When you find out you’re pregnant, your to-do list instantly becomes much longer. There are people to tell, nurseries to decorate and names to consider. You also need to establish where you’ll receive your prenatal care.
Your first prenatal appointment should be scheduled seven to nine weeks after your last menstrual period.
“Early prenatal care is important because it gives your provider an opportunity to review your health history and identify risk factors we need to be proactive about,” says UNC Health certified nurse-midwife Rebeca Moretto. “It’s also an opportunity for you to ask questions about the process of pregnancy so that we address your concerns.”
Moretto and UNC Health obstetrician-gynecologist Kimberly Malloy, MD, talk about what to expect at the first prenatal visit.
Selecting Prenatal Care
“I always encourage patients to have established OB-GYN care and to have a preconception counseling appointment,” Dr. Malloy says. “We discuss your medical history and any medications you’re taking so you can prepare for a healthy pregnancy.”
You may already have a relationship with a practice that delivers babies, and your provider might know that you were preparing for pregnancy. If you don’t have a provider, Dr. Malloy recommends starting by identifying where you want to deliver.
“Patients typically choose the facility that’s closest to them, but if you have a complicated medical or obstetric history, you may want to travel farther if it means you can have access to more accommodations of care, such as a NICU [neonatal intensive care unit] or a maternal-fetal medicine department,” Dr. Malloy says.
Also, think about the people you want to be involved in your prenatal care and delivery, considering these factors:
- You may be able to see a family medicine provider for part of your prenatal care.
- Maybe you prefer a practice with nurse-midwives.
- You might not be able to identify specific providers to be in the room for your delivery, as they rotate hospital shifts.
- At an academic institution, medical students, residents and fellows could be part of your care team.
“With a team-based approach, you’ll be able to see a variety of wonderful providers, and a team ensures there are multiple eyes identifying issues,” Dr. Malloy says.
Be sure to confirm with your insurance provider that your selected healthcare practice is included in your coverage.
Preparing for Your First Prenatal Visit
Once you’ve scheduled your first appointment, there are a few things you can do to prepare and help your provider. If you are a new patient to the practice or health system, arrange to have your prior records sent to your new team or obtain copies so you can bring them to the first appointment.
“If you have a record of your most recent Pap test, or any information about prior pregnancies or complications, bring that to the appointment,” Moretto says. “If you’ve had a cesarean section, an operative report is important, especially if you want to pursue a vaginal birth after cesarean.”
Also, bring a list of any medications you take—better yet, bring the packaging or pictures of the prescription labels—so your provider can review them and make adjustments as necessary.
Start a written list of questions you have about your pregnancy, so you don’t forget to ask them when you see your provider. Talk to your family and your partner’s family about hereditary medical issues that could affect your baby so that you can share those details with your doctor.
While you’re waiting for your initial appointment date, know that you can reach out to your care team with questions or concerns.
“Vaginal bleeding and spotting are common in early pregnancy,” Dr. Malloy says. “If it’s a persistent problem, call the provider so they can assess whether you need to be seen sooner.”
Testing at the First Prenatal Visit
The first prenatal visit probably will be the longest of your pregnancy. It will include a complete physical exam, including pelvic and breast exams. Your blood pressure and weight will be recorded at this and future visits.
A urine sample will be taken so that your provider can check for signs of infection and dehydration and levels of protein and glucose.
You’ll also have your blood drawn for a variety of labs, including anemia, immunity to certain infections, blood type and Rh factor.
At this appointment you might have your first ultrasound, depending on the practice. Some providers schedule the first one beforehand so that the images can be reviewed at this visit. You may also be able to see or hear fetal heart tones.
All of this testing helps your provider identify and monitor potential risk factors and issues that could arise during pregnancy, such as hypertension, diabetes and preeclampsia.
In addition to this testing, you’ll have a consultation with your provider, who will review your entire health history, including medications, surgeries and prior pregnancies. If you have concerns about genetic issues, your provider can identify additional screenings or tests you might wish to pursue.
The care team will also give you guidance on how to make your pregnancy as healthy as possible and to prepare for the rest of pregnancy, childbirth and lactation.
“We’ll go over nutrition issues, such as anticipated weight gain and additional caloric intake,” Dr. Malloy says. “We’ll review vaccines that may be necessary during pregnancy, make recommendations for any medications you may need and discuss precautions you may need to take.”
Moretto adds, “It’s also a time to talk about mental health resources. Pregnancy is impactful on mental health, so we can help make connections for therapy and other relevant resources if needed.”
Your due date will be set at your first prenatal visit, but you won’t find out the sex until the second trimester. Finally, your provider will review the schedule for the rest of your prenatal care, dependent on your individual needs and risks.
If you’re pregnant or thinking about becoming pregnant, you should talk to your doctor. Need a doctor? Find one near you.