Hooray, you’re pregnant! Now what?
You know you need to start seeing your provider for prenatal checkups—but what happens at each of these checkups? And how often will you have them? We’ve got you covered. Here’s what to expect during your prenatal care throughout a typical pregnancy.
First Trimester Prenatal Appointments and Tests
Once you’ve gotten a positive pregnancy test, it’s important to contact your OB/GYN or women’s health provider to understand next steps. Depending on your provider and practice, it can look different for everyone. Many providers will first schedule a urine or blood test in order to confirm your pregnancy. They may order bloodwork to understand your complete blood count, test for sexually transmitted infections, and determine your blood type.
Your first official prenatal appointment is typically on the longer side, as your provider will need to get a full health history to understand how to best manage your (and baby’s) health. They’ll review your medical records and ask questions about your and your partner’s medical history and any medications you take.
Once these details are in order, your provider will likely take record of various measurements such as your height, weight, and blood pressure. They may also conduct a pelvic exam and a pap smear. Some providers may also order a first-trimester ultrasound in order to help confirm your pregnancy, estimate a due date, and listen to baby’s early heartbeat.
Throughout the rest of the first trimester and well into the second trimester, you’ll have a routine checkup roughly every four weeks. During these appointments your provider will typically record your weight, blood pressure, and possibly conduct a urine test to check for protein in the urine. These early appointments are a wonderful time to chat with your provider about how you’re feeling, express any concerns you have, and understand if any of your symptoms are out of the range of normal for pregnancy.
As your pregnancy progresses, your prenatal appointments will also include the use of the fetal Doppler to listen in on baby’s heartbeat. This Doppler monitor bounces sound waves off of baby’s heart and allows your provider to measure the amount of heart beats per minute.
As you near the end of your first trimester and begin your second, your provider will offer a few different options to help to screen baby for certain genetic disorders. These blood tests and ultrasounds can help indicate if there is a risk of your little one having a genetic disorder. Depending on the results, you and your provider may also decide to continue with prenatal diagnostic tests. Diagnostic testing helps determine in a more definitive way whether your baby has an inherited genetic disorder or abnormal amount of chromosomes.
Second Trimester Prenatal Appointments and Tests
Throughout the second trimester your prenatal checkups will continue to happen every four weeks. During these appointments your provider will listen to the baby’s heart, take your weight and blood pressure, and check in with how you’re feeling as your pregnancy progresses. Once your bump starts to grow bigger, your provider will also take a measurement known as the fundal height. This indication of baby’s growth is done by taking a measurement from the pelvic bone, up over your bump to the top of your uterus. As your pregnancy progresses, this measurement will increase and help your provider understand if baby’s growth is on the right track.
As you approach the halfway point of pregnancy, usually somewhere between 18-20 weeks, you’ll have a longer ultrasound appointment. This ultrasound, sometimes known as the anatomy ultrasound, is important for getting a good look at baby’s development. During this scan, your sonographer will take images of the baby’s heart, brain, and other major organs, take critical measurements, and can even tell you the gender of your baby (if you’d like to know, of course!).
The next big testing milestone is a glucose challenge screening or glucose tolerance test. These tests occur somewhere between 24-28 weeks, and will determine whether you have gestational diabetes. During these tests, your provider will ask you to drink a special beverage, and then test your blood to see how well your body processes the glucose.
Third Trimester Prenatal Appointments and Tests
As you enter the third trimester, your standard checkups with your provider become more frequent. At the start of the trimester, you’ll see your provider every other week. During these appointments your provider will continue to listen to baby’s heartbeat with the fetal Doppler, and keep a close eye on your blood pressure and vitals to identify any possible complications such as preeclampsia.
During your final month of pregnancy, you’ll see your provider every week. During these appointments your provider will continue to monitor you and baby, and check baby’s position in your uterus as you prepare for delivery. These appointments are a great time to ask any final questions about your birth plan and what to do if you go into labor.
During the last few appointments, your provider will also do a test for Group B strep (GBS), and administer any immunizations you may need (such as Tdap, which protects you and baby against tetanus, diphtheria and pertussis).
When you’re close to your due date, your provider may check your cervix to determine if it’s starting to dilate. In some instances, your provider or midwife may offer to strip your membranes, which separates the amniotic sac from the uterine wall. This quick process can stimulate the release of hormones, and possibly even cause labor contractions for those whose bodies are ready for labor to begin.
If you make it the whole way to your due date—or past it—you and your provider may start discussing a plan to induce labor. If you have questions about any part of the pregnancy, labor, or childbirth process at Penn Medicine Lancaster General Health, visit our Pregnancy and Childbirth webpage.