Your First Prenatal Visit

Dec 16, 2010 No Comments by

Your first prenatal visit probably will be the longest you’ll have during your pregnancy – and definitely will be the most comprehensive. Not only will there be more tests, procedures (including several that will be performed only at the visit), and data gathering (in the form of complete medical history), but there will be more time spent on questions (questions you have for the practitioner, questions he or she will have for you) and answers.

There will also be plenty of advice to take in – on everything from what you should be eating (and not eating) to what supplements you should be taking (and not taking) to whether ( and how) you should be exercising. So be sure to come equipped  with a list of the questions and concerns that have already come up, as well as with a pen and notebook.

One practitioner’s routine may vary slightly from another’s. In general, the exam will include:

Confirmation Of Your Pregnancy. Your practitioner will check the following: the pregnancy symptoms you are experiencing; the date of your LMP to determine your estimated date of delivery (EDD), or due date; your cervix and uterus for signs and approximate age of the pregnancy. A pregnancy test (urine and blood) will most likely be performed. Many practitioner also do an early ultrasound, which is the most accurate way of dating a pregnancy.

A Complete History. To give you the best care possible, your practitioner will want to know  a lot about you. Come prepared by checking records at home or calling your primary care doctor to refresh your memory on the following:

Your personal medical history (chronic illness, previous major illness or surgery, known allergies, including drug allergies); nutritional supplements (vitamins, minerals, herbal, and so on) or medications (over-the-counter, prescription) you are presently taking or have taken since conception; your family medical history (genetic disorders, chronic diseases, unusual pregnancy outcomes);  your gynecological history (age at first period, usual length of  your cycle, duration and regularity of periods); your obstetrical history (past live births, miscarriages, abortions), as well as the course of past pregnancies, labor and deliveries. Your practitioner will also ask a questions about your social history (such as your age and occupation) and about your lifestyle habits (what you typically eat, whether you exercise, drink, smoke, or use recreational drugs) and other factors in your personal life  that might affect your pregnancy (information about the baby’s father, information on your ethnicity).

A Complete Physical Examination. This may include assessment of your general health through examination of heart, lungs, breasts, abdomen; measurement of your blood pressure to serve as a baseline reading for comparison at future visits; notation of your height and your weight  (prepregnancy and present, if they’re already different); a look at your arms and legs for varicose veins and swelling to serve as a baseline for comparison at future visits; examination of external genitalia and of your vagina and cervix (with a speculum  in place, as when you get a Pap smear); examination of your pelvic organs bimanually using examination gloves  (with one hand in the vagina and one on the abdomen) and also possibly through the rectum and vagina; assessment of the size and shape of the bony pelvis (through which your baby will eventually try to exit).

A Battery Of Tests. Some tests are routine  for every pregnant woman; some are routine in some areas of the country, or with some practitioners and not others; some are performed only when circumstances warrent. The most common prenatal tests given at the first visit include:

.  A blood test to determine blood type and Rh status, hCG levels, and to check for anemia.

.  Urinalysis to screen for glucose (sugar), protein, white blood cells, blood, and bacteria.

.  Blood screens to determine antibody titer (levels) and immunity to such diseases as rubella.

.  Tests to disclose the presence of infections such as syphilis, gonorrhea, hepatitis B, chlamydia, and, very often, HIV.

.  A pep smear for the detection of abnormal cervical cells.

Depending on your particular situation, and if appropriate, you may also receive:

.  Genetic tests for cystic fibrosis, sickle cell anemia, Tay-Sachs, or other genetic diseases.

.  A blood sugar level test to check for any tendency toward diabetes, especially  if you have a family history of diabetes, have high blood pressure, have previously had an excessively large baby or one with birth defects, or gained excessive weight pregnancy. (All women receive a glucose screening test for gestational diabetes at around 28 weeks; )

An Opportunity For Discussion. Here’s the time to bring out that list of questions and concerns.

From Conception To Delivery, Nine Months And Counting, The First Month
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