As early as possible! Here is a schedule of prenatal visits and what to expect.
Visit the doctor as early as possible in your pregnancy as this will help to determine how many weeks pregnant you are, and to identify any possible complications. Bring your husband or another family member or friend to these visits for their support and so they can also ask any questions they might have. Below is a schedule of prenatal visits, what to expect at each one and some questions they could ask their doctor. The WHO recommends a minimum of four prenatal visits around weeks 16, 24-28, 32, 36 for uncomplicated pregnancies. However, in many countries women go every month to the doctor.
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Visit
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Weeks Pregnant
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What to Expect
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1
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6-13 weeks
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- Health check with questions on last menstrual period, number of pregnancies, allergies, previous problems including miscarriage and chronic diseases, family’s medical history including genetic diseases, habits which will impact fetus e.g. smoking, drinking, drugs. Doctor will measure your weight and blood pressure.
- Counseling by the doctor on how to take care of your health, foods to eat or avoid, prenatal vitamins, likely discomforts, any warning signs to watch for, further tests to consider, and the normal changes to expect before your next visit.
- Pelvic exam to check structure and take a swab to look for abnormal cells.
- Lab tests to check blood (blood type, complete blood count, STDs, fetal genetic diseases^), and urine (protein and bacteria levels).
- Ultrasound to check fetal development (gestation and due date, size, heartbeat, blood pressure, structural anomalies), multiple pregnancy determination, and screening for genetic diseases^.
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2
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18-20 weeks
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- Health check with questions on problems or concerns since last visit, how you have been feeling, if you feel the baby move, if you have you been leaking fluid or bleeding. Doctor will measure your weight and blood pressure, and might check your urine if necessary.
- Counseling by the doctor on taking care of your health, warning signs, further tests to consider (e.g. further blood tests and/or an amniocentesis if you are at higher risk for genetic diseases), and changes to expect before your next visit.
- Ultrasound to check fetal development e.g. size, blood pressure, structural anomalies, placenta health.
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3
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25-28 weeks
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- Health check with questions on problems or concerns since last visit, how you have been feeling, how your baby is moving. Doctor will listen to baby’s heartbeat and measure your belly (if you doctor has an ultrasound, they will check baby’s development). Doctor will measure your weight and blood pressure.
- Counseling by the doctor on taking care of your health, warning signs, changes to expect before your next visit, keeping track of your baby’s daily movements.
- Lab tests to check blood (anemia, Rh antibodies, gestational diabetes test), urine (protein levels).
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4
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31-34 weeks
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- Health check with questions on problems or concerns since last visit, how you have been feeling e.g. any contractions, headaches or swelling?, how your baby is moving. Doctor will listen to baby’s heartbeat and examine your belly to estimate baby’s size and position (an ultrasound can also perform these checks, in addition to other fetal checks). Doctor will your measure weight and blood pressure.
- Possible exams/tests might include a pelvic exam if doctor has concerns e.g. preterm labor or to check your baby's position. Doctor might also check your urine if necessary.
- Counseling by the doctor on taking care of your health, warning signs, changes to expect before your next visit, and keeping track of your baby’s daily movements.
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5
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36-38 weeks
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- Health check with questions on problems or concerns since last visit, how you have been feeling, how your baby is moving. Doctor will listen to baby’s heartbeat and examine your belly to estimate baby’s size and position (an ultrasound can also perform these checks, in addition to other fetal checks). Doctor will measure your weight and blood pressure.
- Counseling by the doctor on taking care of your health, warning signs, signs of impending and active labor (including when to call doctor or go to hospital), changes to expect before your next visit, and keeping track of your baby’s daily movements.
- Lab tests to check urine (protein levels), vaginal swab (StrepB test).
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6
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40-41 weeks
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- Health check with questions on problems or concerns since last visit, how you have been feeling, how your baby is moving. Doctor will listen to baby’s heartbeat.
- Pelvic exam to check softening or dilation of your cervix.
- Counseling by the doctor on when and how to induce your labor.
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*The amount you see your doctor will depend on your medical history and if there are any complications that require more checkups. The WHO recommends a minimum of four prenatal visits around weeks 16, 24-28, 32, 36 for uncomplicated pregnancies. However in many countries, women go every month to the doctor, and every week during their last month of pregnancy.
^Together, the blood test and the ultrasound are known as the first-trimester combined screening, which provides a risk assessment of the fetus having Down syndrome as well as other chromosomal problems and birth defects. These tests are optional; you can agree or refuse to have them. These tests are not definitive, but provide a relative likelihood of the fetus having a genetic defect. There are two diagnostic tests that provide a certain result: 1) Chorionic villus sampling (CVS), done at 11-12 weeks; or 2) Amniocentesis, done at 16-20 weeks. These tests are invasive and carry a small risk of miscarriage, so they are typically only performed when the woman shows a higher risk for genetic and chromosomal problems. Your doctor will advise you if an invasive test is necessary, but again this test is optional and it is entirely your decision to have one or not.
Questions to ask at Prenatal Appointments
At every appointment:
Whether or not you are asked, tell your doctor about all of your symptoms, even if they seem normal, like tiredness or aches and pains. Do not let your doctor rush through your appointment or make you think they are too busy. Yes, they may be busy, but your pregnancy is still the most important thing in the world to you.
At your first appointment:
Some ideas of what to ask at your first prenatal appointment include:
- How much weight should I gain, given how much I weigh now?
- Do I need to exercise and if so, what type of exercises and how much?
- Are there any restrictions on sex during my pregnancy?
- Do I have an increased risk of any complications or conditions? What additional tests might I need?
- What should I eat and drink and what should I avoid?
- Are the medications I am currently taking safe? If not, what can I take or do instead? What other over-the-counter medications are safe?
- What beauty treatments are acceptable during pregnancy e.g. hair dye, manicure?
- What symptoms should I expect, and how can I manage them? What is normal, and what should I call you about?
- What should I do if I… Don’t feel well? Cramp? Spot? Have a fever? When should I call you or go to the hospital?
- I've already had C-section delivery. Could I have a vaginal birth this time?
Category: Pregnancy
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