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Your First Prenatal Appointment

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When should I schedule my first prenatal visit? 

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What to expect at your first prenatal appointment

Your kickoff prenatal visit sets the stage for the rest of your pregnancy. Here's what to expect at this information-packed first appointment and how you can prepare.

When to schedule your first prenatal visit

When will your first appointment be, what happens at the first prenatal visit, how to prepare for your first prenatal appointment, what questions to ask at the first prenatal visit.

As soon as you get a positive result on a home pregnancy test , book an appointment with an obstetrician, family physician, or midwife . Depending on the practice, it's normal for another provider in the office, like a nurse practitioner or physician assistant, to handle your first visit.

If you haven't yet chosen a healthcare provider for your pregnancy, that's okay. It's still important to see someone now to start your prenatal care. You can always switch to another provider later. 

Many healthcare providers will schedule your first visit for when you're about 8 weeks pregnant . Some will see you sooner, particularly if you have an existing health condition, had problems with a pregnancy in the past, or are having new or severe symptoms such as vaginal bleeding or abdominal pain .

If you're taking any medications or think you may have been exposed to a hazardous substance, let your provider know as soon as possible.

The first visit will probably be the longest of your prenatal appointments (unless you have complications with your pregnancy along the way). At this and all future visits, don't be afraid to raise any questions or concerns you've been wondering about – it helps to keep a running list between appointments.

Here's what your provider will likely do during your first prenatal visit.

Take your health history. Your provider will ask questions about your gynecological health, personal medical history, and lifestyle habits. Topics commonly covered include:

• Whether your menstrual cycles are regular and how long they tend to last
• The first day of your last period (to determine your due date )
• Symptoms or problems you've noticed since your last period, whether they're related to pregnancy or not
• Current or past gynecological conditions, including sexually transmitted infections
• Details about previous pregnancies
• Current or past diseases and conditions
• Past surgeries or hospitalizations
• Mental health difficulties and diagnoses
• Whether you are being or have been abused , or have another situation that could affect your safety or emotional well-being
• Smoking, drinking, and drug use
• Medications, supplements, vitamins, and herbal drugs you take
• Drug allergies

Your healthcare provider will also ask about your family medical history. Many genetic issues and birth defects are at least partly hereditary, so learning about your family history helps your medical team keep an eye out for potential issues. Let your provider know whether a relative in your or your partner's family has a chromosomal or genetic disorder, had developmental delays, or was born with a structural birth defect.

It's also important to mention any potential exposure to toxins, especially if you live or work near toxic materials.

Check you out and run some tests. You can expect a number of standard exams and tests at your first prenatal visit. Some healthcare providers will do an ultrasound , but if you don't have any medical problems or concerns, it may not be part of the routine. Here's what's typical:

• A thorough physical exam
• A pelvic exam, including a Pap smear (unless you've had one recently) to check for infections such as chlamydia and gonorrhea or abnormal cells that could indicate cervical cancer
• A urine sample to test for urinary tract infections and other conditions

Your provider will also order blood tests to:

• Identify your blood type and Rh status
• Look for anemia
• Check for HIV, syphilis, hepatitis B and, in certain cases, hepatitis C
• Determine immunity to rubella (German measles) and chickenpox

Discuss any high-risk pregnancy concerns. Many people are considered to have high-risk pregnancies , meaning there's a higher-than-average chance of health issues during pregnancy, labor, and birth. High-risk groups include those who:

• Become pregnant for the first time at age 35 or older
• Become pregnant for the first time before age 18
• Have certain medical issues that develop during pregnancy, such as preeclampsia and gestational diabetes
• Have certain preexisting health problems, such as high blood pressure , thyroid disease , or type 1 or type 2 diabetes

High-risk pregnancies need extra care. While many potential complications are treatable or temporary, some can be dangerous to both you and your baby. Your provider will talk through the risks at your first visit and throughout your pregnancy – and don't be afraid to ask questions at any point.

Explain your options for prenatal genetic testing. Your provider will offer you various prenatal screenings that can give you information about your baby's risk for birth defects and chromosomal conditions. These tests include:

• Noninvasive prenatal testing (NIPT) , also called cell-free fetal DNA testing. Performed at 9 weeks or later, it's used to examine the little bits of your baby's DNA present in your blood.
• A first trimester screen, also called a first-trimester combined test. Typically done between weeks 11 and 13, it consists of a blood test and a type of ultrasound called a nuchal translucency .
• A carrier screening if you haven't had one already. It's a simple blood or saliva test done to see whether your baby is at risk for any of 100 genetic disorders such as cystic fibrosis, sickle cell disease, thalassemia, and Tay-Sachs disease.

Finally, if you're high-risk, there are invasive genetic diagnostic tests that can tell you for sure whether your baby has Down syndrome or certain other conditions. These tests include chorionic villus sampling (CVS) , generally performed at 10 to 13 weeks, and amniocentesis , usually done at 16 to 20 weeks.

CVS and amniocentesis are invasive and may carry a small risk of miscarriage , so women who choose to have these procedures are usually those with a higher risk for genetic and chromosomal problems. Some moms-to-be choose to wait for the results of screening tests before deciding whether to have one of these diagnostic tests.

For more information, your provider can refer you to a genetic counselor .

Give you advice and let you know what's ahead. Your healthcare provider will give you information about eating well , foods to avoid , healthy weight gain , and prenatal vitamins . They'll also give you a heads-up about the common discomforts of early pregnancy and let you know which pregnancy symptoms require immediate attention .

Your emotional health is very important. Your provider may screen you for signs of depression during pregnancy . But don't wait to be asked. If you're feeling depressed or anxious, let your provider know so they can refer you to someone who can help.

The dangers of smoking , drinking alcohol, using drugs, and taking certain medications will be a topic of discussion, as well. If you need help quitting smoking or any other substance, your provider can recommend a program or counselor.

Other topics include the do's and don'ts of exercise , travel , and sex during pregnancy ; environmental and occupational hazards that can affect your baby; and how to avoid certain infections, such as toxoplasmosis . Your provider will also discuss recommended vaccinations , like the flu shot and the COVID-19 vaccine .

To help your visit go as smoothly as possible, try taking the following steps.

Review your medical history. Brush up on your health status so you can better answer questions. This includes information about your:

• Overall physical and mental health
• Current and past diseases, conditions and other health issues
• Current medications, including prescriptions, supplements, vitamins and herbal supplements and teas
• Fertility and pregnancy history
• Family medical history
• Partner's medical history

If possible, bring documentation along, such as immunization records or a list of your medications. You may even want to bring a baggie containing the medications themselves.

