Patient education: Prenatal care (The Basics)

Written by the doctors and editors at UpToDate.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Oct 28, 2016.

What is prenatal care? — Prenatal care describes the medical care women get during their pregnancy. As part of your prenatal care, the doctor or midwife will:

●Figure out when your baby is due

●Talk to you about nutrition, physical activity, work, and common pregnancy complaints, such as morning sickness, heartburn, and backache

●Monitor your health to watch for problems

●Monitor your baby’s health to check that he or she is growing well

●Talk with you about pregnancy, labor, and delivery, and make a plan for your labor and delivery

●Talk with you about taking care of yourself and your baby after the birth

●Do tests to check you and your baby for different health conditions

What happens at my first prenatal visit? — Your doctor or midwife will ask about your health and medical history, and figure out when your baby is due.

He or she will also do an exam, including a speculum exam. For this, the doctor or midwife will place a metal or plastic device (called a speculum) in your vagina (figure 1). The speculum holds the walls of the vagina open. That way, the doctor or midwife can see the cervix. He or she will also put 1 hand on your belly and insert 1 or 2 gloved fingers of the other hand into the vagina. This is so your doctor or midwife can check your ovaries and the size of your uterus.

He or she will also do tests that can include:

●A urine test

●Blood tests – Some blood tests check your general health. Other blood tests check for specific conditions that could cause problems for you or your baby.

●Lab tests on a sample of cells from the cervix – The doctor will use a swab to take some cells from the cervix. He or she will test the sample for infections or cancer of the cervix.

●An ultrasound – An ultrasound uses sound waves to create pictures of the inside of your body and of your baby. This test is done to check your due date and see if you are pregnant with more than one baby.

What will happen at each prenatal visit? — In the United States, at all prenatal visits (including the first visit), the doctor or midwife will:

●Ask about your symptoms and answer any questions you have

●Check your blood pressure – Having high blood pressure can lead to problems, including a serious condition called “preeclampsia.”

●Check your weight – The amount of weight you should gain during pregnancy depends partly on what your weight was before you got pregnant.

●Measure the size of your uterus – Your uterus will get bigger as your pregnancy progresses.

●Listen for your baby’s heartbeat – The doctor or midwife will be able to hear your baby’s heartbeat starting at about 12 weeks of pregnancy.

●Test your urine to check for sugar or protein – Having sugar or protein in your urine might be a sign of a more serious problem.

●Ask about your baby’s movements – Women start feeling their baby move at different times. Most women feel their baby move by 20 to 25 weeks of pregnancy.

●Check your baby’s position in your uterus – In the last 3 months of pregnancy, the doctor or midwife will check your baby’s position at each visit. He or she will check whether your baby’s head or buttocks are down and closest to your vagina (figure 2).

What other tests are part of prenatal care? — Your doctor or midwife will order other tests during your pregnancy. These include routine tests that all pregnant women will have. They also include tests that some women choose to have.

Tests done during pregnancy can include:

●A test to check for diabetes (high blood sugar) – This involves drinking a sugar drink and then having your blood drawn.

●Blood tests to check for certain conditions or infections – These include tests to check your blood type and see if you have a condition called anemia. They also include tests to check for infections that you could pass to your baby or that could harm your baby. Some of these infections are rubella, hepatitis B, and syphilis.

●An ultrasound – This test checks your placenta, the fluid around your baby, how your baby is growing, and how your baby’s organs are developing.

●Tests to check for birth defects or problems babies can be born with – For example, women can choose to test their baby for Down syndrome. Down syndrome is a life-long condition that causes medical and learning problems. Another common test is to check for spina bifida, a birth defect that involves the spine (backbone). If a disease runs in your family, your doctor or midwife can tell you whether your baby might be at risk.

●Tests on your vaginal discharge (the fluid that leaks from your vagina) to check for an infection

How often will I see my doctor or midwife during pregnancy? — Your visits to your doctor or midwife will get more frequent as your pregnancy progresses. One common schedule of visits is the following:

●Every 4 weeks until you are about 28 weeks pregnant

●Then every 2 to 3 weeks until you are about 36 weeks pregnant

●Then every week until delivery

Women with certain medical conditions (including conditions they had before they got pregnant) might need to see their doctor or midwife more often. They might also need other tests to follow their medical condition during pregnancy.