What Happens at Prenatal Care Appointments

1
Your First Prenatal Care Appointment

Mixed race nurse taking patient's blood pressure
Ariel Skelley/Blend Images/Getty Images

Your first prenatal appointment will probably be your longest appointment. Here you will provide your doctor or midwife your complete health and pregnancy history. (Sometimes this appointment is done by an office nurse or assistant.) This information is important because it will give your practitioner a good idea of how healthy you are and what type of problems you are most likely to experience during your pregnancy.

There are many things that may be done in the way of physical exam, including:

  • Pelvic Exam
  • Pap Smear
  • Breast Exam
  • Blood Work
  • Pregnancy Test
  • Ultrasound (if you are having pain or bleeding or underwent fertility treatments)
  • Check your blood pressure
  • Record your weight
  • Check your urine for protein and sugar

Most women will be seen for their first appointment between 8 and 10 weeks gestation. You may be seen earlier if you are having problems or if it is your doctor or midwife's policy.

2
Your Second Prenatal Care Appointment

Barely Pregnant - Heart Hands Over Belly
Photo © WONG SZE FEI - Fotolia.com

Your second prenatal appointment is usually done about a month after your first appointment, unless you are having problems or are requesting specific prenatal testing that is best performed in a specific time range. Here is what will most likely happen during this prenatal care visit:

  • Check your blood pressure
  • Screen your urine for sugar and protein
  • Record your weight
  • Listen for a fetal heart beat using a Doppler
  • Additional testing as needed

Your baby's first heart beat will usually be heard with a Doppler between 8 and 12 weeks gestation. If you have trouble hearing the baby's heart beat, you will normally be asked to wait until your next visit when your baby is a bit bigger. Sometimes an ultrasound will be ordered.

These tests are optional but may be requested by you or recommend by your doctor or midwife. Be sure to discuss all of your option regarding these tests, including the risks and benefits, how the test results are given and whether the test is a screening test or a diagnostic test:

3
Your Third Prenatal Care Appointment

Measuring Fundal Height - Prenatal Care
Measuring fundal height helps ensure that your baby is growing well. Photo © iStockPhoto

Towards the third prenatal visit you are mostly likely around 14-16 weeks pregnant. You are feeling better and the most dangerous part of pregnancy is over. You are now probably feeling more confident in your pregnancy and sharing your good news. It's been about a month since you've seen the midwife or doctor. Here is what a prenatal appointment may look like:

  • Urine sample to screen for sugar and protein
  • Check your blood pressure
  • Record your weight
  • Listen for baby's heart beat
  • Measure your fundal height to check baby's growth

You may also have the following prenatal testing done if you request it:

4
Your Fourth Prenatal Care Appointment

Ultrasound may be offered at this point in prenatal care.
Ultrasound may be offered at this point in prenatal care. Photo © A.D.A.M.

You are most likely between 16-20 weeks at this point, and it's been about a month since your last appointment. Many times you feel like you've made a huge amount of growth since your last appointment and may now be wearing maternity clothes and possibly even feeling your baby move. Here is what a prenatal appointment may look like:

  • Urine sample to screen for sugar and protein
  • Record your weight
  • Listen for baby's heart beat
  • Measure your fundal height to check baby's growth
  • Check your blood pressure

You may also have the following prenatal testing done if you request it:

5
Your Fifth Prenatal Care Appointment

It's a girl! 20 Weeks
Photo © Kymberli

Between 18-22 weeks you may be having your fifth prenatal care visit. Here is what a prenatal appointment may look like:

  • Record your weight
  • Urine sample to screen for sugar and protein
  • Listen for baby's heart beat
  • Measure your fundal height to check baby's growth
  • Check your blood pressure

You may also have the following prenatal testing done if you request it:

6
Your Sixth Prenatal Care Appointment

3D Ultrasound Photos 24 Weeks Pregnant - Ultrasound Photos
Photo © A. Phillips

Between 22-26 weeks of pregnancy you are likely to have another prenatal care appointment. You are still being seen monthly. Here is what a prenatal appointment may look like:

  • Record your weight
  • Urine sample to screen for sugar and protein
  • Listen for baby's heart beat
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Check your blood pressure

There is still a lot of stuff to be done in your pregnancy. Have you:

  • Found a childbirth class?
  • Talked to and/or hired a doula?
  • Registered for baby registry?

