Your First Prenatal Visit
Your first prenatal visit is exciting! To schedule this visit, call as soon as you find out you are pregnant. Even if you are still under the care of another practitioner but know you will eventually be seen at a different practice, make the appointment early. Sometimes it takes quite awhile to get in for an office visit.
Before your first visit you may have many questions about what you can do or can't do. Be sure to keep a list of these questions to take with you to visit the practitioner. If you are taking any type of medication that your fertility team prescribed, talk to the nurse or other medical practitioner at that office as well as at the new office about whether or not it is safe during pregnancy. It may be that you need to change a prescription to a different medication or stop altogether. Your practitioners may need to make this as a joint decision.
The majority of practitioners will want to see you for the first time at 8 to 9 weeks of pregnancy. This might come as a shock to you if you were expecting to begin seeing a practitioner immediately. With all the emphasis recently on the importance of prenatal care, many people find it difficult to believe that they are left on their own to be pregnant for several weeks with no medical supervision. Be assured that there is nothing inherently dangerous about the average pregnancy. Be sure to tell the person making the appointment if you have a special situation, like previous losses or infertility.
One of the most important things that will happen at your first prenatal visit will be the taking of your health history. Usually, the nursing staff will ask you a bunch of questions about all aspects of your health. Be prepared to talk about previous surgeries, your menstrual history, the health of your immediate family, and other important topics of health. This can alert your practitioner to any potential complications based on what your body has previously done. It will also point out any current health problems, such as high blood pressure.
Your doctor or midwife will generally go over this information with you again during the visit. Be sure to answer these questions as honestly as you can. If you don't have all of the information you need, feel free to say you're unsure. Offer to get a copy of other medical records for your practitioner's office.
The ExaminationThe nurse or nursing assistant will measure your height and your weight. They will chart this in your records. A weight check is done at every prenatal appointment. It can tell your practitioner if you are gaining too little weight; it can also indicate problems to your practitioner if you have a sudden weight gain.
Your blood pressure will be taken at every visit. The blood pressure reading taken at this first visit will typically serve as your baseline blood pressure. In a normal pregnancy your blood pressure will rise slightly from this base line. That is perfectly normal and to be expected. However, a sharp rise from the base line can be indicative of a problem; therefore, it will be monitored closely.
You will be asked to give a urine specimen at every visit. Your doctor or midwife will be looking for signs of problems indicated by the presence of protein or ketones in the urine. This can indicate that you are experiencing a problem with dehydration or even eclampsia.
They may even take a sample of blood. This is to run blood typing and to check your Rh factor. They may look at hormone levels like hCG or progesterone levels. This screening may also include blood counts to test for anemia. They may also test you for diseases like hepatitis, HIV, and others.
Your midwife or doctor will generally do a very thorough physical exam at this visit. It may include listening to your heart and lungs and checking all of your body systems. It may also include a breast and pelvic exam. If you have not recently had a pap smear, this may also be performed. They will also be checking the size of your uterus to see that it is normal for how pregnant you are. The good news is that once you do this pelvic exam, you generally will not have another unless a problem arises or until you've reached the end of your pregnancy.
You may be referred for an ultrasound exam. This may be because the size of your uterus is larger or smaller compared to your dates from your period. You might be referred to the ultrasound tech because of a previous loss or ectopic pregnancy. However, typically ultrasound is not performed for the average pregnancy at this stage.
The HeartbeatYou might expect to hear your baby's heartbeat at your first appointment. This will probably not happen unless it has been at least ten weeks since your last normal period. The Doppler equipment used to listen for fetal heart tones simply can't pick up the beating heart until about ten to twelve weeks. There are also certain instances when you will not be able to hear it even at ten to twelve weeks, sometimes because of the shape or position of your uterus. Being overweight can also make it more difficult to find the heartbeat.
If your doctor or midwife listens for the heartbeat and doesn't hear it, she may ask you to come back in 2 weeks to listen again. They may also choose to make an appointment for an ultrasound, which can pick up a heartbeat at this age much more easily.
No matter what, not finding the heartbeat can be a very scary experience. This is particularly true if you've ever experienced a miscarriage. The good news is that this problem is usually only related to the gestational age.
When you do finally hear the galloping beats of your new baby's heart, words will not be able to express what you feel! Bring someone with you to this appointment to share your joy. If your husband can only attend a few prenatal visits with you, the visit at which you hear your baby's heartbeat for the first time is usually a good one to choose. You might even consider taking something to record the sounds of baby to listen to between visits.
Always write your questions down before your visit so you don't forget to ask them. You can quickly write down the answers you get or bring someone with you to help you remember the answers so that you are sure not to forget them.
The rest of your prenatal visits will be less detailed than this first visit. You will have your weight, blood pressure, and urine measured. The doctor or midwife will listen for the baby's heartbeat at every visit after it's first heard, and later, around week 20, they will begin to feel for the baby's position. There will be a chance for him or her to ask you questions about your pregnancy and a period for you to ask questions about your pregnancy.
Your pregnancy will be a delightful time of new prospects and healthy adjustments. Get to know yourself and your practitioner. Prepare for a healthy birth and ready your home for you new bundle of joy! Good luck!