Take your partner, a family member, or friend. Another person can write down notes, ask questions, and provide emotional support during this information-dense first visit.

Get there on time or a little early. This can be helpful for filling out forms and reviewing your insurance. Make sure to bring your insurance information and cash or a credit card for any necessary co-pays.

Just as your provider will ask you questions at your first prenatal visit, it's a good idea to come prepared with a list of questions for your provider. Ask anything – and don't be shy. Again, try to keep a running list in the weeks before the appointment, so nothing important slips your mind.

Here are some questions to consider if your provider doesn't bring up the topic first.

• How much weight gain is healthy for me? The first prenatal visit is a great opportunity to learn about how your body will change. It's also a good time to ask about nutrition, including which foods to prioritize in your diet.
• What are the foods I should avoid ? Raw fish and unpasteurized cheeses are long-established no-no's for pregnant people, but ask your provider for a full list of what to skip, since the accepted wisdom has changed over the years. Ask about caffeine and alcohol, too. Coffee is typically alright in limited doses, but no amount of alcohol is considered safe when you're having a baby.
• Are prenatal supplements a good choice? Your provider will likely recommend a prenatal vitamin containing folic acid and iron, both of which are needed more during pregnancy.
• Can I exercise? What about sex? With some exceptions, both are usually okay when you're pregnant. They're important to discuss, however, since certain conditions may complicate matters.
• Is it safe to keep working? If you have a physically or emotionally demanding job , you may want to ask how you can ease the effects on your body and mind.
• Is travel okay? While planes, trains, and automobiles are typically safe well into pregnancy, people with particular complications may need to limit or avoid traveling.
• Which medications are safe to take? Ask about your current prescriptions, herbal products, teas, supplements, and any over-the-counter drugs you may use, such as pain relievers and cold medicines. Non-steroidal inflammatory drugs (NSAIDs) like ibuprofen and naproxen are not recommended, for example.
• What are common symptoms of pregnancy? Your provider can tell you what to expect and how to cope. Remember to ask what symptoms are uncommon, too, and what red flags to watch for.
• What should I do in an emergency? Find out who to contact and where to go if you begin to experience new, unusual, severe, or long-lasting symptoms.
• Who will treat me over the course of my pregnancy? If your provider is part of a group practice, you may see other members of the group during appointments. They may even deliver your baby.
• Do you recommend taking prenatal classes? Whether they're in a hospital, at a university, online, or somewhere else, prenatal classes can be invaluable learning experiences for parents-to-be. On top of the usual childbirth classes you hear about, you can also find courses in everything from stress management to good nutrition and even breastfeeding.

Last but not least, ask about your next visit and schedule the appointment before leaving the office. Until your 28th week of pregnancy, you'll likely see someone every four weeks or so.

You may also want to ask whether future visits will be in-person or virtual. Certain practices offer virtual visits for low-risk patients, those whose providers aren't close by, or even higher-risk patients that need to be evaluated more often.

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Prenatal visits: What to expect and how to prepare

What happens at second trimester prenatal appointments

NIPT (Noninvasive prenatal testing)

Chorionic villus sampling (CVS)

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

March of Dimes. 2017. Prenatal Care Checkups.  https://www.marchofdimes.org/pregnancy/prenatal-care-checkups.aspx Opens a new window  [Accessed March 2024]

MedlinePlus. 2022. Prenatal care in your first trimester.  https://medlineplus.gov/ency/patientinstructions/000544.htm Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Prenatal care: 1 st  trimester visits.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044882 Opens a new window  [Accessed March 2024]

American Pregnancy Association. (2021). Your First Prenatal Visit.  https://americanpregnancy.org/healthy-pregnancy/planning/first-prenatal-visit/ Opens a new window  [Accessed March 2024]

Kids Health. 2022. Prenatal Visits: First Trimester.  https://kidshealth.org/en/parents/tests-first-trimester.html Opens a new window  [Accessed March 2024]

Mount Sinai. 2021. Prenatal care in your first trimester.  https://www.mountsinai.org/health-library/selfcare-instructions/prenatal-care-in-your-first-trimester Opens a new window  [Accessed January 2024]

Centers for Disease Control and Prevention. 2022. Recommended Clinician Timeline for Screening for Syphilis, HIV, HBV, HCV, Chlamydia, and Gonorrhea.  https://www.cdc.gov/nchhstp/pregnancy/screening/clinician-timeline.html Opens a new window  [Accessed March 2024]

Alabama Perinatal Excellence Collaborative. 2015. APEC Guidelines for Routine Prenatal Care.  http://apecguidelines.org/wp-content/uploads/2016/07/Routine-Prenatal-Care-6-30-2015.pdf Opens a new window  [Accessed March 2024]

Kids Health. 2019. Toxoplasmosis.  https://kidshealth.org/en/parents/toxoplasmosis.html Opens a new window  [Accessed March 2024]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2017. What is a high-risk pregnancy?  https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/high-risk Opens a new window  [Accessed March 2024]

Kids Health. 2022. What's a “High-Risk” Pregnancy?  https://kidshealth.org/en/parents/high-risk.html Opens a new window  [Accessed March 2024]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2018. What are some factors that make a pregnancy high risk?  https://www.nichd.nih.gov/health/topics/high-risk/conditioninfo/factors Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Prenatal Tests.  https://www.marchofdimes.org/pregnancy/prenatal-tests.aspx Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2022. Carrier Screening.  https://www.acog.org/womens-health/faqs/carrier-screening Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Chorionic Villus Sampling.  https://www.marchofdimes.org/pregnancy/chorionic-villus-sampling.aspx Opens a new window  [Accessed March 2024]

Office on Women's Health. 2021. Prenatal care and tests.  https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests Opens a new window  [Accessed March 2024]

MedlinePlus. 2021. What is noninvasive prenatal testing (NIPT) and what disorders can it screen for?  https://medlineplus.gov/genetics/understanding/testing/nipt/ Opens a new window  [Accessed March 2024]

Voyage Healthcare. 2021. Prenatal Care Overview.  https://www.voyagehealthcare.com/how-to-make-the-most-of-your-first-prenatal-visit-guide Opens a new window  [Accessed March 2024]

