Alright, so you just found out you are pregnant. What next? One of the first things you will do is set up an initial prenatal visit with your healthcare provider. Waiting for that first appointment to finally roll around can be exciting; however, it can also cause a lot of anxiety when you don’t know what to expect. Luckily, I have been there and done that (more than once). Below are the things I think every new mom should know about the first prenatal appointment.
5 Things You Need to Know About Your First Prenatal Appointment
1. Here is what you need to know about the checkup…
Whether you are a first-time mom or a fifth-time mommy veteran, prenatal visits are still crucial for your and your baby’s health, as every pregnancy can vary greatly. This initial visit covers a lot and can feel overwhelming. Bringing a support person with you to take notes and help you remember what questions you want to ask is a great idea. It is also helpful to come to the visit with vital dates and information, in addition to your list of questions.
Your healthcare provider will measure your progress in pregnancy by gathering baseline vitals and information.
Baseline vitals include:
- Pre-pregnancy weight
- Current weight
- Blood pressure
- Date of last menstrual cycle
- They may also get a detailed medical and family history from you to determine possible risk factors.
- They will also review your current medications and determine if any changes or updates need to be made.
Your provider may also do a complete physical exam at this appointment. The provider may do a breast exam, pelvic exam, and pap smear during the physical exam.
This physical exam portion might have you wondering about what to wear to first prenatal appointment. You really should wear whatever you feel most comfortable in! I do recommend picking a two-piece outfit over a dress or jumper, though, as it will make it easier to take off your clothes for certain exams.
Another important thing to note; If you feel uncomfortable with these physical exams, consider sharing this information with your provider. Doing so will allow the provider to make adjustments to help ease any discomfort. Providers can help by keeping you informed before and during each step of the exam to help you know what is supposed to happen and why.
You may also ask to bring a trusted person to accompany your bedside, in the exam room. A nurse can also be in the room for additional support. Also, remember you can ask the provider to stop at any point. If doing all of the exams in one visit feels too overwhelming, you can ask for the exams to be split up over multiple visits to give you the opportunity to get used to the office and the healthcare team. If needed, you may call ahead to see if the staff and healthcare provider have additional training or feel comfortable dealing with trauma-informed exams.
2. Yes, there will probably be lab work
At this appointment, you will have a lot of labs done. Typically, you will have blood drawn and a urine sample collected. Eating something before your appointment or bringing a small snack with you may be a good idea if you tend to feel faint or pass out with blood draws.
Your provider may do blood work to:
- Check your blood type and Rh sensitization – Rh factor refers to a protein found on your red blood cells. If you are Rh negative and the baby’s father is Rh positive, you may need special care to keep your pregnancy safe and viable. This special care is typically an injection given around the 28th week of pregnancy. You can read more about Rh Disease here.
- Check hormone levels – Testing for hCG (human chorionic gonadotropin) levels is often done early in the pregnancy. These hormones are only produced during pregnancy and play a vital role in supporting the uterus lining and the implantation of the fertilized egg.
- Check for immunity – Immunity to infections such as chickenpox (varicella) and German measles (rubella) will be checked unless you have well-documented proof of immunizations.
- Measure hemoglobin and hematocrit levels – Hemoglobin and hematocrit levels are checked to rule out anemia. Anemia is common among pregnant people. When you’re anemic, it means that your body is not producing enough healthy blood cells to carry oxygen throughout your body.
- Screen for infections – Blood tests check for infections, including STIs. These include hepatitis B, HIV, and syphilis.
- Measure vitamin B12 levels – Your healthcare provider may look at B12 levels if you are vegan or vegetarian. B12 is essential during pregnancy to maintain the health of your nervous system. B12, combined with folic acid, is believed to help prevent spina bifida and other spinal and central nervous system congenital disabilities in your baby.
- Measure creatinine levels – This checks your kidney function. Maintaining healthy creatinine levels is essential to a healthy pregnancy, specifically if you have previously dealt with hypertension (high blood pressure).
- Check for ethnic risk factors – Depending on your ethnic background, you may undergo screening for sickle cell disease and thalassemia.
In addition to blood work, you’ll also give a urine sample. The urine sample will test for bladder and kidney infections, diabetes, dehydration, preeclampsia, and STIs like syphilis and gonorrhea.
3. You will likely have a lengthy discussion at your first prenatal appointment (making it one of the longest appointments of your whole pregnancy)
You will learn a ton of information at your first prenatal appointment. Your healthcare provider will likely talk to you about many things, be prepared to discuss openly:
Your ethnic background. Some ethnic groups are more likely to pass on genetic disorders.
Lifestyle habits. Some habits could affect the growth and development of your baby. These could include alcohol use, smoking, and illicit drug use.
History of sexual or domestic abuse.
Mental health. This may include your current mental health or mental health issues and/or struggles in the past.
Personal and family health history. This may include chronic health, obstetrical health, and potential disease exposure.
As your provider starts sharing new information, have your support person take notes for you. Taking notes is an excellent way for your support person to provide support during the appointment and feel they are contributing helpfully.
4. Come prepared with questions
After getting all this information from your provider, you will have many questions. This is ok! Your provider fully expects you to have lots of questions. Start with any new questions or clarifications you may need about the discussion you just had with the provider. Starting with these allows you to ask about them while they are fresh on your mind. Then, move on to any pre-prepared, unanswered questions you have.
Here are some questions you may come prepared with:
- How do I reach out to my health care team between appointments? What about after-hours?
- How much weight should I expect to gain, and at what rate?
- What types of food should I eat? Which should I avoid?
- Are there any medications, prescription or over-the-counter, I should avoid?
- Are there symptoms I should inform my health care team of or signs to watch out for?
- Do I need to make changes to my exercise routine?
- Who will be delivering the baby?
- What vitamins do I need to take?
- Should I do any prenatal genetic testing?
- Which hospital should I go to for a pregnancy-related emergency?
- Can we set up a time to discuss my birth plan?
- What should I consider when making a birth plan?
- What vaccinations should I get?
- What prenatal resources do you have that I can look into?
5. Find out more about Future Appointments
Most healthcare providers’ standard of care for pregnancy is the same. You should expect an appointment every four weeks from the beginning of pregnancy until your 28th week. At 28 weeks, you will move to bi-weekly visits, seeing your healthcare provider every two weeks. Then, at 36 weeks, you will have weekly check-ins until your baby is born.
This first prenatal appointment may feel overwhelming, but it’s an exciting first step in your pregnancy journey. After your appointment, you’ll be armed with lots of information to help you make the best, informed decisions for you and your little one.
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