Pregnancy Timeline: Here’s What to Do and When

You’re pregnant! Congrats! You might be feeling excitement, anxiety, joy, trepidation or all of the above. That’s normal.

Not only are you on the verge of a new chapter in life—especially if this baby will be your first—but it also seems there is so much to keep track of in those approximately 40 weeks of pregnancy.

Fortunately, you’re not alone. Your doctor or midwife is there to help.

“A big part of your provider’s job is to help you navigate through this new and exciting—and sometimes overwhelming—pregnancy journey,” says Brian Brimmage, MD, an obstetrician who delivers babies at UNC REX Healthcare. “No matter how much you read and plan, there will always be surprises. Your OB or midwife will try to prepare you as much as we can so you can focus on keeping yourself and your baby healthy.”

Use this timeline to help you stay on top of important health-related tasks and milestones.

Weeks 4 to 8

  • If you took a home pregnancy test and it’s positive, call your women’s health provider. Your physician, obstetrician or midwife will typically want to see you around eight weeks after your last missed period.
  • If you need a primary care provider, obstetrician or midwife, you can find one near you.
  • If you wish to deliver at a certain hospital, check with any potential providers to find out where they deliver babies. Most providers deliver at only one hospital.
  • If you weren’t taking a prenatal vitamin before (they’re recommended when trying to conceive), start one now. Make sure it has folic acid or add a folic acid supplement to help prevent birth defects.
  • If you smoke or vape, try to stop right now. Also, quit drinking alcohol and don’t use any illegal drugs. If you need help with your substance use, talk to your provider.
  • Ask your provider if your medications are safe to continue taking during pregnancy. Many are, so don’t assume yours must be stopped immediately.
  • Talk to your care team about foods and activities that are safe during pregnancy and what is best avoided. For example, experts recommend pregnant women eat two servings of fish per week to help fetal brain development but warn against high-mercury fish such as shark, swordfish or king mackerel.
  • Check your vaccination record—or track it down with your doctor’s office if you don’t have it—to find out which immunizations you received in childhood and as an adult. Pregnant women can’t get the measles, mumps and rubella (MMR) vaccine, so you’ll want documentation that you had that shot earlier in life. If you haven’t, talk to your provider about how to protect yourself; rubella during pregnancy is especially dangerous.
  • If it’s flu season, get a flu shot. Tell the person administering it that you are pregnant. Practice good hand hygiene and social distancing when appropriate, to avoid the transmission of the flu, the coronavirus disease 2019 (COVID-19) and other illnesses.

Weeks 9 to 12

  • Ask your doctor’s office to schedule your next two or three appointments.You’ll have frequent appointments, including ultrasounds and a gestational diabetes screening, and you’re most likely to keep them if they’re scheduled far in advance and noted in your calendar. Some appointments can be done virtually.
  • Schedule time to rest and sleep during the day and week. In the first trimester, nausea, vomiting and fatigue are common. Ask your doctor about anti-nausea medication if your symptoms are interfering with your ability to function. Enlist help with daily tasks from your partner or anyone else in your household.
  • If you feel up to it, exercise. Talk to your doctor about what workouts are safe for you, but a general guideline is that—if you have a healthy, uncomplicated pregnancy—the activities you did before you were pregnant are safe while pregnant, as long as you are comfortable. A good routine would be to walk briskly five to seven times a week for at least 30 minutes at a time.

Weeks 13 to 28

  • Sometime in the second trimester, you’ll feel your baby move for the first time. Some women feel flutters as early as 13 weeks, while others, especially first-time moms, might not feel anything until week 20 or even 25. Your obstetrician or midwife will monitor the baby’s heartbeat and measure your bump to check how your baby is growing.
  • Contact a hospital financial counselor to discuss the details of the costs so you aren’t surprised by bills during your first few weeks at home with your baby. It’s possible that some providers you will interact with are in-network, like your obstetrician, while others could be out-of-network, like an anesthesiologist. It’s best to know up front what to expect.
  • Talk to your insurance company about what is covered related to prenatal care, labor and delivery, and care for you and your baby after birth. These options could include anesthesia, lactation services and a hospital-grade breast pump.
  • At 28 to 32 weeks, get a whooping cough (pertussis) vaccine, known as Tdap. The vaccine will create protective antibodies that you’ll pass on to your baby; whooping cough can be life-threatening for newborns. The vaccine also protects against tetanus and diphtheria.
  • Keep tabs on your emotional health and seek help if you need it from your primary care provider, obstetrician or a mental health professional. Some stress during pregnancy is normal and will not hurt your baby, but help is available.

Weeks 29 to 36

  • Remember to sign up for any classes you want to take on important topics including birth, infant CPR and breastfeeding. Contact the hospital where you will deliver to find out what options are available for in-person or virtual classes and hospital tours. Write down your questions about what the labor and delivery experience and what your hospital stay will be like so you can get them answered in person or over the phone.
  • Install your rear-facing infant car seat according to manufacturer guidelines and safety standards.
  • Make sure you have a safe space at home for your infant to sleep. Remember the basics: The baby should sleep in your room but in a separate space (a crib or bassinet), on his or her back, with no blankets, positioners, toys or other items except a snug fitted sheet. Review the American Academy of Pediatrics safety guidelines to reduce the risk of sudden infant death syndrome (SIDS) and suffocation.
  • Reduce your stress by planning ahead for care for your older children and pets while you’re in the hospital. Say yes to friends and family who offer to drop off meals or run errands for you.

Weeks 37 to 40

  • Pack a hospital bag. Include comfortable pajamas, your phone and charger, a copy of your birth plan if you have one, toiletries, a nursing bra and going-home clothes for your little one and for you. Pack maternity clothes; your uterus will still be expanded and pre-pregnancy pants won’t fit—that’s normal and OK!
  • Talk to your doctor about your birth plan, including pain management during labor and the person you want in the delivery room. Make sure your partner or another loved one who will be with you understands what’s expected of him or her during labor, whether it’s helping you breathe, rubbing your back or keeping family members updated on progress.
  • If you have a breast pump at home, sterilize its parts and wash baby bottles according to the manufacturer’s instructions. Plug in the pump and learn how to use it. But don’t try it on your breasts, as that could stimulate labor.
  • If your hospital has a navigation app, like the UNC Health app, download it to use for quick driving directions and parking information.

And a final to-do no matter where you are in the pregnancy journey, or postpartum period, for that matter: Be patient with yourself, your body and your emotions.

“I know it’s hard. Try not to stress too much, and don’t spend all your energy focusing on what you think you’re doing wrong,” Dr. Brimmage says. “Focus on what you are doing well, and try to enjoy this precious, unique time in your life.”

Need a primary care doctor, OB-GYN or midwife? Find one near you.