Gifford Health Care. Undated. Preparing for Your Appointment.  https://giffordhealthcare.org/patients/preparing-for-your-appointment/ Opens a new window  [Accessed March 2024]

Mayo Clinic. 2023. Pregnancy nutrition: Foods to avoid during pregnancy.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20043844 Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2023. Nutrition During Pregnancy.  https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Prenatal vitamins: Why they matter, how to choose.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-vitamins/art-20046945 Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2022. Exercise During Pregnancy.  https://www.acog.org/womens-health/faqs/exercise-during-pregnancy Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Sex during pregnancy: What's OK, what's not.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/sex-during-pregnancy/art-20045318 Opens a new window  [Accessed March 2024]

Kids Health. 2022. Sex During Pregnancy.  https://kidshealth.org/en/parents/sex-pregnancy.html Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2023. Travel During Pregnancy.  https://www.acog.org/womens-health/faqs/travel-during-pregnancy Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Over-the-counter medicine, supplements and herbal products during pregnancy.  https://www.marchofdimes.org/pregnancy/over-the-counter-medicine-supplements-and-herbal-products.aspx Opens a new window  [Accessed March 2024]

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Prenatal care: 1st trimester visits

Pregnancy and prenatal care go hand in hand. During the first trimester, prenatal care includes blood tests, a physical exam, conversations about lifestyle and more.

Prenatal care is an important part of a healthy pregnancy. Whether you choose a family physician, obstetrician, midwife or group prenatal care, here's what to expect during the first few prenatal appointments.

The 1st visit

When you find out you're pregnant, make your first prenatal appointment. Set aside time for the first visit to go over your medical history and talk about any risk factors for pregnancy problems that you may have.

Medical history

Your health care provider might ask about:

• Your menstrual cycle, gynecological history and any past pregnancies
• Your personal and family medical history
• Exposure to anything that could be toxic
• Medications you take, including prescription and over-the-counter medications, vitamins or supplements
• Your lifestyle, including your use of tobacco, alcohol, caffeine and recreational drugs
• Travel to areas where malaria, tuberculosis, Zika virus, mpox — also called monkeypox — or other infectious diseases are common

Share information about sensitive issues, such as domestic abuse or past drug use, too. This will help your health care provider take the best care of you — and your baby.

Your due date is not a prediction of when you will have your baby. It's simply the date that you will be 40 weeks pregnant. Few people give birth on their due dates. Still, establishing your due date — or estimated date of delivery — is important. It allows your health care provider to monitor your baby's growth and the progress of your pregnancy. Your due date also helps with scheduling tests and procedures, so they are done at the right time.

To estimate your due date, your health care provider will use the date your last period started, add seven days and count back three months. The due date will be about 40 weeks from the first day of your last period. Your health care provider can use a fetal ultrasound to help confirm the date. Typically, if the due date calculated with your last period and the due date calculated with an early ultrasound differ by more than seven days, the ultrasound is used to set the due date.

Physical exam

To find out how much weight you need to gain for a healthy pregnancy, your health care provider will measure your weight and height and calculate your body mass index.

Your health care provider might do a physical exam, including a breast exam and a pelvic exam. You might need a Pap test, depending on how long it's been since your last Pap test. Depending on your situation, you may need exams of your heart, lungs and thyroid.

At your first prenatal visit, blood tests might be done to:

• Check your blood type. This includes your Rh status. Rh factor is an inherited trait that refers to a protein found on the surface of red blood cells. Your pregnancy might need special care if you're Rh negative and your baby's father is Rh positive.
• Measure your hemoglobin. Hemoglobin is an iron-rich protein found in red blood cells that allows the cells to carry oxygen from your lungs to other parts of your body. Hemoglobin also carries carbon dioxide from other parts of your body to your lungs so that it can be exhaled. Low hemoglobin or a low level of red blood cells is a sign of anemia. Anemia can make you feel very tired, and it may affect your pregnancy.
• Check immunity to certain infections. This typically includes rubella and chickenpox (varicella) — unless proof of vaccination or natural immunity is documented in your medical history.
• Detect exposure to other infections. Your health care provider will suggest blood tests to detect infections such as hepatitis B, syphilis, gonorrhea, chlamydia and HIV , the virus that causes AIDS . A urine sample might also be tested for signs of a bladder or urinary tract infection.

Tests for fetal concerns

Prenatal tests can provide valuable information about your baby's health. Your health care provider will typically offer a variety of prenatal genetic screening tests. They may include ultrasound or blood tests to check for certain fetal genetic problems, such as Down syndrome.

Lifestyle issues

Your health care provider might discuss the importance of nutrition and prenatal vitamins. Ask about exercise, sex, dental care, vaccinations and travel during pregnancy, as well as other lifestyle issues. You might also talk about your work environment and the use of medications during pregnancy. If you smoke, ask your health care provider for suggestions to help you quit.

Discomforts of pregnancy

You might notice changes in your body early in your pregnancy. Your breasts might be tender and swollen. Nausea with or without vomiting (morning sickness) is also common. Talk to your health care provider if your morning sickness is severe.

Other 1st trimester visits

Your next prenatal visits — often scheduled about every four weeks during the first trimester — might be shorter than the first. Near the end of the first trimester — by about 12 to 14 weeks of pregnancy — you might be able to hear your baby's heartbeat with a small device, called a Doppler, that bounces sound waves off your baby's heart. Your health care provider may offer a first trimester ultrasound, too.

Your prenatal appointments are an ideal time to discuss questions you have. During your first visit, find out how to reach your health care team between appointments in case concerns come up. Knowing help is available can offer peace of mind.

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• Lockwood CJ, et al. Prenatal care: Initial assessment. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• Prenatal care and tests. Office on Women's Health. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests. Accessed July 9, 2018.
• Cunningham FG, et al., eds. Prenatal care. In: Williams Obstetrics. 25th ed. New York, N.Y.: McGraw-Hill Education; 2018. https://www.accessmedicine.mhmedical.com. Accessed July 9, 2018.
• Lockwood CJ, et al. Prenatal care: Second and third trimesters. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization. http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/. Accessed July 9, 2018.
• Bastian LA, et al. Clinical manifestations and early diagnosis of pregnancy. https://www.uptodate.com/contents/search. Accessed July 9, 2018.

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by HealthPartners

Preparation is a big part of pregnancy. Whether you’ve just gotten your positive pregnancy test or are still waiting on it, there are probably a few things that you know you’re going to do next. You might have a list of articles or books to read about what to expect, and you may be wondering about when to schedule your first pregnancy appointment.

