Your First Prenatal Appointment: What To Expect

When that pregnancy test came up positive, your mind probably started running wild with plans for what comes next.

But before you start picking out cribs and debating daycares, remember, pregnancy is a marathon, not a sprint. So, take a seat, take a sip of water and take a few deep breaths.

Now, one of your next orders of business is to connect with a healthcare provider — like an Ob/Gyn or a midwife — to get started on your prenatal care. Frequent prenatal visits will allow you and your provider to ensure healthy fetal development and a healthy pregnancy.

And your first prenatal appointment is your chance to get answers to those questions that’ve been racing through your mind since that second line appeared on the stick. It’s your first chance to see how your pregnancy is progressing and plan for the months ahead.

We talked with certified nurse midwife Kellann Gaines-El Hunter, CNM, about your first pregnancy visit so you can know what to expect and how to prepare.

When should you schedule your first prenatal appointment?

There’s no reason to wait. Call a healthcare provider soon after getting your positive home pregnancy test to get the ball in motion to start your pregnancy care.

You can expect that they’ll want to see you for your first prenatal appointment sometime between eight weeks and 10 weeks after the first day of your last period. (That’ll probably be one of the first questions they’ll ask, so it’ll help if you know when your last period started. If you don’t remember, don’t sweat it, they’ll let you know when they want to see you based on other factors.)

“When you call an Ob/Gyn or a midwife and let them know your pregnancy test was positive, they might ask about your health status and medical history,” Gaines El-Hunter says. “If you aren’t already taking a prenatal vitamin, you can use that first call to get a recommendation of what kind they suggest. You can also ask any other pressing questions on your mind, like if a medication you’re taking is safe to continue.”

Don’t feel like you need to cram in every question from the get-go, though. There’ll be plenty of time for that during your appointment. Use that first contact with the provider’s office to get the info you need to care for yourself until the appointment comes.

What happens at your first prenatal visit

Your healthcare provider may do things differently depending on your health and their process, but a typical first pregnancy appointment will include questions for you, several tests and time for you to ask your questions.

“Different providers may do things a little differently, but in general, you can expect to visit your provider regularly throughout your pregnancy to make sure you’re doing well and that the fetus is developing properly. Prenatal visits are a chance to spot any issues as early as possible,” Gaines-El Hunter notes.

Here is an idea of what else will happen during that first appointment.

Vital stats

During your first prenatal visit, you can expect your provider to ask you to step on a scale to track your weight. They’ll also get your height on file. They’ll take your temperature and blood pressure, too.

Urine sample

You can expect your provider to ask for a urine sample during your first prenatal visit (and at each future appointment).

They’ll test your urine to confirm your pregnancy, test your kidney function and check for things like protein in your urine.

Blood test

Your provider will likely need to draw some blood as part of your first prenatal visit. They’ll test your blood to better understand your health and any conditions you may have that can affect your pregnancy and the fetus.

During your first trimester, your provider will check your blood to determine your blood type and look for signs of:

• Blood issues, such as anemia (low iron).
• Immunity to rubella (German measles).
• Hepatitis B (a liver infection).
• Cystic fibrosis gene.
• Sickle cell anemia and other blood disorders.
• Certain sexually transmitted diseases and infections.

Health history

You can expect that your healthcare provider will have some questions about your health and biological family history to tailor your prenatal care to your needs.

“The more we know about your health and the families’ medical histories on both sides, the better we can care for you and ensure healthy fetal development throughout your pregnancy,” Gaines El-Hunter states. It’s OK if you don’t know all the specifics about diseases and conditions that run in either family. Any information you can provide is helpful.

Your provider might ask questions like:

• What was the first day of your last period?
• Is this your first pregnancy?
• Do you have a history of miscarriages or gynecological issues?
• Do you have a history of serious medical conditions, like lung disease or heart disease?
• Are you aware of any genetic conditions that may affect you or the fetus?
• Do you smoke, vape, drink alcohol in excess or use recreational drugs?
• What medications are you currently taking?
• Have you been experiencing any concerning symptoms?

