Prenatal Care

Reviewed by James Brann, MD

Importance of Prenatal Care

Prenatal care is the type of medical care a pregnant woman gets throughout her pregnancy. As part of this, your doctor or midwife helps figure out when you’re due, monitors you for potential health problems and checks your baby to make sure she or he is growing normally. Additionally, during prenatal care they’ll discuss your pregnancy, labor and delivery with you, and then help you come up with a labor and delivery plan. Finally, they’ll do routine tests, checking out both you and your baby for various health conditions.

Your first prenatal visit

At your first prenatal visit, your doctor or midwife finds out about your medical and health history, and determines your due date. You can expect an exam, including what’s called a speculum exam. This is when a speculum, or rather a plastic or metal device, is placed in your vagina to hold the walls of your vagina open. This allows them to see your cervix. They’ll put one hand on your belly and then insert either one or two gloved fingers into your vagina. This allows them to check the size of your uterus and check your ovaries.

You may also do a series of tests including:
  • Urine test
  • Blood tests - Some check your general health, while others check for conditions, which could lead to problems in a mother or her baby.
  • Lab testing of cell samples from your cervix - A cotton swab will be used to take a sample of cells from your cervix. These cells will then be tested for cancer of the cervix or infections.
  • Ultrasound - This uses sound waves to translate pictures of your baby and the inside of a mother’s body. It’s used to see if you have more than one baby, and to check your due date.

Future prenatal visits

If you live in the United States, every prenatal visit will include your doctor or midwife doing these things:
  • Checking your blood pressure - High blood pressure may lead to preeclampsia, a serious condition, or other problems.
  • Checking your weight - The recommended weight you gain may depend, at least partly, on your pre-pregnancy weight.
  • Answering your questions and asking about your symptoms
  • Listening for your child’s heartbeat - Your doctor or midwife can hear your child’s heartbeat at around week 12 of your pregnancy.
  • Measuring your uterus - Your uterus gets larger during pregnancy.
  • Asking about your child’s movements - While women feel their child move at different times, most women do feel something by around week 20 of their pregnancy.
  • Testing your urine for protein or sugar - Discovering protein or sugar in your urine may signal a more serious problem.
  • Checking your child’s position - During the final trimester, expect your doctor or midwife to check on every visit your child’s position. They’ll want to know whether your child is head or buttocks down.

Other prenatal care testing

Other testing may be ordered during your pregnancy, including routine tests. This includes the tests all women have, and those only some women choose.

Tests may include:
  • Checking for diabetes, or high blood sugar - This is when you drink a sugary drink and then have your blood drawn.
  • Ultrasound - This checks the fluid surrounding your baby, your child’s organ development, your child’s growth and it checks the placenta.
  • Vaginal discharge - This is fluid leaking from your vagina. The testing is to find an infection, if there is one.
  • Testing for birth defects/other problems - There is an optional test for Down syndrome. This lifetime condition causes both learning and medical problems.
  • Blood tests - This includes testing to find out your blood type and check to see if you have anemia. This may also include checking for infections that can be passed on to your baby, and potentially harm your child. These include hepatitis B, rubella and syphilis.

Frequency of checkups

The closer you get to your due date, the more frequent your visits to your doctor or midwife become. Commonly, though, this is how visits are scheduled:
  • Once every 4 weeks until week 28 of pregnancy
  • Every 2-3 weeks between then and week 36 of pregnancy
  • Once per week until delivery

If you have a certain medical condition, you may need to go for checkups more often than this. You may also need additional testing of your medical condition as your pregnancy develops.

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