In the weeks following conception, your doctor or midwife and the rest of your care team will start seeing you for prenatal appointments. These appointments allow your care team to check in on you and your baby to make sure you’re both healthy and on track.

Below, we provide a sample pregnancy timeline with prenatal appointments, common tests and a few key milestones, so you can get an idea of how often you’ll see your care provider throughout your pregnancy and what may happen at each prenatal appointment.

How often are prenatal visits?

For people with uncomplicated pregnancies, prenatal appointments generally happen every four weeks until approximately week 36 of pregnancy. The next visit is usually around week 38, and then once per week until birth.

However, every pregnancy is different, and different health care providers stick to different schedules. At HealthPartners, for example, our patients have freedom in how they schedule their appointments. The timeline provided below is just one recommendation and is based on the schedule that people typically follow.

The appointment timeline for high-risk pregnancies

You may be asked to come in for prenatal appointments more frequently if your pregnancy is considered high risk. This is because your care team will want to make sure they’re giving you all the care you need. Factors that make a high-risk pregnancy include having multiples, being over age 35 or having a health condition (like diabetes or high blood pressure) that could affect or be affected by your pregnancy.

There are also complications that may show up after you become pregnant, like pregnancy-related high blood pressure, which can require more frequent visits.

Pregnancy appointments timeline example

Visit #1: 6-10 weeks, visit #2: 10-12 weeks, visit #3: 16-18 weeks, visit #4: 20-22 weeks, visit #5: 24-28 weeks, visit #6: 32 weeks, visit #7: 36 weeks, visits #8-10: 38-40 weeks.

Your first prenatal appointment will be a bit longer than the rest, as it will involve a wide range of tests and exams to assess your overall health, establish baseline measurements and look for factors that could complicate your pregnancy. This appointment will cover:

Your medical and lifestyle histories

Your health care provider may ask about a variety of topics, including your mental health , any medications and supplements you’re taking, your menstrual history, and your use of tobacco, alcohol and other drugs.

Your (estimated) due date

If you know the date that your last period started, you don’t have to wait for a care provider to calculate roughly when you’ll deliver. Simply add seven days and count back three months to find out when you’ll be 40 weeks pregnant. For example, if your last period started on January 1, you’d count back three months from January 8, and get an estimated due date of October 8.

If you aren’t sure about the date of your last period, your doctor or midwife may suggest a fetal “dating” ultrasound to find out. It’s unlikely that you’ll actually give birth on your due date, but it helps your care team track the progress of your pregnancy.

A physical exam

You may receive a full physical exam, which includes checking your weight and height, as well as pelvic and breast exams. If you’re healthy and haven’t had one in three years, you may also get a Pap test.

Samples of your urine and blood will be taken for testing. Urine tests check for infections, which can cause issues during pregnancy even if you don’t have any symptoms.

With the blood tests, your provider will check your red blood cell count, which shows if you have anemia, and your platelet count, which shows if you have trouble with blood clotting. They’ll also check your blood for its type and Rhesus (Rh) factor, which could be an issue in the future. But having this information early in the pregnancy means that your care team can use medication to prevent most problems.

Your samples will also be examined to make sure that you’re up to date on your measles, mumps, rubella and other immunizations if your vaccination record isn’t available.

After your first appointment, your prenatal visits will start to fall into a pattern. At every visit, your care team will ask about how you’re feeling and check a few key things: the growth of your baby and uterus, your weight and your blood pressure. And starting around 10-12 weeks into your pregnancy, you’ll get to hear your little one’s heartbeat.

This will be another routine appointment. Your care team will take measurements like they did at your last visit and check in with you about how you’re feeling.

Remember that every visit is an opportunity to ask any questions you have – whether they’re about what foods you can eat while you're pregnant , which exercises are safe during pregnancy , or creating a birth plan . Your care team is there to help you feel confident and healthy throughout your pregnancy, so never hesitate to ask whatever comes to mind. It also helps to keep a list of questions that may arise during the time between appointments.

At this visit, you’ll have another ultrasound – referred to as the “anatomy scan.” This ultrasound is used to measure your baby’s body, and check the condition of their organs and the amount of amniotic fluid around them. It also checks for rare conditions such as spina bifida or cleft lip. This is your chance to finally find out your little one’s biological gender.

Once you’re near the end of your second trimester or beginning of your third trimester , your care team will repeat some of the tests that were done at your first visit. They’ll check for signs of Treponema bacteria (which are the cause of many sexually transmitted infections) and may do a blood test to check for anemia (to see if you need more iron). They may also perform a glucose test to check for signs of gestational diabetes .

This is also a good time to find a doctor for your baby . You’ll have a full plate once your baby is born, so finding their doctor now will ensure that you have one less thing to think about later on.

This will be another routine appointment. Your care team will take the usual measurements and check in with you about how you’re feeling.

As you approach your due date, there will be a new test that involves a vaginal swab: The Group B Streptococcus (Strep) screening. Group B Strep bacteria naturally come and go in your body, but they have the potential to cause serious infections in newborns. If necessary, you’ll be given antibiotics during labor.

At around 36 weeks, your doctor or midwife may also do another pelvic exam to check your baby’s position. If your baby isn’t positioned for a head-first delivery, they may recommend exercises or physical manipulation to get the baby into the correct position. If it doesn’t look like it will be possible to get your baby into a head-first position, your care provider will discuss the possibility of a C-section with you.

By week 38, the big day will be close enough that your care team will start keeping closer track of your progress. Again, each pregnancy is different, but from this point on, you may have a prenatal appointment every week until you deliver.

These visits will feel similar to the routine prenatal appointments you’re used to. Your care team will measure your weight and blood pressure, as well as monitor your baby’s size, heartbeat and position. The main difference is that your doctor or midwife may also check to see if your cervix is dilating, which can happen gradually as your baby lowers into your pelvic area – and in some cases can be an early sign of labor .

Additional testing

Again, this is an example timeline and doesn’t reflect all the appointments and tests that every pregnant person will have. In addition to the unique frequency of your prenatal appointments, you may be offered optional tests. Early in your pregnancy, for example, there are several options available that check for chromosomal issues in your baby. Talk to your care provider to learn more.

You may also have a few more appointments and tests done if your pregnancy lasts beyond week 40. In this case, your care team will want to keep even closer track of you and your baby’s progress.

