Next OB Appointment
Even before you get pregnant, it's a good idea to schedule an appointment with your OB/GYN to let him or her know you are trying to conceive, undergo a complete physical, discuss what you can do to prepare your body for pregnancy, how to track your ovulation (if you aren't already) and increase your chances of conceiving.
During the appointment, your doctor will take a complete medical, family, and gynecological history and ask you about any pre-existing conditions you may have, any medications you are currently taking, and your lifestyle and habits. If you smoke, drink alcohol and/or consume illicit drugs, stop immediately. The earlier you break bad habits, the healthier you will be and a better environment you will provide for your baby.
He or she will probably recommend you begin taking a prenatal vitamin as studies have shown that folic acid (one of the primary components of prenatal vitamins) is essential to healthy fetal development in the early weeks of pregnancy.
This is a good time to bring up any questions or concerns you may have about your health or your ability to get pregnant.
As soon as you suspect you're pregnant, schedule an appointment with your doctor or midwife. Even if you've confirmed your suspicion with a home pregnancy test, most offices want to get a blood serum test to confirm the pregnancy. However, you probably won't be scheduled to see your OB until you are about 8 weeks pregnant unless it is a high-risk pregnancy. This is because most problems occur before week 8 and by the time you see your doctor or midwife, your little one will be big enough to be seen during a vaginal ultrasound.
Your doctor or midwife will take a complete medical and family history and discuss any concerns you may have, so make a good list of questions to take with you. This will probably be the longest visit you have with your doctor or midwife (unless you encounter problems along the way). This is also an important opportunity for you to discuss any medications you are taking - prescription or over-the-counter. And if you didn't start taking a prenatal vitamin before getting pregnant, your doctor or midwife will recommend one to you.
At this appointment, your doctor or midwife will also give you a thorough physical, including a pelvic exam. You will also get a Pap smear to test for cervical cancer. Routine blood tests are taken to determine your blood type, Rh factor, and whether you're deficient in iron. You will also be tested for immunity to German measles (rubella) and for sexually transmitted diseases such as syphilis. Depending on your ethnic background and medical history, you may also be tested for sickle-cell anemia, Tay-Sachs disease, and thalassemia. African-Americans, Jews, French-Canadians, and people of Mediterranean descent are most at risk for these illnesses. If you're significantly overweight, have high blood pressure or a family history of diabetes, are an older mother, or previously gave birth to a large baby you will be tested for diabetes. And finally, your doctor or midwife will determine your due date!
This appointment will be much shorter than your first prenatal appointment and will establish the standard set of tests and checkups you will have at virtually every appointment from now on. Your doctor or midwife will examine your abdomen to feel the top of your uterus; measure the size and height of your uterus; take your weight and blood pressure; test your urine for sugar, protein, and signs of infection; examine your extremities for swelling or fluid retention; and check your hemoglobin and hematocrit for anemia. If having blood drawn made you squeamish before getting pregnant, you may be completely desensitized by the time you deliver!
You may have a few new pregnancy symptoms such as nausea and/or vomiting, constipation, itchy skin, and heartburn or indigestion since your first appointment so make sure to discuss these with your doctor or midwife. He or she may also discuss the upcoming window of opportunity for tests such as chorionic villus sampling, amniocentesis, alpha-fetoprotein, and prenatal screening for genetic problemsbased on your family history. Your doctor or midwife will explain how each test is done, what it is used for, and any risks to you or your baby. If there is a reason for you to have a chorionic villus sampling performed, it is usually done before the end of your first trimester.
Although your OB appointments will all be fairly routine and similar during the middle of your pregnancy, you will probably be excited for each appointment just to make sure your baby is doing fine, listen to his or her heartbeat, and ask questions and make plans for your labor and delivery.
If you are interested in creating a birth plan, now would be the time to bring this option up with your doctor or midwife. Find out what he or she considers routine during labor and delivery and if he or she is open to any special ideas you may have, such as having a doula with you during labor and delivery or having a water birth.
You may begin to gain weight more rapidly in these next few weeks as your nausea and fatigue decrease. Your doctor or midwife may choose to do an ultrasound to look for possible birth defects, confirm the number of babies you're carrying, determine the location of your placenta, and to measure the baby to confirm your estimated due date. You can also expect a triple screen test for possible genetic defects.
