Week 8 to 10: Your first prenatal visit
Even if you only have the tiniest hint of a bump right now, your first prenatal visit will make your pregnancy feel very real. Block that calendar—because you’ll be sharing a lot with your doctor. It’s worth it: All those conversations and exams help prevent complications and give you the info you need to protect your growing baby.
To know
- You’ll find out your estimated due date, as determined by the first day of your last menstrual period (LMP) and sonogram. (If you had fertility treatments, you may know your estimated due date before your first prenatal visit.)
- You’ll have an examination and some basic tests (urine, blood, maybe a Pap smear).
- You might have an ultrasound.
- You’ll be asked lots of questions about your personal and family medical history, discuss your diet and overall health and review pregnancy nutrition.
- You’ll get information about your upcoming prenatal visits. In general, you can expect monthly visits until week 28 of pregnancy, two visits per month until week 36, and then weekly visits. Additional visits and their timing will depend on the specifics of your pregnancy and your health.
To ask
- What over-the-counter (OTC) and prescription medications are safe to take?
- How much weight should I gain during pregnancy?
- What prenatal screening schedule do you recommend?
- What’s the best way to deal with morning sickness?
- What are signs I should call you?
- What is the set-up of the practice and when is the best time to call with questions?
- Is there a nurse I can call if you aren’t available?
To prepare for the visit
- Bring your partner, family member or close friend, if possible.
- Jot down the date of your last menstrual period (LMP)—it’ll help your OB figure out your due date.
- Be ready to answer questions about previous pregnancies, birth control, allergies, surgeries and any chronic health conditions.
- Make a note of any medications you take—prescription and OTC—and any supplements or herbs that are part of your routine.
- Ask your parents and, if possible, your partner’s parents if any genetic conditions run in the family—this can help your OB determine if genetic counseling makes sense for you.
Week 11 to 13: The first-trimester screen
As you near the end of your first trimester, your doctor will discuss options for genetic screening—tests that help determine whether your pregnancy might be affected with one of the three most common genetic conditions, including Down syndrome. The risk of these genetic disorders is increased in women over 35 and those with a family or personal history of chromosomal abnormalities. First-trimester screening involves a blood test and an ultrasound exam called a nuchal translucency (NT) test. It’s noninvasive and doesn’t put you or baby at risk.
There’s another screening test that can be done around this time. Called a noninvasive prenatal screening (NIPS) or cell-free fetal DNA screening, it involves only a blood test (no ultrasound), and also checks for possible genetic conditions. It can also detect a Y chromosome, giving you a sneak peek at the sex of your baby. It’s available any time after 10 weeks.
To know
- For the first-trimester screen, you’ll get a blood test (either a finger prick or a blood draw).
- You’ll also have an ultrasound exam to measure the fluid accumulation at the back of baby’s neck—(NT test), which may be done at your doctor’s office or in a specialized OB ultrasound suite.
- Both the first-trimester screen and the cell-free fetal DNA test are screening tests, which means that they can give false positive and false negative results—that is, they can suggest a problem when one doesn’t actually exist, or fail to detect a real problem. Possible follow-up tests, such as amniocentesis and chorionic villus sampling (CVS), are more invasive but give more definitive results.
To ask
- Do I have a higher-than-average risk of any specific complication or condition?
- Should I speak with a genetic counselor?
- When can I expect the test results, and how should I obtain them?
- What’s the next step if there are any concerns?
- Do you recommend any follow-up tests, such as amniocentesis or CVS?
To prepare for the visit
- Keep calm and carry on—remember, this screen just gives you a ballpark estimate of baby’s risk for certain conditions.
- Consider whether you want to have this test or not—it can provide you with potentially helpful information, but it’s not required.
- Bring a bottle of water—a full bladder during the NT sonogram helps give the ultrasound technician the best view of baby.
- Carry a snack—baby may take a while to get into the correct position for the test.
- Check with your insurance company to find out if the test is covered.
