different from an internal pelvic exam because it’s done outside the vagina. The doctor will also check for any vaginal infections and other abnormalities using this method.
The frequency that you’ll need to have this done depends on your risk factors and medical history: If you have no history of any sexually transmitted diseases (STDs) or human papillomavirus (HPV), then you probably won’t need one until age 21. However, if you do have symptoms such as abnormal bleeding or discharge—or if you’re over 30 years old—you should ask why these tests are required before agreeing to them.
Your blood pressure will be taken.
Your blood pressure will be taken. This is a pretty simple step, but it’s important nonetheless. Blood pressure can help determine what kind of care you’ll need during your pregnancy and whether or not you’re at risk for complications down the road.
Your doctor will check your heart rate as well, which is another indicator of overall health and wellness. Most women have an accelerated heart rate during pregnancy, but there are some instances where this isn’t normal—like if you’re under stress or feeling anxious about something specific—in which case it may be a cause for concern and may warrant further investigation by your healthcare provider.
If all appears well with both your heart rate and blood pressure readings, then congratulations! You get to move on to the next step in our prenatal appointment checklist: taking out a handful of money from the ATM so that all these tests don’t cost you anything extra later on when they inevitably do anyway because everything always costs more than expected when we’re pregnant with babies growing inside us doing things like making their own organs out of nothing at all except food molecules so that they grow into big strong healthy adults who someday might become doctors who specialize in checking other people’s blood pressure for them too if those people aren’t lucky enough (or wealthy enough) themselves yet, either way, we won’t get paid much either way so maybe just forget about money altogether?
You’ll have a urinalysis.
You may have to pee in a cup. Yeah, it’s not fun, but it helps your doctor determine if there is anything wrong with your urine. They’ll use the sample to look for any blood or protein in it. They might also check for glucose, ketones, and bacteria in the urine as well as white blood cells and nitrates (which can indicate a urinary tract infection). Your doctor is also looking at the pH level of your urine because this can indicate problems with other organs like your kidneys or bladder.
You’ll be weighed and measured.
You may be weighed and measured.
You’ll be asked to remove your shoes and socks, then step on the scale and off of it again—for good measure!
Your doctor will measure your fundal height.
Fundal height is the distance from the top of your pubic bone to the top of your uterus (your baby’s home). It’s measured in centimeters and should be between weeks 28 and 38 of pregnancy. Your doctor will measure it at each prenatal appointment, starting with your first visit.
Normal fundal height varies depending on factors like your age, how many times you’ve given birth before, and whether or not you’re carrying twins (or more).
The significance of measuring fundal height is that it gives healthcare providers an idea of how far along you are in your pregnancy. Knowing this information helps them give better care since they’ll know what to expect from you as well as when to expect certain symptoms and changes during labor and delivery.
Your doctor will listen to the baby’s heartbeat.
At this point in your pregnancy, you might be wondering how old the baby is. Your doctor will use an instrument called a Doppler to listen for the baby’s heartbeat. The Doppler sends sound waves through your belly, which bounce off of the baby’s bones and organs. These waves then return to the device as an audible “whooshing” sound that you can hear on a monitor.
The heartbeat is usually heard at 12 weeks but can sometimes be detected earlier than this by feeling for it with your fingers or pressing lightly on your abdomen.
Your doctor may also use a fetoscope (or stethoscope) during this appointment to examine how well-developed your uterus and cervix are at this stage of pregnancy and whether or not there are any abnormalities present in order to keep track of their progress throughout each trimester leading up until birthday!
A complete blood count will be done.
A complete blood count is a test that measures your red and white blood cells, platelets and hemoglobin. Your doctor will likely order this test to check for signs of anemia and infection. A normal complete blood count can help rule out conditions like anemia or leukemia.
White blood cells (WBCs) 3,500 to 10,000 per microliter
Red blood cells (RBCs) 4.2 to 5.2 million per microliter
A viral screen will be done.
An important part of your first prenatal appointment is the viral screen (sometimes known as a STD screen). This test is used to check for hepatitis B and C, HIV, syphilis and other infectious diseases.
The viral screen can be done anywhere from 2 weeks after conception to 14 weeks into your pregnancy. The only way to know the exact date of conception is if you keep track of your ovulation cycle with an app like Glow or Clue. We recommend scheduling this test early in your pregnancy because it needs to be repeated at 28 weeks due to changes in blood flow during the later stages of gestation.
If you have insurance coverage for testing for sexually transmitted infections (STIs), then the cost will likely be covered by your plan; otherwise, it’s around $50–$100 out-of-pocket per test depending on where it’s done and how far along you are when you get tested.
You’ll have an ultrasound if you’re at high risk for complications or if you’re carrying more than one child.
If you’re at high risk for complications, or if you’re carrying more than one child, your doctor will likely want to do an ultrasound. Ultrasounds can be done with a handheld probe that’s moved over your belly or they can be done using an external machine.
Ultrasounds help the doctor see how many babies are in your womb and what position they are in. They also detect any abnormalities (like problems with the heart or brain) that may occur early on during pregnancy. If something seems wrong with your baby, we’ll let you know right away so that we can talk about our options together as a family.
Make sure to come prepared for this appointment by bringing along any medications or supplements you’re taking regularly. This includes vitamins and herbal remedies—if there’s anything unusual about them (like taking them every day), make sure it is noted on your chart before going in for treatment!
The doctor will ask you about lifestyle choices that could affect your pregnancy, such as whether you use tobacco, alcohol, or illegal substances.
Smoking: If you smoke and are over 18 weeks pregnant, your doctor will ask you to stop smoking. If you don’t, he or she will talk with you about options for support such as counseling or nicotine replacement products.
Alcohol: If you drink alcohol while pregnant, the doctor may recommend limiting how much alcohol is in your body each week. He or she might also discuss other lifestyle choices that could affect your pregnancy health and your baby’s health. For example:
Illegal substances: The doctor will ask about illegal substances such as drugs (including marijuana) and street drugs (such as cocaine). He or she may ask whether you have used these during this pregnancy and in previous pregnancies so they can better understand any risks to the baby if there are any problems with this pregnancy
Medications: The doctor might discuss medications that can affect a fetus during pregnancy (for example, antibiotics for infections). The doctor will help decide which medications are needed during this time period
Exercise: If exercise has been recommended by a doctor before getting pregnant, it is important that women continue exercising throughout their pregnancies—especially now because it helps with symptoms of morning sickness!
Weight gain: Your healthcare provider can make suggestions on healthy weight gain through the course of your pregnancy based on recommendations from the Institute of Medicine (IOM).
These are some things to expect at your first prenatal appointment
At your first prenatal appointment, you can expect to:
Be asked about lifestyle choices that could affect your pregnancy, such as whether you use tobacco, alcohol, or illegal substances.
Have a urinalysis. This is a test that checks for bacteria in your urine and any sign of infection.
Have a Pap smear. This test checks for abnormal cells on the cervix (the opening to the uterus). Abnormal cells may indicate cervical cancer or other serious conditions that are treatable before they become life-threatening problems if detected early enough during pregnancy when treatment is more effective than later in the course of the disease process.
Have your doctor measure your fundal height (also known as belly size) using an instrument called a tape measurer along with his/her hands (if needed). Fundal height measures how far along you are based on how high up on mom’s abdomen her uterus is located from where it began growing inside her body at conception (conception being when sperm meets egg).
While there are some questions that you may not feel comfortable answering, it is important to remember that the more information your doctor has about your medical history, the better they can care for you and your baby.