This appointment will be very much like those in the preceding weeks. Your doctor or midwife will perform all the routine examinations of you and your baby. You may have begun to feel your baby move and kick and your doctor or midwife will ask you to describe how often your baby moves and what it feels like, so make sure to note when you feel these movements (date and time of day), what they feel like (sharp kicks, gentle flutters, etc.), and their intensity. This is good habit to get into early in your pregnancy as your baby's movements are an important tool your doctor or midwife uses to determine your baby's well-being throughout your pregnancy.
Your breasts may be extremely sensitive and may begin leaking colostrum, the nutrient-rich precursor to breastmilk. You may also be feeling some big pains on the sides of your pelvic cavity. These are called round ligament pains and they are not serious (although they may feel it!). They are simply the ligaments on either side of your uterus stretching to accommodate your growing baby. But if you are feeling any pain that causes you concern, don't hesitate to tell your doctor, just to be safe.
You are past the halfway point! Congratulations! The time between your prenatal appointments may seem to fly and the time you spend with your doctor or midwife may do the same. Your appointments may be a little shorter now because your doctor or midwife has a baseline of health on you and your baby and he or she can spot anything out of the normal with relative ease. Unfortunately, recent surveys have shown that the average time a doctor spends with their patient during a prenatal visit is five minutes. Midwives usually spend more time with patients, while the doctor's or midwife's nurse or nurse practitioner spends the most time with the expectant mother. If you feel your doctor or midwife is rushing you don't be shy to speak up and say so. Remember, you are paying them and they should take as much time as necessary to thoroughly answer your questions and address your concerns.
Your doctor or midwife will continue to check your weight, blood pressure, and the size and height of your uterus. In addition to a urinalysis, you will also have a vaginal culture done to screen for beta strep infection. Group B streptococcus (GBS) is a common bacteria found in the vagina. Many women unknowingly carry the GBS bacteria and have no symptoms, yet run the risk of passing it on to their baby during delivery. This will probably not be the last culture of this type you'll have to undergo since you can carry the bacteria one month and not the next. If the test shows you do carry the GBS bacteria, your doctor or midwife will prescribe a round of antibiotics so it is cleared before you deliver your baby.
Congratulations, you have just finished your second trimester and are heading for the finish line! If your doctor or midwife has special concerns about your pregnancy or if you have developed any complications such as gestational diabetes, high blood pressure, or signs of preeclampsia, you may begin to have prenatal appointments every two weeks during months seven and eight. But if you are having a normal pregnancy with no complications, you will continue to see your doctor or midwife once a month until week 30 and then most doctors and midwives will want to see you every two weeks until you deliver.
Now may be the week that your doctor or midwife will take a hard look at your weight gain to make sure you keep on track. Your baby will grow by leaps and bounds over the next several weeks and it is very easy for mom to fall into the same pattern. If you have gained a significant amount of weight already, your doctor or midwife may want to review your diet and may refer you to a nutritionist to help you keep your weight gain under control for the duration of your pregnancy. Your doctor or midwife will most certainly want you to give an assessment of your baby's movements. If there is some reason to believe that baby is not thriving, your doctor or midwife may opt to run a non-stress test (NST). This is most often used when a pregnancy has gone past term but your doctor or midwife can use it at anytime to assess your baby's well-being. The test measures your baby's heartbeat in relation to his or her movements, is risk free and painless for both you and baby, and it can be performed in your doctor's office.
You will begin to be a very regular face around your doctor's or midwife's office as you will probably come in for a check-up every two weeks and then every week after week 34. You will continue to be assessed for weight gain, blood pressure, sugar, infection, and protein in your urine. Your doctor or midwife will continue to monitor your baby's heartbeat with a Doppler, measure the size and height of your uterus and check for swelling and varicose veins in the legs.
Starting this week, your doctor or midwife may ask you start keeping a record of kick counts. The kick count theory is based on the simple idea that an active baby is a healthy baby. You will be asked to keep track of how much time it takes for your baby to produce 10 kicks (the average amount of time for 10 kicks is usually 20 minutes).
This week you will also need to make sure your birth plan (if you've chosen to create one) is on file at the hospital or birthing center where you will deliver, and go over the details with your doctor or midwife (if you haven't already) to discuss any questions or changes.
You are in the home stretch and there is no one more excited or happy to be at the end of your pregnancy than you are. Your body is busy getting ready for labor and delivery and you may begin to feel some Braxton Hicks contractions. Your appointments will be every week now and some may be very short or some may take a bit longer as your doctor or midwife discusses what you should expect between visits and instructs you regarding signs of labor.