7
Your Seventh or Eighth Prenatal Care Appointment

Blood Draw in Lab
Blood may be draw to screen for anemia or gestational diabetes. Photo © iStockPhoto

Between 26-28 weeks of pregnancy you are likely to have another prenatal care appointment. You are still being seen monthly. Here is what a prenatal appointment may look like:

  • Record your weight
  • Urine sample to screen for sugar and protein
  • Listen for baby's heart beat
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Check your blood pressure

Around this time in pregnancy you may have other tests ordered. Some may be specific to the point you are in pregnancy, like the Glucose Tolerance Test (GTT) used to screen for gestational diabetes, while other tests or procedures are specific to you and your baby like the Rhogam shot around 28 weeks of gestation for women who are Rh negative. Your doctor or midwife may also give you information on screening for preterm labor on your own. So that you know what to do should you show signs of preterm labor.

8
Your Tenth or Eleventh Prenatal Care Appointment (Bi-weekly Visits)

36 weeks Pregnant - 3rd Pregnanct - Belly Gallery
Photo © S. Anderson

Between 28-36 weeks of pregnancy you are likely to have another prenatal care appointment. In fact, you are likely to have at least two prenatal visits. You are now being seen every other week. Here is what a prenatal appointment may look like:

  • Urine sample to screen for sugar and protein
  • Record your weight
  • Listen for baby's heart beat
  • Palpate to check baby's position (vertex, breech, posterior, etc.)
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Check your blood pressure

The screening guidelines for Group B Strep (GBS) will be done normally between weeks 34-36. It involves a rectal and vaginal swab. You will continue to be seen every other week until about the 36th week of pregnancy. Your visits are fairly routine with very few extra tests being performed.

9
Your Prenatal Care Appointments - Weekly Visits

This is an external fetal monitor used to listen to baby in labor.
This is an external fetal monitor used to listen to baby in labor and for certain tests like the non-stress test. Photo © iStockPhoto

Between 36-40 weeks of pregnancy you are likely to have several prenatal care appointment. In fact, you are likely to have at least two prenatal visits. You are now being seen every other week. Here is what a prenatal appointment may look like:

  • Urine sample to screen for sugar and protein
  • Record your weight
  • Listen for baby's heart beat
  • Palpate to check baby's position (vertex, breech, posterior, etc.)
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Check your blood pressure

You will continue to be seen every other week until about the 41st week of pregnancy, at which point you may be seen every few days until your baby is born. Your visits are fairly routine with very few extra tests being performed.

You may also have an ultrasound to tell you determine what position the baby is in at this point. They will also try to predict the size of your baby. This is usually not very accurate. It is not recommended that you have an induction of labor based on the size of your baby.

If you are having a home birth, you may have a home visit during this time frame if your midwife doesn't do her normal prenatal visits there. You will be able to give her a tour of your home and answer questions she may have about where everything is located.

10
Your Prenatal Care Appointments - Overdue Pregnancy Visits

41 Weeks Pregnant
Photo © J. Bock

At 40 or 41 weeks of pregnancy you may begin to see your midwife or doctor every few days. Here is what a prenatal appointment may look like:

  • Record your weight
  • Urine sample to screen for sugar and protein
  • Listen for baby's heart beat
  • Measure your fundal height to check baby's growth
  • Palpate to check baby's position (vertex, breech, posterior, etc.)
  • Questions about baby's movements
  • Check your blood pressure

Since you are officially past your due date, your midwife or doctor may want to watch you and your baby more carefully until labor begins. This may include the following tests:

These tests will help determine if your practitioner needs to intervene with an

induction of labor

for the health of your baby or let your pregnancy continue.

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