Overview of the Prenatal visit!!!

The Prenatal visit

After taking “the test” and finding out you are indeed pregnant, it’s time to select an obstetrician, certified nurse midwife, or family practitioner to care for you and your growing baby. Ideally, one should select a care provider prior to becoming pregnant. However, the majority of women begin the selection process after the fact. This article serves as an outline of things to expect during each trimester. While many practitioners have their own style, at a minimum, you should encounter the following during your pregnancy journey.

The first visit
Whether the initial visit occurs during the first, second, or third trimester, you can expect a series of initial questions to aid your provider in getting to know you and your expectations for the pregnancy. Expect questioning regarding the date of your last menstrual period, physical health, social habits (drinking, smoking, drug use), medication use, etc. In addition, a general physical exam will occur. If it has been more than a year since your last pap smear, expect to receive one during this visit.
Many providers will also perform a cervical exam. This involves placing two fingers into the vagina until the cervix can be felt and assess how “open” or dilated it is. Eventually your cervix will reach 10cm (or maximal dilation) and it will be time to push, but hopefully this will not occur before 37 weeks! Finally a series of lab work will occur, including testing for sexually transmitted infections and blood work to determine blood type, etc. Finally, the health care provider will make arrangements for you to receive an initial ultrasound to confirm the “due date.” Seems like a lot? Don’t worry, the following visits aren’t as intense J

First and second trimester routine visits
During the first two trimesters, women can expect to visit their healthcare provider at 3-4 week intervals. At every visit, women can expect questions regarding contractions, vaginal bleeding, and whether or not the baby is moving regularly. Fundal height is also measured. This involves placing a tape measure on the abdomen (belly) and measuring how long the uterus is. At 20 weeks, the top of the uterus is within a few centimeters of the belly button. The fundal height helps to assess whether or not baby is growing appropriately.
In addition to the routine visits, many women will receive a second ultrasound between 18-22 weeks to determine if baby’s organs are forming appropriately along with discovering baby’s gender. If everything checks out OK, the majority of women will not receive another ultrasound during the pregnancy.

Third trimester
The third trimester is a time of excitement because the finish line is in sight. The routine prenatal questions and fundal height assessments continue and the time between visits decreases. Additional testing occurs to assess for gestational diabetes (pregnancy induced high blood sugar). This occurs between 24-28 weeks. It involves drinking an orange colored solution and having blood drawn an hour later. Your healthcare provider will notify you of the results and if additional testing will occur. At 36 weeks, testing occurs to determine the presence of a vaginal bacterium called Group B Strep. This is done by placing a cotton swab in the vagina and the rectum to collect a sample which is sent to the lab. If the sample contains Group B Strep, it is necessary to receive antibiotics during labor to prevent baby from catching an infection during birth. In addition to this test, many healthcare providers repeat testing for gonorrhea and chlamydia. The prenatal visits will continue until it’s time for baby to be delivered! Pregnancy is an exciting time. Make sure to enjoy it (even the aches and pains)!

© CGees 2009