Week 13: Your monthly prenatal visit
This is a big week—you’re finishing your first trimester and heading into your second. The good news: Morning sickness typically subsides around now. Visits at this point are shorter, but make sure you take the time to get all the answers you need.
To know
- You’ll have a urine test.
- Your blood pressure and weight will be checked.
- Your doctor will listen to baby’s heart.
- You’ll discuss any symptoms or concerns.
- Your doctor will feel and measure your belly.
To ask
- What tests and screenings do you recommend in the coming weeks?
- How can I make sure I’m getting the nutrition my baby and I need, especially if I have morning sickness?
- What foods should I avoid?
- Can I keep to my regular exercise routine?
- If I’m going to be pregnant during flu season, should I get a flu shot?
Week 15 to 20: The modified sequential screen
Between weeks 15 and 22, you can expect to get a special blood test for screening. This blood test is also known as the multiple marker screening test, and checks the levels of four hormones. It analyzes baby’s risk (or lack thereof) for certain genetic conditions and birth defects. It is similar to the first-trimester screen in that it estimates the risk of baby having Down syndrome and a couple of other genetic conditions, but the modified sequential screen also evaluates baby’s risk of neural tube defects, such as spina bifida, as well as potential growth issues. In addition, this test can help your doctor assess your risk for gestational hypertension—high blood pressure in pregnancy—and a condition called preeclampsia, which is also related to blood pressure. Combining the results of a first-trimester screen and the modified sequential screen can give a more accurate picture of your baby’s risk of Down syndrome than either test alone.
To know
- You’ll have blood taken (either at your doctor’s office or a lab).
- Your doctor will get the results after about a week.
To ask
- Do I have a higher risk of any specific complications or conditions?
- How will I get the test results?
- What’s the next step if there are any concerns?
- Do you recommend genetic counseling or amniocentesis?
- Are there steps I should take to reduce the risk of conditions like preeclampsia? What symptoms can I look out for?
To prepare for the visit
- Consider whether you want to have this test or not—it can provide you with potentially helpful information, but it’s not required.
- Consider meeting with a genetic counselor to understand your risk factors, along with the limitations and pitfalls of screening tests.
Week 20: The mid-pregnancy ultrasound
You’re halfway through your pregnancy, and it’s time for your mid-pregnancy ultrasound, also known as the level II sonogram. This milestone exam gives you a chance to see your baby, head to toe. If you haven’t already found out baby’s sex, now you can—if you want to know, that is.
To know
- You’ll get a sonogram to check out baby’s size and development. This might be done at your OB’s office, or at an ultrasound suite run by Maternal-Fetal Medicine specialists who have undergone additional years of training in thoroughly evaluating the health of a pregnancy.
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby's heartbeat.
- Your doctor will feel and measure your belly.
To ask
- Can I take home a printout of the image?
- What happens next if there are any concerns about baby’s growth or development?
- When can I expect to feel the baby move, if I haven’t already?
- Has my due date changed now that you’ve measured the baby?
- Will I have any more ultrasounds?
To prepare for the visit
- Decide whether you want to know if you’re having a boy or girl.
- Consider bringing your partner or a family member, if that’s an option—it can be great to get your first glimpse of baby together.
- Ask if you’re allowed to take photos or a video of the screen—offices may have different policies in order to limit distractions for the sonographer performing the test.
Week 24: Your monthly prenatal visit
You’re past the halfway mark in your pregnancy, so you may be starting to think about the delivery. Now is a good time to talk with your doctor about what to expect during labor and any preferences you might have, from all-natural to a scheduled cesarean.
To know
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby’s heartbeat.
- Your doctor will feel and measure your belly.
To ask
- Do you anticipate I may need an induction for any reason? How far can I go past my due date before you recommend an induction?
- How long will you let me labor before recommending a C-section?
- What is your policy on epidurals and other pain-relief options?
- How can I connect with childbirth and breastfeeding classes available through your office or the hospital?
- Are there any restrictions on travel for the rest of my pregnancy?
