As soon as you suspect you’re pregnant, schedule an early appointment with your obstetrician, family physician or midwife. Once that is accomplished, one of our nurses will contact you to review your medical history and medications considered safe during pregnancy.
You and the nurse will also discuss the regularity of your cycles and what the first day of your last period was to determine your due date. The nurse will also review your information with your primary care provider to determine if anything is considered high risk and needs to be evaluated immediately.
Your first OB visit
At your first OB visit, done between six and eight weeks, your history and any pregnancy symptoms will be reviewed again. If your cycles are irregular or you are uncertain of your last menstrual period (LMP), then an ultrasound will be done to confirm your due date. The earlier you have an ultrasound, the more accurate your due date will be.
Usually, baby and heartbeat can be seen between six and seven weeks. If you know your LMP, your provider may use a small handheld ultrasound called a VSCAN to allow you to see your baby and the heartbeat. A physical exam is not usually necessary at this visit.
Your second OB visit
At your next OB visit, done between 10 and 12 weeks, your history will be reviewed again by your provider, followed by a complete physical exam. Your provider will check to make sure your Pap smear is up-to-date per the current guidelines. A culture from your cervix will be done to check for chlamydia and gonorrhea. Your family’s medical history will also be reviewed, which is important because many health problems are at least partly hereditary.
Urine, blood and genetic testing
You will need to leave a urine sample at your second OB visit. At your subsequent prenatal visits, you may or may not need to leave a urine sample, so remember to ask your provider if you need to come to your visit with a full bladder. You will also do blood work at one of your OB visits to check for:
- Blood type and Rh status (if you’re Rh negative, you will get Rhogam at around 28 weeks and then possibly after delivery depending on your baby’s blood type).
- Infectious disease testing including syphilis (this will be checked three times during pregnancy as recommended by the State of South Dakota), hepatitis B, immunity to rubella and HIV.
- Early gestational diabetes and identifying risk factors including body mass index (BMI) of 30 or higher, history of gestational diabetes, and history of polycystic ovarian syndrome (PCOS). Fasting isn’t necessary, but try to avoid eating or drinking anything sweet before this test. If you don’t have any risk factors, this test will be done between 24 and 28 weeks.
Your provider will also discuss genetic testing options with you. These can provide information about your baby’s risk for Down syndrome, sickle cell disease, cystic fibrosis, as well as other chromosomal problems and birth defects.
The options for genetic screening and testing continue to expand very rapidly. If you have questions or would like more information, it is recommended that you meet with a genetic counselor. The counselor’s role is to translate all the technical and scientific information and to help you sort out your feelings so that you can make informed choices and decide what’s right for you and your family.
Getting appropriate care from the beginning is the first step in keeping yourself and your baby as healthy as possible throughout your pregnancy. For any additional questions you may have, talk to your provider.