During your first prenatal appointment, your obstetrician or midwife will do a physical exam and test your urine. What else should you expect?
If you just took a pregnancy test, now what? Making an appointment with a care provider is an important part of staying healthy. Here are some things to know about your first prenatal visit.
Signs and Symptoms of Pregnancy
When you go in for your first prenatal appointment, you may be initially interviewed by a nurse or nurse practitioner, rather than the doctor. They will want to know any symptoms of pregnancy you are currently having including:
- missed period
- breast tenderness
- frequent urination
Reviewing Your Health and Personal History at Your First Prenatal Appointment
A complete history will be then taken so that your doctor or midwife can be alerted to any potential problems with your pregnancy. Some of the personal questions will include your age, race, marital status, occupation, name of baby’s father, insurance information and emergency contacts. Questions about your health history include:
- menstrual history
- previous pregnancies
- chronic illnesses such as hypertension, diabetes, thyroid, kidney disease, etc.
- any alcohol, smoking or drug use
- any allergies to drugs
- any surgeries and dates
- family history of genetic problems such as cystic fibrosis, Down Syndrome, neural tube defects or other birth defects
- history of STD’s or HPV or living with someone with an infectious disease
Nutritional Information at First OB Visit
The care provider will typically want to know what your diet consists of. Do you eat three healthy meals a day? Are you currently taking prenatal vitamins? Do you have a special diet such as vegan or lactose intolerance? Are you diabetic? Are you having any problems such as morning sickness that affect your nutrition?
If you are having any difficulty with your pregnancy diet, your care provider will usually refer you to a nutritionist for more individual help.
Physical Exam at Your First Prenatal Visit
The nurse will often check you out from head-to-toe at the first appointment. He or she will check your heart, lungs, skin color, lymph nodes, as well as the size of your uterus. As part of the physical exam, your blood pressure, height and weight (both pre-pregnancy and current weight) will also be assessed.
You will be expected to report to the nurse or care provider the date of your most recent pap smear.
Estimating Your Expected Due Date
Knowing the first day of your last menstrual period (LMP) will help the care provider to estimate your due date. They will take that date, subtract three months from it and add 7 days in order to come up with the estimated due date (EDD). This formula is known as Naegele’s Rule. Other ways to estimate due dates would be to count 40 weeks after the date of conception.
If you have irregular cycles and do not know the date of your LMP or conception date, the provider can do an ultrasound to estimate the baby’s due date.
Tests at Your First Prenatal Visit
There are a number of tests that may be recommended at your first prenatal visit. These early prenatal lab tests include:
- blood tests for anemia or infection
- blood typing to check for Rh and irregular antibodies
- rubella titer to see if you are immune to rubella
- urine testing to check for infection, diabetes, PIH or renal disease
- Pap test – to screen for herpes, HPV
- vagina/Rectal smear to test for STD’s and GBS for women at risk
- HIV blood test to screen for HIV infection
- hepatitis B testing if you have not received the hepatitis B vaccine
Seeing a medical care provider, whether it is a clinic nurse, midwife, family doctor or obstetrician is a crucial part of having a healthy pregnancy. Knowing what to expect at a first prenatal visit can help to prepare you for the questions that will be asked. Some of the information gathered at the appointment you will know off the top of your head but other information you may need to jot down ahead of time and bring with you.
Lowdermilk, Perry and Bobak, Maternity and Women’s Health Care, Mosby,