To prepare for the visit
- Read about different childbirth methods and about strategies to make breastfeeding as easy as possible.
- Think about whether you’d like to hire a doula or other childbirth coach.
- Research childbirth classes if you and your partner are interested.
Week 26 to 28: The glucose challenge test
Pregnancy hormones can do a lot of crazy things—even affect the way your body uses insulin. Up to 10% of pregnant women will develop gestational diabetes (GDM); this test checks if you’re one of them, so you and your doctor can come up with a plan to monitor and control it. (If you’ve had GDM before or are at higher risk, you may have been tested as early as week 13.)
To know
- You’ll be given a very sweet beverage to drink.
- After an hour, your doctor or a lab technician will take a blood sample to check how your body reacts to the sugar.
- If the results are positive (indicating that GDM is possible), you’ll be asked to come back for a longer glucose tolerance test to confirm the diagnosis.
To ask
- Is there any reason I might be at higher risk for GDM?
- If I need to return for the glucose tolerance test, how should I prepare for it?
- What special diet and exercise plan should I follow if my test results are positive?
- Can you refer me to a registered dietitian who specializes in prenatal nutrition?
- What changes can I make now to lower my risk for developing GDM?
To prepare for the visit
- Eat normally—there’s no need to fast for this test.
- Remember, this is just an initial screening; a positive result simply means you’ll need further tests.
Week 28: Your monthly prenatal visit
Welcome to your third trimester! You’ll see your doctor every two to three weeks this month, feel more movement and kicks (and learn to keep track of them), and get things in place for the trip to the hospital and bringing home baby.
To know
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby’s heartbeat.
- Your doctor will feel and measure your belly.
- If an earlier blood test determined that you’re Rh-negative, your doctor will give you a shot of Rh immunoglobulin, or RhoGAM.(To prevent possible problems in future pregnancies, you’ll get another one within 72 hours of giving birth if baby is found to be Rh-positive.)
To ask
- Which childbirth classes do you recommend?
- Where can I get information about cord blood banking?
- Is there someone I can talk to if I’m feeling blue?
- Do I need a booster shot for whooping cough (pertussis) or any other vaccines?
Week 30: Your biweekly prenatal visit
Hopefully, you coasted through the second trimester. You may be finding things a little more challenging as you move through the third trimester: back pain, constipation, sleepless nights and itchy skin are all fairly common for women at this stage. Your doctor is there to help—make sure you discuss all your concerns.
To know
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby’s heartbeat.
- Your doctor will feel and measure your belly.
To ask
- Are there any other tests or screenings you recommend in the next few weeks?
- Do you have a list of pediatricians you recommend?
- Do you have advice for getting more sleep?
- What’s the best way to deal with back pain, leg cramps and sciatica?
- What can I do about itchy breasts and belly?
Week 32: Your biweekly prenatal visit
As your baby grows bigger, you’ll feel lots of kicks and even baby hiccups. You also may have more trouble catching your breath, finding a comfortable position for sleep and, yes, even figuring out how to get out of bed. Use this visit to discuss healthy strategies for getting through the next two months.
To know
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby’s heartbeat.
- Your doctor will feel and measure your belly.
To ask
- How can I tell the difference between Braxton Hicks contractions and real labor?
- What type of vaginal discharge is normal and what should I call you about?
- Am I gaining weight at a healthy rate?
- What newborn screenings does the hospital require?
- What can I safely take to ease heartburn?
Week 34: Your biweekly prenatal visit
Six weeks to go, and your baby will soon be sliding down into position. The good news is you get a little more breathing room. The trade-off? You’ll have to pee more often than ever.
To know
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby’s heartbeat.
- Your doctor will feel and measure your belly.
To ask
- What signs of early labor should I watch for?
- Has the baby started descending yet?
- What can I do to avoid getting a laceration at delivery?
- Is it still OK for me to go to work?
- How can my partner best prepare to help me through labor?
