Prenatal Care

Prenatal care at a glance

  • Prenatal care involves care provided before and during pregnancy for both the mother and the baby.
  • The initial prenatal appointment will include preconception counseling for how to get pregnant and prepare for pregnancy if prior to pregnancy.
  • During the first prenatal appointment after the woman has conceived, the doctor will confirm the pregnancy and order a number of tests to check the woman’s and baby’s health.
  • Subsequent first trimester and second trimester prenatal visits will be regular check-ups for the mother and baby.
  • Third trimester prenatal visits become more frequent closer to the baby’s due date, and will include more intensive monitoring of the baby’s heart and movement, blood tests, and pelvic exams to determine the woman’s readiness for delivery.

First trimester prenatal appointments

The initial prenatal visit will include an extensive health exam and testing to ensure a healthy pregnancy. This will include your provider taking a medical health history to help predict any issues that may arise during pregnancy.

The doctor will perform an overall health physical exam, which will include a pelvic examination to confirm pregnancy. The doctor will also establish the baby’s due date – either by calculating days from the woman’s last period, or with an ultrasound.

Tests include checking the woman’s urine for any existing conditions, and blood tests to determine the mother’s and baby’s blood types, as well as check for any genetic disorders or other problems, such as sexually transmitted diseases (STDs).

All women should be screening for HIV (human immunodeficiency virus), which can be passed from the mother to the baby. If the woman tests positive for HIV, medication during pregnancy can reduce chances of the baby being born HIV-positive.

Specific prenatal tests to determine the baby’s health include ultrasound, blood tests and other screening tests to check for fetal abnormalities.

The doctor will also address unhealthy lifestyle habits that can negatively impact the pregnancy (for both the mother and the baby), and discuss healthy lifestyle choices.

After the initial prenatal exam, subsequent visits are usually spaced about four weeks apart and are general check-ups so the doctor can monitor the progress of the pregnancy and answer any of the woman’s questions.

Second trimester prenatal appointments

The woman’s blood pressure and weight are checked at each prenatal visit to help monitor the pregnancy’s progress.

The doctor will track the baby’s growth by measuring the woman’s abdomen from the top of the uterus to the pelvic bone.

The baby’s heartbeat can be heard through a special stethoscope during the second trimester. An instrument called a Doppler can also project the baby’s movements as sounds.

The woman should start noticing movement and kicking from the growing baby during the second trimester and should discuss any developments with the doctor.

Routine lab tests – such as additional screenings for diseases or conditions – as well as fetal ultrasounds will also be part of routine second-trimester prenatal exams.

Third trimester prenatal appointments

During the last few months of pregnancy, the woman will continue to have regular prenatal visits to monitor the baby’s development and make sure the pregnancy is on track for a healthy delivery. As the due date approaches, prenatal appointments may increase to weekly visits.

The doctor may request the mother keep track of how often the baby moves, and call immediately if the baby is moving less than normal.

The doctor will also check the woman’s vitals closely, especially measuring weight gain and performing blood tests.

A test that is often ordered in the last trimester is for group B strep (GBS), which is harmless in adults, but can make infants extremely sick. If GBS is present, antibiotics can be given intravenously during birth to protect the baby.

Pelvic exams

Pelvic exams will resume during third-trimester prenatal visits so the doctor can monitor the baby’s position and any changes to the cervix. As the due date approaches, the baby’s head should be pointed down toward the lower abdomen.

If the baby’s head is positioned up toward the top of the uterus, the doctor may apply pressure to the abdomen to cause the baby to rotate. If this doesn’t work, a C-section during delivery may be necessary.

The cervix should begin dilating – or opening – near the time for delivery, and the tissue will soften and thin (efface). The doctor will measure the opening (in centimeters), as well as how effaced the cervix is.

When the baby is born, the cervix should be about 10 centimeters dilated and 100 percent effaced – which can occur over a period of weeks, or quickly as the woman enters labor.