The check-up rundown

By Published On: January 24th, 2013

For roughly nine months, you will plan your life around […]

doctorandpreggers_3For roughly nine months, you will plan your life around prenatal visits. Fifteen-plus trips to the OB’s office might sound kind of overwhelming, but you can exhale: You will not have your feet in stirrups every time. Here’s what to expect at your regularly scheduled dates with the doc.
First trimester
Positive pregnancy test? It’s time to schedule your first appointment! Your doctor will want to see you by the eighth week of your pregnancy.
The inaugural appointment will be a doozy; set aside plenty of time (at least an hour), and bring your best penmanship—you’ll be filling out a handful of forms. You will need to share your personal and family medical histories, as well as information about any previous pregnancies. Do your best to determine the date your last period began, since your doctor will use it to predict your due date.
This appointment will also include a physical exam and Pap smear if you haven’t had one recently. And when the fun stuff is over, your doctor will send you away with a prescription for prenatal vitamins (or advice on what to look for in an over-the-counter brand), tips on what to eat, recommendations for healthy pregnancy habits, and a list of substances and activities to avoid. If you have any lingering mama-to-be life-style questions, speak up!
After the first visit, appointments will become routine and speedy—for the most part. One exception: At some point during the first trimester, your doctor will book you for a blood test and ultrasound. Your blood will be tested to check your blood type and Rh status, and to look for anemia and diseases such as hepatitis B and STDs. Both the blood test and the ultrasound will begin to determine the likelihood of Down syndrome and other birth defects. If your initial screen comes back positive, your doctor may recommend invasive testing (chorionic villus sampling —CVS—during the first trimester or amniocentesis in the second trimester) to determine if your baby has a birth defect.
Second trimester
Many moms-to-be favor the second trimester over the others—energy is up, nausea is down, and the maternity wardrobe is still fresh. To add to the mirth, prenatal visits can be fairly carefree during this phase of pregnancy.
Each appointment will begin with a urine sample, so come poised to pee. Your urine will be tested for urinary tract infection, as well as risk of preeclampsia (evidenced by protein in the urine) and gestational diabetes (suggested by sugar found in the urine).
Next comes a trip to the scale. Don’t panic over the rising number—just do your best to eat well and stay active. As long as you’re within the weight range recommended by your doctor, those pounds are perfectly OK.
Your blood pressure will be measured at each appointment as well to make sure you have a healthy flow and to watch out for preeclampsia, which is also indicated by high blood pressure.
If you haven’t heard your baby’s heartbeat by the end of the first trimester, you’ll hear it early in trimester two, and from then on, a nurse will check on the little ticker at each visit. Your baby’s heartbeat—heard through a handheld device pressed against your belly—will sound very rapid compared to your own.
The second trimester ultrasound, generally administered at about 20 weeks, may be the most unforgettable appointment of them all. This glimpse into the uterus will show baby from various angles, revealing bones, organs, a cute little profile, tiny toes and—usually but not always—baby’s gender. This is bound to be an emotional occasion, and you may want to share it with one or two supporters (but probably not 10—it’s a small room). In addition to showing off your little lad or lassie, this ultrasound will reveal the position of the placenta and show the amount of amniotic fluid you’re toting about.
From about 20 weeks on, your doctor will measure your belly, from the top of your uterus to your pubic bone, to keep tabs on baby’s growth. She’ll also ask about baby’s movements and quiz you about swelling and other pregnancy symptoms. This “talk time” at the end of each appointment is your opportunity to address any concerns you’ve had since your last visit. (Tip: Bring a list of questions so you won’t be overcome by pregnancy brain and forget what to ask.)
Third trimester
Right around the beginning of your third trimester, you’ll be asked to take a glucose challenge test. You’ll need to fast beforehand, but that’s the hardest part. Once you arrive, you’ll be given an ultra-sweet fruity beverage to down in an allotted amount of time. An hour after your syrupy cocktail, you’ll have your blood sugar tested. At this point, you’ll either be told you’re in the clear or will be invited back to participate in a three-hour glucose tolerance test. (This test works similarly to its predecessor but lasts longer, with blood drawn each hour to make sure your sugar levels drop appropriately.) The glucose tolerance test will tell whether you have gestational diabetes. While most moms-to-be pass this second test, don’t beat yourself up if you’re not one of them—gestational diabetes is a common condition, and your doctor will help you handle it through diet adjustments. As the name implies, gestational diabetes typically lasts only as long as the pregnancy.
The nature of your other third trimester prenatal visits will depend upon your particular needs. If your pregnancy is considered high risk—based on age, weight, health conditions or other factors—you’ll likely be offered more tests (such as a nonstress test to monitor baby’s heartbeat) and scheduled for additional ultrasounds. On the other hand, if you’ve had a relatively easygoing pregnancy, your visits will continue to be brief.
As you near your due date, your doctor may check your cervix to see how it’s progressing. She’ll look for softening, effacing and dilating; these clues could indicate how close you are to giving birth. She may also be able to tell if your baby has dropped into your pelvis, a sure sign he’s getting ready to make his appearance. While your doctor can generally surmise baby’s position by feeling the outside of your belly or conducting a vaginal exam, she may schedule you for an ultrasound if she suspects the baby is breech.
In the final weeks before your due date, you’ll be tested for group B strep. This common infection is not harmful to you, but if you test positive, you’ll be given anti-biotics during labor so the infection won’t be passed on to baby.
In preparation for delivery, your OB will talk you through the signs of labor so you’ll know when “it’s time.” She may also agree to help you write your birth plan, if you choose to have one. Don’t put off any labor and delivery questions, because after 36 weeks, any given appointment could be your last!
Your doctor may ask if you want to schedule an induction or C-section, but think it over before you decide on either. Weigh the pros and cons of these scenarios so you can make the best choice for you and your baby.