Get your prenatal care started

Prenatal appointments are key to the care and treatment of people during pregnancy. The checkups and testing done at each visit are how your care team will ensure that you and your baby get the support you need at every stage. Whatever makes your pregnancy unique, you can be sure that when the big day rolls around, you’ll be ready.

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The Ultimate Pregnancy Appointment Guide: What to Expect Week by Week at Your Prenatal Visits

Central to ensuring the health and well-being of you and your growing baby is seeing your care team regularly for touchpoints and milestones that are part of your pregnancy appointment schedule. Diana Kaufman, MD , UnityPoint Health, shares the recommended timeline for prenatal visits, and the importance of each test and discussion that’ll prepare you for a safe pregnancy and delivery.

Confirming Your Pregnancy

Every woman’s body is unique, but it’s a good idea to visit a doctor to confirm a pregnancy when you’re experiencing early symptoms, such as a missed period or you’ve received a positive home pregnancy test. Typically, this visit happens at 6-8 weeks of pregnancy.

Your doctor may confirm your pregnancy through urine tests, blood tests or ultrasounds.

Initial Prenatal Appointment: 5-12 Weeks

Your first prenatal visit consists of important screenings and discussions, so your healthcare team can create a care plan that ensures you and baby stay healthy throughout your pregnancy. Prepare a few things for this visit, including:

• Complete medical history: It’s important for your doctor to know your past and present health conditions or concerns, medications and any history of disease, substance abuse or known genetic conditions in your family.
• Insurance information: This includes consents for care, your insurance carrier and other paperwork

Here’s what to expect at your first pregnancy appointment

• A physical, which will likely include a breast and pelvic exam.
• A urine sample is collected to check for certain infections and conditions that can occur during pregnancy. Urine tests may be taken at your following prenatal visits as well. Urine drug screening tests are also recommended for women, or their partners, with a history of substance use — including smoking.
• Routine testing that includes blood draws to check your blood type and complete blood count (CBC) and look for specific diseases including hepatitis, HIV, syphilis and checking for immunity against rubella. Other testing that may occur includes genetic screening and testing for diabetes.

Your care team will review prenatal educational materials with you and remedies for any unpleasant pregnancy symptoms, such as nausea or vomiting . Your team also will provide an estimated due date for baby.

It’s also important to take good care of your teeth and gums during pregnancy. Changing hormone levels make your gums more sensitive to disease, which increases your risk for a low-birth weight or premature baby. Consider making an appointment to see your dentist during your first trimester.

Prenatal Appointment: Second Trimester (13 – 26 Weeks)

During weeks 13-26, you’ll see your doctor every four weeks. It’s a good idea to write down questions or concerns before your appointments to ensure they’re addressed.

At each appointment throughout the rest of your pregnancy, your care team will check the following:

• Blood pressure
• Position of baby
• Baby’s heartbeat

Here are some additional things to expect.

• Prenatal genetic testing: There are many different options for prenatal genetic testing. Your care team will review these with you.
• Pregnancy blood tests: These are tailored to your specific needs. Most patients are tested for anemia and diabetes of pregnancy between weeks 24-28. Other recommended tests will be reviewed with you.
• Ultrasound: It’s common to have an ultrasound in the first trimester to confirm the estimated due date. Ultrasound is also common at 20 weeks to check on baby's growth and development. Further ultrasounds could be needed if changes in your pregnancy make it necessary, such as concerns about baby’s growth or to see if baby is head down.
• Discuss preterm labor signs: Preterm labor refers to labor that begins before the 37th week of pregnancy and requires medical attention. Knowing what to look for — such as contractions, changes in vaginal discharge  — is important for preventing potential complications.
• Childbirth classes: It’s a good idea to register for a class  to help you prepare for baby’s arrival.

When to Call Your Doctor

Pregnancy creates new and unfamiliar symptoms in many women. However, some symptoms need attention. Here’s when to call your doctor in the second trimester:

• Vaginal bleeding, even a small amount
• Leg pain with numbness or leg weakness
• Pain or tenderness in one of both calves that doesn’t go away
• Thoughts of hurting yourself or others
• Severe headaches that don’t go away with Tylenol
• Persistent changes in vision such as blurriness or floaters
• More than five contractions in an hour

Now, your visits to your care team become more frequent — happening every two weeks until you’re 36 weeks pregnant. Your care team continues to monitor you and baby. Here’s what else to expect:

Prenatal Appointments: Third Trimester (27 Weeks – Baby’s Arrival)

• Check fetal movement: It’s important to be aware of your baby's movements. If you notice a sudden change or absence of fetal movement, let you care team know.
• Rhogam injections: If an Rh-negative blood type was found during your initial prenatal visit, you’ll receive an injection to prevent immune system complications for future pregnancies. This usually happens at 28 weeks.
• Additional prenatal testing: Around 35-37 weeks, you’re checked to see if you carry group B streptococcus bacteria . This is one of many bacteria that can live on our skin and typically does not cause problems. However, it can infect a newborn when you deliver. Antibiotics are given during delivery to prevent infection in a newborn if you test positive.

Prenatal Appointments: 36 Weeks – End of Pregnancy

Once you’ve reached 36 weeks, you’ll see your doctor every week until you deliver. These visits are essential for ensuring the well-being of both you and your little one, as well as preparing for a safe and smooth delivery. In addition to routine physical examinations and checking baby’s heartbeat and movement, here’s what else you can expect:

• Cervical exams: If you’re having frequent contractions or preparing to be induced, your doctor will likely need to perform this exam.
• Discuss labor signs: You’ll likely discuss signs of labor with your doctor and when to go to the hospital.
• Discuss birth preferences: It’s not necessary to have a birth plan. Your care team has that covered. Our goal is to keep you and your baby healthy throughout the entire pregnancy and delivery process. However, if you have strong desires or needs for delivery, please discuss those during a prenatal appointment. It’s also helpful to write these things down and bring them to the hospital, since you may not be able to fully express your wishes during labor.

Postpartum Visits

After delivering baby, but before you leave the hospital, call your doctor to make your postpartum appointment, if it hasn’t been scheduled yet. This visit typically occurs around 6 weeks after you deliver. Other visits are scheduled based on your individual needs.

These visits are a time for your doctor to check on your healing , discuss normal or abnormal postpartum bleeding, talk about your well-being and any signs of postpartum depression or anxiety , discuss when it’s safe to start exercising again and address other questions or concerns you may have .