In addition to all the physical checks you and your baby have had in the previous weeks, at this appointment your doctor or midwife will feel your uterus to determine the position of your baby, perform an internal exam, and possibly even an ultrasound to confirm the size and position of your baby. You may begin to dilate at anytime and your doctor or midwife will track this indicator to help pinpoint when labor may begin. If you have had a positive Group B strep (GBS) vaginal culture in any past appointments, you will be retested and put on a round of antibiotics if GBS is found again.
If your partner has not yet been able to attend any of your prenatal appointments, now is good time to make this a priority. He will feel more comfortable at the time of delivery if he has met your doctor or midwife before the big day and had an opportunity to ask questions and receive instructions.
The big day is almost here and no one is more excited than you. Your pregnancy has been a most miraculous journey but you are probably ready to kiss your belly and maternity stretch pants goodbye and say hello to your new baby. Your appointments will continue to be weekly and, unless you already have complications or develop any in the next few weeks, your appointment will be short and sweet.
In addition to all the routine physical checks you and your baby have had in the previous weeks, your doctor or midwife will feel your uterus to determine the position of your baby, perform an internal exam, and may do another ultrasound to confirm the size and position of your baby. Your doctor or midwife will want to determine how your baby is presenting (head or buttocks first, facing toward the front or the back) and if the presenting part is engaged? You may begin effacing and dilating at any time now and your doctor or midwife will track this change to help pinpoint when labor may begin. As your due date grows near, it is not a bad idea for your partner accompany you to each prenatal appointment, since (depending on what he or she finds during your examination) your doctor or midwife may decide to send you straight to the hospital!
The end of pregnancy can be difficult for many women, both physically and mentally. You may be uncomfortable, unable to sleep, nervous about labor and delivery, and impatient to meet your baby! Your doctor or midwife will continue to observe the changes in your cervix as your body and your baby prepare for delivery.
Your appointments will continue to be weekly. Your doctor or midwife will give you more instructions regarding signs of early labor and when to notify them or come to the hospital or birthing center. You will undergo all the routine tests and examinations, and your doctor or midwife will make sure that you and your baby are still healthy and thriving. You may have begun to efface and/or dilate and your doctor or midwife will measure these changes to your cervix to help pinpoint when labor may begin. If you have had a positive Group B strep (GBS) vaginal culture in any past appointments, you will be retested and put on a round of antibiotics if necessary.As your due date grows near, it is not a bad idea for your partner accompany you to each prenatal appointment, since (depending on what he or she finds during your examination) your doctor or midwife may decide to send you straight to the hospital!
You have done a great job and you only have a couple more weeks to go (or less!). This appointment will be very similar to your last few appointments, as you will be tested and examined for any infections, symptoms of preeclampsia or signs that your baby is not thriving. Your doctor or midwife will confirm the position of your baby (head or buttocks first, facing to the front or to the back), and if the presenting part is engaged. If your baby is found to be in a breech position (feet or buttocks first) your doctor or midwife may attempt to turn it using external cephalic version (ECV).
You may have already begun to dilate and/or efface and your doctor or midwife will track these changes to help pinpoint when you might go into labor.
Because you are so close to your due date, it is a good idea for your partner to go with you to each prenatal appointment from this point on, since depending on what your doctor or midwife finds during your appointment, they may decide to send you straight to the hospital!
This is it - your due date is sometime in the next seven days! For the most part, this week's appointment will be short and sweet and your doctor or midwife will check your cervix to determine if you've started to efface and/or dilate and by how much. In addition to all the physical checks you and your baby have had in the previous weeks, your doctor or midwife will palpate your uterus to determine the position of your baby, and possibly perform an ultrasound to confirm his or her size and position. Your doctor or midwife will want to determine how your baby is presenting (head or buttocks first, facing to the front or to the back), and if the presenting part is engaged.
Your doctor or midwife will discuss what you can expect in the next few days, signs of labor, and any signs of distress you should watch for. This week is a good time for you to relax and rest up before your big delivery, remember to drink your water, go for walks, and tie up those loose ends while you still have your hands free!
If your due date comes and goes this week and still no baby, your doctor may begin discussing your options. Most doctors will allow a pregnancy to continue a week to 10 days after the due date if both mother and baby are healthy; however, the placenta is a temporary organ and it begins to break down after about 40 weeks. This means that your baby may not be receiving as much oxygen or as many nutrients as he or she needs. If your doctor determines this to be the case, he or she will recommend inducing labor or performing a c-section.