From the time you pee on that pregnancy test to actually going to your first prenatal visit seems like an eternity. It. is. BRUTAL! I remember calling my midwife all giddy when I told her that I was pregnant and she said “I’ll see you in 10 weeks.” TEN WEEKS?!?! Are you crazy? What if something happens to the baby? What happens if I mess something up? What? Wha? Wha?
Then I remembered to breath… and I realized that there really isn’t anything a midwife could do to “save” my baby in these very precious early weeks. And so I surrendered. And waited. And wondered. What do I need to bring to my first prenatal visit? Can I prepare in any way? And what exactly goes on during the first prenatal visit?
Here’s what you can expect and how you can prepare.
When is my first prenatal visit?
Typically women see their healthcare provider for prenatal care between 8 and 12 weeks. If you are seeing a midwife they may suggest you wait until 10 – 12 weeks for your first appointment. This is because this is about the time when you can hear your baby’s heartbeat on a doppler. Don’t be sad or scared if they still can’t find the heartbeat, as it is really more like 12-14 weeks for a definite reading.
Many OBs and even family doctors expect you to schedule your first prenatal care appointment much earlier than this though.
An ultrasound can pick up a heartbeat as early as 6-7 weeks, and some women are led to believe that an early ultrasound is necessary for a healthy pregnancy. This analysis shows that routine ultrasound does not improve perinatal outcomes while this analysis shows no improvement in maternal outcomes.
Here’s a post dedicated to the risks vs. rewards of baby ultrasounds.
Another reason that some doctors want you to schedule an earlier appointment is for a full pelvic exam. The reasoning is that, for some women, prenatal care is their first or only chance to see a doctor and undiagnosed STDs can be dangerous for the baby.
Your provider may also take the opportunity to do a pap smear to check for cervical cancer. However, vaginal exams do carry a small risk of infection, so if you are relatively healthy and don’t have a history of ectopic pregnancy or other serious concerns, then you are probably fine to wait until around 12 weeks.
What should I expect at my first prenatal visit?
What happens during the first visit will vary from provider to provider, but for the most part you can expect to do four main things.
1. Build a relationship
One of the advantages to using midwives is that you have continuity of care, meaning that the midwife you see at each (or most) appointments will be the one who attends your birth. Even in a larger office with multiple midwives, at least each appointment was nice and long with plenty of time to talk and bond with these awesome ladies. By the end of my pregnancy, I knew I was in good hands no matter which midwife was on call and this is a very good feeling!
At the first prenatal visit you can get to know your midwife or doctor, learn about her background, and begin to build a relationship of trust. You can ask questions and get information on good books to read or specialists you may want to see during your pregnancy, such as a chiropractor or lactation consultant.
If you are using a family doctor, then you may have a similar continuity of care. With OBs in hospitals you aren’t likely to be able to choose the OB that attends your birth, so a prenatal visit won’t always focus on this kind of relationship building.
2. Assess your health
Your midwife will ask about your health history, family health history, and present health to get a baseline for what is normal for you. She will counsel you on nutrition, exercise and holistic healing and wellness. She will address common pregnancy complaints and offer holistic, natural remedies.
She will also ask if you are having unusual symptoms that may be a sign of something serious. Headaches are common in early pregnancy, but can also be a very early sign of preeclampsia. Your midwife will want to know if you are having headaches or other symptoms and will keep a record of them.
3. Routine tests
Your midwife will order a different blood tests that will tell her your blood type, red and white blood cell counts, hematocrit, hemoglobin, and platelet count. Your midwife needs to know your blood type for your safety, but the other tests should be optional.
These blood tests will also tell your midwife if you are Rh positive or negative. If you are positive (or you are negative and your partner is negative) you have nothing more to do. If you are negative and your partner is positive or you don’t know, your midwife may discuss your receiving an Rhlg shot to prevent any complications.
Your midwife will also tests for various Sexual Transmitted Diseases like syphilis, gonorrhea, chlamydia, which could harmfully affect your pregnancy if not treated. She will also take your blood pressure, pulse, weight, and check the baby’s heartbeat if you are ok using a doppler, which contains ultrasound waves. I chose to use the doppler for the first appointment so I could really believe I was pregnant and then waited till 20 weeks to use the fetoscope for the baby’s heartbeat.
She may palpate your abdomen to check the fundal height (a measure of the size of your uterus). She will rule out any medical problems that may affect your pregnancy and assess whether a homebirth or birth center birth is safe for you (it usually is).
You will also be asked to test your urine for the presence of protein (a sign of toxemia), sugar (a sign of gestational diabetes), or bacteria (a sign of Group B Strep positive). You will pee into a cup and dip a test strip in. Depending on the brand of test strips you will read it after 60 second or immediately. You will do this test at every appointment until birth.
At your first prenatal visit you will probably have some paperwork to sign and your midwife or doctor’s office will probably need a copy of your health insurance card. Many midwives will give you an estimate costs for your pregnancy and birth care, so you are both on the same page in terms of cost.
How can I prepare for my first prenatal visit?
Prepare your questions
Your first prenatal care appointment may be the first time you meet your midwife or doctor, so it’s a good idea to have questions prepared in order to get a feel for your provider’s background and philosophy. If you are seeing a doctor, ask what her thoughts are about: labor induction, ultrasounds, the glucola drink, treating GBS+ during birth, and natural childbirth in general. You can use these questions as a guide to see if your healthcare provider is a good fit for you.
If you’ve already interviewed your practitioner, you still may have some questions about what to expect during your pregnancy, what symptoms or concerns you may have, or how many weeks pregnant you may be.
I wrote down questions beforehand so that I wouldn’t forget anything during the actual appointment (between excitement, nervousness and pregnancy brain, I had a feeling I would forget a thing or two!)
Gather health info
Ask family members about pregnancy related health concerns that may run in the family. Write down any patterns of health you notice. Also take note of your partner’s family health history, especially genetic diseases. My mom had two c-sections so I wanted to get my midwife’s thoughts on if she thought I could have a vaginal birth.
Write down any past gynecological history, like an abnormal pap smear or a previous pregnancy or miscarriage. Write down any medications you are taking.
If you don’t know your due date, use our due date calculator before your appointment. If you do know your due date and want to know when you most likely conceived, use our reverse due date calculator. And here’s an article for you if you’re unsure how many weeks pregnant you are.
Do your research for prenatal care
Do your best to pick the practitioner who is right for you. But if you go to your first visit and don’t like him or her, remember that you can change at any time! My dear friend changed her care at 34 weeks! And she was so happy that she did.
Your midwife needs to know your blood type for your safety, but the other tests should be optional. A good practitioner will let you know at each appointment what tests or procedures will be coming up at the next appointment so you can have time to research and decide what’s best for you.
A good practitioner should also be able to guide you and answer any questions you have about tests and procedures.
Best wishes for your first prenatal visit!
The first prenatal care visit is an amazing and nerve-wracking time. You may get to hear the heartbeat for the first time! That’s why I would encourage your partner to come along for that first prenatal visit. Hearing your child’s heartbeat for the first time, together as parents, is truly a special and sacred moment. Plus, you now have more “proof” that you really are pregnant.
Knowing what to expect and how to prepare should ease your mind and let you enjoy the excitement of your pregnancy!
- Beech, BL. Ultrasound unsound? Association for Improvements in the Maternity Services. 1996