Our UnityPoint Health care team is here to care for you and baby throughout the entirety of your pregnancy and beyond. Call us  to schedule your first appointment or if you have questions about any future appointments.

More Maternity Content

Group B Strep in Pregnancy: Understanding Risks, Testing and Treatment

Second Time Mom Gets Wish of Vaginal Birth After C-Section

An OBGYN Answers 17 Questions to Help You Prepare for Postpartum

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Your First Prenatal Visit

If you did not meet with your health care provider before you were pregnant, your first prenatal visit will generally be around 8 weeks after your LMP (last menstrual period ). If this applies to you, you should schedule a prenatal visit as soon as you know you are pregnant!

Even if you are not a first-time mother, prenatal visits are still important since every pregnancy is different. This initial visit will probably be one of the longest. It will be helpful if you arrive prepared with vital dates and information. This is also a good opportunity to bring a list of questions that you and your partner have about your pregnancy, prenatal care, and birth options.

What to Expect at Your First Pregnancy Appointment

Your doctor will ask for your medical history, including:.

• Medical and/or psychosocial problems
• Blood pressure, height, and weight
• Breast and cervical exam
• Date of your last menstrual period (an accurate LMP is helpful when determining gestational age and due date)
• Birth control methods
• History of abortions and/or miscarriages
• Hospitalizations
• Medications you are taking
• Medication allergies
• Your family’s medical history

Your healthcare provider will also perform a physical exam which will include a pap smear , cervical cultures, and possibly an ultrasound if there is a question about how far along you are or if you are experiencing any bleeding or cramping .

Blood will be drawn and several laboratory tests will also be done, including:

• Hemoglobin/ hematocrit
• Rh Factor and blood type (if Rh negative, rescreen at 26-28 weeks)
• Rubella screen
• Varicella or history of chickenpox, rubella, and hepatitis vaccine
• Cystic Fibrosis screen
• Hepatitis B surface antigen
• Tay Sach’s screen
• Sickle Cell prep screen
• Hemoglobin levels
• Hematocrit levels
• Specific tests depending on the patient, such as testing for tuberculosis and Hepatitis C

Your healthcare provider will probably want to discuss:

• Recommendations concerning dental care , cats, raw meat, fish, and gardening
• Fevers and medications
• Environmental hazards
• Travel limitations
• Miscarriage precautions
• Prenatal vitamins , supplements, herbs
• Diet , exercise , nutrition , weight gain
• Physician/ midwife rotation in the office

Possible questions to ask your provider during your prenatal appointment:

• Is there a nurse line that I can call if I have questions?
• If I experience bleeding or cramping, do I call you or your nurse?
• What do you consider an emergency?
• Will I need to change my habits regarding sex, exercise, nutrition?
• When will my next prenatal visit be scheduled?
• What type of testing do you recommend and when are they to be done? (In case you want to do research the tests to decide if you want them or not.)

If you have not yet discussed labor and delivery issues with your doctor, this is a good time. This helps reduce the chance of surprises when labor arrives. Some questions to ask include:

• What are your thoughts about natural childbirth ?
• What situations would warrant a Cesarean ?
• What situations would warrant an episiotomy ?
• How long past my expected due date will I be allowed to go before intervening?
• What is your policy on labor induction?

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Your first prenatal appointment: What to expect

The first prenatal visit is one of the longest appointments a woman will have during pregnancy, with several tests and a lot of important information conveyed..

During pregnancy, you need regular prenatal visits to keep yourself and the pregnancy healthy. These visits are called prenatal care appointments. In these visits, you might meet with an OB/Gyn, a midwife or a nurse practitioner.

During pregnancy, you'll meet with your prenatal care provider every four weeks until you are about 28 weeks (7 months) pregnant. After that, you'll come every two weeks. Then, in your last month of pregnancy, we'll want to see you weekly.

Your first appointment will likely be the longest of the many prenatal visits to come. At that visit, we will discuss your overall health, answer your first round of questions and help you prepare for the next nine months.

Most women make an appointment after they get a positive result from a home pregnancy test. Often, this is one or two weeks after a missed period. Call us at 505-272-2245 , and we will schedule your first prenatal appointment between six and eight weeks of pregnancy.

What to Expect

Confirming the pregnancy.

Sometimes, home pregnancy tests give false positives—it says you are pregnant, but you aren't. And unfortunately, approximately one in four pregnancies ends in miscarriage , often early in pregnancy. Before we do any other tests, we'll first confirm your pregnancy with a urine test and blood draw.

Estimating Your Due Date

We’ll also ask about your periods:

• How old you were when they started
• How regular they are
• When your last period started

This information helps us estimate your due date—when we expect the baby to come. The due date is approximately nine months from the first day of your last period.

We’ll also discuss whether you want to continue with the pregnancy. Nearly half of all pregnancies in the U.S. are unplanned. It’s OK to not immediately know how you feel about being pregnant, or what you want to do. At your first prenatal visit, we  can talk you through your options . We will support you in whatever you decide.  

Personal and Family Medical History

Be prepared to discuss your personal and family medical history. This information helps us determine whether the embryo might be at risk for health problems.

Some of the topics we'll discuss include:

• Alcohol, tobacco and caffeine use
• Chronic conditions, such as diabetes and high blood pressure
• Exposure to potentially toxic substances
• Genetic disorders
• Medications, including supplements and over-the-counter drugs
• Past surgeries
• Pregnancy complications
• Travel to countries where infectious diseases—such as Zika virus or malaria—are common

At your first visit, we'll also discuss social concerns, such as whether you feel safe at home and at work. Your employer is required to give you accommodations if your job is unsafe for pregnancy. If you don’t feel safe, we can discuss options to manage that situation.

You’ll also get a battery of tests to examine the health of you and your baby. These can include blood and urine tests to look for:

• Blood type and Rh status to determine if you are Rh negative, which can affect the pregnancy
• Glucose levels
• Immunity to measles and chickenpox
• Infections such as rubella, hepatitis B and C, syphilis and HIV
• Urinary tract infections, gonorrhea and chlamydia

Depending on your age and health history, your may also be offered an optional blood test called noninvasive prenatal testing (NIPT) . This screening can be done as early as nine weeks and can determine whether the embryo may be at risk for genetic conditions such as:

• Down syndrome (trisomy 21)
• Edward’s syndrome (trisomy 18)
• Patau syndrome (trisomy 13)

Physical Exam

We’ll check your vitals such as blood pressure and calculate your body mass index to determine how much weight you should gain during pregnancy. We’ll also do a head-to-toe physical exam that may include a breast exam, pelvic exam and screenings of your heart, lungs and thyroid. If you’re due for a Pap smear to check for cervical cancer, we can also do that test at the first visit. We may also try to find out how big your uterus is and if this corresponds to how many weeks pregnant you think you are. We can usually hear fetal heart tones with a doppler after 10 weeks.