Week 36: Group B strep test
You’ve hit the eight-month mark—the rest of your pregnancy will go by quickly, though it may feel like an eternity. As you hit the home stretch, be sure to mention any new symptoms—headaches, discharge, unusual swelling, dizziness—to your doctor.
To know
- Your doctor will take a vaginal swab to check for group B strep. This bacteria is not a sexually transmitted infection and poses no health risk to you—but it can affect baby as he or she descends through the birth canal. If the test is positive, your doctor will recommend antibiotics during labor to protect baby from any negative effects.
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby’s heartbeat.
- Your doctor will feel and measure your belly.
- Your doctor may check your cervix to see if it has begun to dilate.
To ask
- When will I get the results of the strep test?
- What treatment will I need if it’s positive?
- Are there any hospital forms I need to fill out now?
- What are my chances of needing a C-section and what will help me avoid one if I want a vaginal birth?
- If I’m having a boy, what are the pros and cons of circumcision?
Week 37: Your weekly prenatal visit
With weekly checkups from now until your due date, you may be seeing your doctor even more than your family! Be sure to meet the other partners in the practice as well—you never know who’ll be on call when your baby is ready to make his or her grand entrance.
To know
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby’s heartbeat.
- Your doctor will feel and measure your belly.
- Your doctor may check your cervix if you seem to be close to labor.
To ask
- What position is the baby in? If it’s breech, are there ways to move him or her into a better position?
- What happens if I go into labor when you’re not on call? Who is your backup?
- Can you recommend a lactation consultant in case I need help breastfeeding?
- What kind of fetal monitoring does the hospital require?
- Is it still OK to have sex?
- Any advice on what to pack in my hospital bag?
Week 38: Your weekly prenatal visit
It’s getting snug in there for your almost full-size baby, so you may notice a change in movement. This week, you may have a nonstress test, a noninvasive test that measures baby’s heart rate in response to his or her movements—an indicator of baby’s oxygen levels.
To know
- If you have a nonstress test in addition to the usual checks, two monitors will be strapped around your belly to listen to baby’s heartbeat, measure movement and detect uterine contractions.
- If baby’s sleeping, your doctor may use a device to make a loud vibrating noise next to your belly, or ask you to eat or drink something.
- You may be asked to repeat this test a few times before delivery, especially if you go past your due date.
To ask
- Why do you recommend I have this test now?
- What should I do if I don’t feel baby moving for a couple of hours?
- How long should I wait before coming to the hospital after labor starts?
- What is bloody show and how will I recognize it?
- Can my baby stay in the room with me after delivery?
- What types of post-baby birth control should I consider?
Week 39: Your weekly prenatal visit
Take a deep breath—in just a few days you’ll finally get to meet your baby. Whether you’ve already started maternity leave or plan to work until the moment your water breaks, enjoy these last few moments of peace and quiet.
To know
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby’s heartbeat.
- Your doctor will feel and measure your belly.
- Your doctor may check your cervix if you seem to be close to labor.
- You may have a nonstress test.
To ask
- What natural ways do you recommend to induce labor?
- What will happen if I go past my due date?
- What resources are available if I develop postpartum depression?
Week 40: Your weekly prenatal visit
Congratulations: You’re at the finish line! That is, unless your baby decides to stay snug and cozy inside for a while longer. As long as there’s plenty of amniotic fluid and both you and baby are doing well, your doctor may let you go to 41 weeks or so, but expect more frequent monitoring and checkups while you wait.
To know
- Your urine, blood pressure and weight will be checked.
- Your doctor will listen to baby’s heartbeat.
- Your doctor will feel and measure your belly.
- Your doctor may check your cervix for signs of labor.
- You may have a nonstress test and/or a biophysical profile—another noninvasive method of assessing baby’s well-being, done with the sonogram machine.
To ask
- Have I started dilating or effacing or showing other signs of labor?
- What can I do to move things along now?
- How many more days can I go before you induce?
- Do I need any other tests now?
- If I go past my due date, how frequently do you want to see me?