Once you find out you are pregnant, you should call your doctor to schedule an appointment. You may not be seen right away, but you will need to get it scheduled quickly. Whether you have a positive home pregnancy test or suspect you might be pregnant, you should be checked out by your obstetrician. Since the COVID-19 pandemic, prenatal and antenatal care appointments have changed radically, and in-person visits have been significantly reduced.
Read more about the new prenatal and antenatal care appointment model during COVID.
Instead of the previous each pregnancy month, and then weekly visits during the last month for a total of about 8-14 visits, nowadays the number of prenatal in-person visits has been reduced by about one-half. You should find out if you can have telemedicine prenatal visits with your doctors instead of in-person visits.
Doctor’s appointments in the first trimester
For now, during the first trimester you will most likely have just one in-person appointment with your doctor, unless your pregnancy is considered a high-risk pregnancy or you have other medical conditions or problems. This is done to decrease in-person visits since the COVID-19 pandemic. While you may only see your obstetrician once during the first trimester, it is one of the most important appointments during your pregnancy, and also one of the longest. Expect to have the first appointment between 6 and 12 weeks of pregnancy, sooner if you are considered high-risk. This first appointment will include a series of tests, including blood tests and a sonogram, and this should also be the time when you ask any and all questions you have. You also should discuss with your doctor if you can have telemedicine visits to discuss any concerns.
If this is the first time you have visited this doctor or midwife, you will be asked questions about your general health and the health of your immediate family. This gives the doctor an idea of any conditions, such as diabetes or high blood pressure, which may affect the pregnancy. Previous pregnancies and current medications will also be discussed; all of this is useful in evaluating the current pregnancy. Your doctor will more than likely have you start taking a prenatal vitamin if you aren't already. Finally, you will also be asked the date of your last menstrual period, and this will help the doctor determine your due date.
A pelvic and general health exam is next. The general exam will consist of height measurement, current weight, and blood pressure. These will serve as a baseline for future visits and, with the exception of height, will be checked at subsequent appointments. Your doctor will likely check your glands, eyes, ears, nose, throat, lungs, heart, breasts, and abdomen. A pelvic exam is performed to check the health of your cervix and uterus. If you have not had a recent pap smear, this will be done during the pelvic exam.
Your doctor will likely order a variety of routine prenatal tests and lab work. Some of the tests that may be ordered are a complete blood count, tests to detect a variety of sexually transmitted diseases, and tests that check for genetic abnormalities. Depending on how far along you are, an ultrasound may also be recommended.
What to ask
After discussing a variety of general health information, your doctor or midwife should give you a chance to ask questions. Weight gain expectations, dietary changes, and some of the changes you can expect your body to undergo should all be part of the information your doctor can provide. As this first visit can be overwhelming you may want to prepare a list of questions before your appointment. Some questions you may want to ask are the name of the hospital you will be delivering in, pain management options, and policies about labor induction, episiotomies, and cesarean sections. You will think up new questions at each visit so don't worry if you forget to ask something in this first appointment.
Learn more about what happens in the first trimester!
Tests and screenings in the first trimester
The bulk of your first appointment will be going through tests and screenings, as well as questioning you about your medical history, and that of your spouse or significant other. A personal medical history will be assessed, including any medical conditions you have, what medications you take, and if you have ever had surgery before. You will also need to take the following tests:
Lab tests in the first trimester:
A series of tests are performed during your first prenatal visit. This includes a complete blood count, blood typing, screening tests to look for sexually transmitted diseases, a screen to look for the rubella virus, hepatitis panel, syphilis test, screening for cystic fibrosis, urine analysis, and an HIV test. An Rh and other antibodies test will be done during your first trimester. This looks for antibodies that may cross the placenta and affect the fetus. In addition, between 10-13 weeks of the pregnancy a first-trimester screen test is recommended which consists of blood tests and an ultrasound.
Ultrasounds in the first trimester:
Your first prenatal visit will also include an ultrasound, which is done internally with a wand that uses sound waves to look at your uterus. This helps determine the position, size, viability (heart rate), and age of the fetus.
This seems like a lot of tests you need to undertake, but they only need to be done once in the first trimester in most cases. As your longest prenatal appointment, much of it involves tests, screenings, and paperwork. If you have anything unusual, like severe cramping or heavy bleeding, ask to be seen sooner than the typical 8-week mark. Between 10-13 weeks the first-trimester screen test is recommended which consists of a sonogram and blood tests.