Getting an ultrasound at your first prenatal appointment is not required. But we do them more often than not. The ultrasound helps narrow down your due date and confirms that the pregnancy is in the uterus. We also may be able to hear the heartbeat at this time and see if you’re having than one baby.

However, if you’re hoping to learn whether you’re having a boy or girl, you'll have to wait a bit longer! The baby won't be that apparent on ultrasound until approximately 20 weeks.

Education and Resources

Education is a big part of prenatal care. All patients who deliver at UNM Hospital get access to:

• Managing pregnancy symptoms: Some early pregnancy body changes are weird, but normal. These include tender, swollen breasts, fatigue or nausea and vomiting. We can discuss how to manage these symptoms and when to see your doctor.
• Prenatal vitamins: It’s important to take prenatal vitamins with folic acid to prevent neural tube defects and walk you through some foods to avoid—such as alcohol, unpasteurized cheeses, deli meats, and raw fish. We also can suggest exercises that are safe to do during pregnancy .
• Drug and alcohol support: During pregnancy, it's important to quit drinking, smoking and using drugs. If you need help to quit, we can recommend pregnancy-safe medications and options. For example, our Milagro Clinic is designed specifically to give pregnant patients safe, respectful addiction care.
• Prenatal classes: From new parent classes to childbirth classes , we offer a range of in-person and Zoom classes to help you prepare for parenting.
• Financial assistance: There are financial programs at UNM Hospital and in the community to help families with no or limited health insurance.
• Home visits: We can connect you to programs for first time moms that offer home visits at no charge to families with new babies. At these visits, we'll answer your questions and help troubleshoot feeding concerns.

Your first prenatal appointment might seem a bit overwhelming. But we are here for you. We will give you all the information you need to have a healthy pregnancy. And we’ll be by your side, all the way.

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Pregnancy · July 8, 2023

First Prenatal Visit: What to Expect and How to Prepare

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Congrats on your pregnancy, mama! Did you already schedule your first prenatal visit?!

I know the wait between a positive pregnancy test and your first prenatal visit can feel like foreveeer …

And a bit surreal too.

Then you FINALLY get to go to your first prenatal appointment and BAM— the reality of your pregnancy really hits you!

After all, that’s when your pregnancy will be confirmed!

But in the meantime, while you’re waiting, you may be thinking a lot about your first pregnancy appointment.

What should I expect? How do I prepare? What should I wear? What questions should I ask?

So to shed some light on what may be the longest prenatal appointment you’ll ever have, let’s get into your first prenatal visit: what to expect and how to prepare !

In this post

When to make your first prenatal appointment

Before you call to make a prenatal appointment, make sure you have this info ready:, an example of what to say when scheduling your first prenatal appointment:, urine sample, confirmation of your pregnancy, calculation of your estimated due date, blood pressure check, weight check, review of you and your family’s medical history, surgical history, reproductive history, gynecological history, medication history, review of previous or current substance use, review of lifestyle habits, review of social and mental health history, assessment for domestic violence, full physical exam including pelvic exam and pap smear, fetal heart check, schedule next prenatal appointment, what is the normal schedule of routine prenatal care, how to prepare for your first prenatal visit, what questions to ask at your first prenatal visit, 7 tips and hacks to help you make the most of your prenatal appointments, now you’re totally ready for your first prenatal visit.

So when should you make your first prenatal appointment?

My BEST answer is to call to schedule a prenatal appointment as soon as you get a big fat positive (BFP) on your pregnancy test .

Even though you won’t get seen until you’re about about 8-10 weeks pregnant.

Why? Because prenatal appointments are booked pretty quickly. And the longer you wait, the further into the future your first prenatal appointment will be scheduled.

It’s bad enough that waiting for your first prenatal visit can feel like an eternity. So spare yourself those extra days (or weeks) of anxious waiting…

And call, like right now, if you haven’t already.

What to say when scheduling your first prenatal visit

I totally get it. This may be your first pregnancy, you might be nervous, shy or have social anxiety. It’s possible you never made a call to schedule an appointment before.

So I’m going to give you a script of what to say when scheduling your first prenatal appointment!

But before doing that, I want to give you some tips on how to prepare for the call. This is REALLY important!

• Name and date of birth (DOB): Yep, have your name and DOB ready LOL. Trust me, nervousness can make you forget your name, age, DOB, the reason why you’re calling in the first place, etc.
• First day of your LMP: They might ask, so they can get an idea of how far along you are in your pregnancy.
• Insurance cards: You’ll most likely be asked to provide your insurance name (e.g., Aetna) and your policy number (i.e., member ID number). Remember to ask about any co-payments!
• Your (& maybe your partner’s) schedule: Know when you’ll be free to make it to your appointment. You might be asked if you prefer an AM/PM time slot. If your partner is going, make sure you know his schedule and when he might be available to go with you.
• Calendar: Have a calendar in front of you. You can check your phone’s calendar, but you’ll have to put the call on speaker. So it might be better to have a physical calendar. This will help you see the day (e.g., Monday) a prospective appointment falls on and make it easier for you to schedule your appointment.
• Pen and paper/notebook: Have this in hand to write down any info you might be given (e.g., date, time, what you’re required to bring to your first appointment, any other specific instructions, etc.). I absolutely LOVE using pocket planners/calendars (like this ) to keep my scheduled appointments and other info all in one place. They usually have a notes section for you to write down any questions you may have .

Seriously, all of this preparation is 100% WORTHWHILE!

Okay, so now that you know how to prep for the call, here is…

“Hi, good [morning, afternoon]. My name is [your name]. I just found out I’m pregnant, so I’m calling to schedule my first prenatal appointment. Are you accepting new patients and do you take [name of your health insurance] insurance?”

Filled out version of the example above:

“Hi good morning. My name is Olivia Williams. I just found out I’m pregnant, so I’m calling to schedule my first prenatal appointment. Are you accepting new patients and do you take Aetna insurance?”