Pelvic and breast exam

Your provider will ask you to undress privately and put on a hospital gown to prepare for an exam of your breasts and pelvis. For that reason, it might help to wear clothes you can slip out of easily. (It’s a smart idea for your future prenatal appointments, too. Changing into a gown will be pretty standard for your prenatal visits.)

Your provider will check your breasts for any signs of lumps or swelling.

They’ll also perform a pelvic exam to check on the health of your vagina, uterus, ovaries, fallopian tubes and cervix. They also may do a Pap smear or swab your cervix to look for any abnormalities and test for sexually transmitted diseases and infections, like:

• Chlamydia.
• Gonorrhea.
• HIV.
• HPV (human papilloma virus).
• Syphilis.

Transvaginal ultrasound

Depending on how far along you are in your pregnancy, your provider may perform a transvaginal ultrasound during your first prenatal visit. This is a test that uses a kind of “wand” that’s inserted in your vagina. It uses sound waves to project real-time images to a screen.

A transvaginal ultrasound can allow your provider to confirm your pregnancy is progressing in a healthy way and to determine how far along you are in your pregnancy.

If your first prenatal appointment comes later in your pregnancy, around 10 or 12 weeks or later, your provider may use a traditional ultrasound or Doppler to check the fetal heartbeat. Earlier than that, the fetus’ heartbeat will likely be too faint to be detected by those devices.

Due date calculation

Based on the first day of your last period, the ultrasound and other factors, your healthcare provider will calculate your estimated due date.

Normally, your due date is estimated to be 280 days from the first day of your last period. That’s 40 weeks or about 10 months. But if your periods aren’t regular or aren’t 28 days in a cycle, your due date might be different from the standard “280-day rule.”

While your due date is a helpful indication of the timeframe when you can expect to deliver, Gaines El-Hunter explains due dates really aren’t meant to be taken literally.

“A full-term pregnancy lasts between 37 to 42 weeks, so your actual date of delivery can be quite different from your estimated date of delivery.”

A very small number of babies are actually born on their due dates. Think of it more as a guideline for when you might go into labor, not the be-all-end-all due date.

Prenatal care plan

If you’re able, it can be helpful to schedule out future prenatal care visits before leaving your first appointment. That way, they’re marked off in your calendar and you can make any arrangements you need ahead of time.

The schedule of your prenatal care visits will depend on any special circumstances or risk factors you might have. Generally, it’s recommended to have follow-up visits as follows:

• Every four weeks until 28 weeks of pregnancy.
• Every two to three weeks from 28 to 36 weeks of pregnancy.
• Weekly from 36 weeks until delivery.

Questions to ask at your first prenatal appointment

When you meet with your provider, there may be a lot of things on your mind. Gaines El-Hunter recommends writing down any questions as they come up and bringing them with you to your first prenatal visit.

Some common questions to get you started:

• Is it OK to continue taking the medication I’m currently on?
• What kind of prenatal vitamins do you recommend?
• What changes should I make in my diet?
• Is it OK to continue working out (or start a new fitness routine)?
• What are some signs or symptoms I should contact you about right away?

What to expect for your future prenatal appointments

As your pregnancy continues, you’ll visit your healthcare provider regularly to make sure it’s progressing well. During each prenatal care visit, your weight and blood pressure will be taken and a urine sample will be tested. Your provider will measure your uterus to check on the growth of the fetus. They’ll also check the fetal heartbeat, first with a transvaginal ultrasound and later with other, less intrusive devices, like ultrasound or Doppler.

Your provider also may recommend additional tests, depending on your individual conditions or any special needs.

Further in your pregnancy, your office visits will include discussions about labor and delivery. They also may include an internal examination to check your cervix (the lower end of your uterus) for thinning (called effacement) and opening (called dilation).