Note: If new patients are being accepted, the receptionist will ask for your name, DOB and health insurance information to register you into their system and set up your appointment.

What to expect at your first prenatal visit

Here is a quick glance at what to expect at your first pregnancy appointment:

• Review of previous and current substance use

Here’s a deeper look at what to expect at your first prenatal appointment:

One of the first things you’ll be asked to do is go to the bathroom to collect a urine sample.

You’ll be given a specimen bag with a specimen cup and a few packs of pre-moistened wipes to clean yourself beforehand.

Make sure to clean front to back and it’s better to collect a midstream catch (i.e., pee a little bit into the toilet then fill the cup with the rest of your urine).

If the outside of the cup gets soaked with pee, don’t panic. Just use some tissue to wipe the OUTSIDE of the cup dry and make sure you secure the top before placing into the specimen bag.

Give it to the nurse, or drop it off at the place you were directed to leave it.

Your urine will be checked for excess protein, sugar and other substances that may indicate an infection or pregnancy complication such as gestational diabetes.

Even though you got a positive home pregnancy test, your pregnancy still has to be confirmed at your first prenatal appointment.

They have to do their own pregnancy test so they can enter it into their system.

The urine sample you provided can be used to confirm your pregnancy, but it can also be confirmed with a blood test and/or ultrasound.

They will ask you for the first day of your last menstrual period. This helps them to give you an estimated due date by calculating 40 weeks from that date.

Don’t worry if you can’t remember the date of your LMP because an ultrasound can be done to predict your baby’s estimated due date (EDD).

Your EDD can also be calculated based on the date of your conception, if you happen to know it.

Your blood pressure will most likely be checked after you give them your urine sample.

It’s normal for your blood pressure to decrease when you’re pregnant due to the increase in blood volume, but sometimes it can be abnormally high.

Monitoring your blood pressure is an important part of prenatal care, so you’ll be checked at each prenatal visit.

Regular blood pressure checks are an easy way to detect and treat pregnancy complications like gestational hypertension (i.e., high blood pressure during pregnancy) early.

Your weight will be checked at every prenatal visit—starting with your first. This initial weigh-in will be used as a baseline for all future weigh-ins.

And based on your BMI, you’ll be expected to gain a certain amount of weight during your pregnancy.

Regular weigh-ins can check for sudden fluctuations in your weight and help your provider to see how your pregnancy is progressing.

You’ll be asked a lot of questions about you and your immediate family’s medical history (e.g., diabetes, high blood pressure, asthma, heart disease, allergies etc.).

You might also be asked about your partner’s medical history, as well as the medical history of your partner’s immediate family.

All of this information will help your provider to determine if you’re at risk for certain pregnancy complications and conditions.

If there are any concerns or an increased risk for genetic conditions, you’ll be given the opportunity to receive genetic counseling and genetic testing.

Any prior surgeries? They’ll want to know this because this info can shape your prenatal care.

For example, letting your provider know you’ve had a prior c-section can help them set up a TOLAC (trial of labor after c-section) if your goal is to have a VBAC (vaginal birth after c-section).

Any prior pregnancies, including miscarriages and abortions? They’ll need to know this too.

They will assess you for GTPAL to get a complete reproductive history:

• Gravida: Number of pregnancies you’ve had
• Term: Number of babies delivered after 37 weeks gestation
• Preterm: Number of babies delivered between 20- 36 weeks gestation
• Abortion/miscarriage: Number of losses before 20 weeks gestation
• Living: Number of living children you have

Your provider will want to know any current or past gynecological issues.

This is to determine if you have any potential or actual risks for birth defects and other pregnancy complications.

What’s your STD history? (e.g., herpes, HIV, chlamydia, gonorrhea, syphilis, genital warts, trichomoniasis and more).

It’s BEST to be honest here, so you and your partner can be treated if necessary!

Plus, untreated STDs during pregnancy can be really dangerous for your developing baby.

Your provider will want to know what medications you take (prescribed and over the counter) to assess whether or not it’s safe for you to take during pregnancy.

For any medications that aren’t safe, an alternative one may be provided. But usually the pros and cons of continuing that specific medication during pregnancy are weighed against each other. Meaning—do the benefits outweigh the risks? And vice-versa.

Your OB/midwife will also need to know if you’re allergic to any medications, so it can be entered into your patient record.

Your provider will want to know if you have any previous or current use of alcohol and/or drugs. This includes cigarettes, marijuana and other illicit drugs.

Being transparent can make it easier to get whatever help you may need.

For example: If you smoke cigarettes, but want to stop now that you’re pregnant, your provider can offer a smoking cessation program and other helpful resources to help you.

You will be asked about your lifestyle habits (e.g., exercise, diet, career, hobbies, etc.).

It’s important to be honest, so your provider can give you the best recommendations based on your situation.

Your provider can also let you know what things are safe vs unsafe for you to continue to do while you’re pregnant.

Tips may also be shared about how you can improve the health of your pregnancy.

You’ll be asked about your social history (e.g., emotional support system) and mental health history (e.g., depression, anxiety, prior mental health counseling, etc.).

These questions are asked to get a better idea of how your provider can best support you during your pregnancy.

Domestic violence tends to start or spike during pregnancy ( source ), so you’ll be asked if you’re experiencing any kind of abuse.

Studies have associated domestic violence (aka intimate partner violence) during pregnancy with:

• Poor maternal nutrition and inadequate weight gain
• A negative impact on a woman’s ability to receive regular prenatal care.
• Prenatal and postpartum depression
• A higher risk of substance use
• Adverse neonatal outcomes like low birth weight and premature birth
• An increased risk of miscarriage, stillborn death and induced abortion

If you’re experiencing abuse during pregnancy, your provider can give you all the resources and help that you need.

This includes connecting you with a domestic violence specialist to help you set up a safety plan .

You will also get the proper advice on how to get out of your abusive situation in the SAFEST way possible.

But, of course, you will NOT be forced or coerced to leave your situation if you don’t feel ready to.

You’ll get a full physical exam after you’re done answering questions and asking questions of your own . This usually involves a breast and pelvic exam.

A pap smear with cultures might also be done, especially if you’re due for one.

All of these exams check for infections, STDs and other abnormalities that may complicate your pregnancy.

Your provider will ask you to lie down and expose your abdomen, so a fetal doppler can be used to listen to your baby’s heartbeat.

Just so know, it’s not always possible to detect a fetal heart beat with a doppler in the very early weeks of pregnancy.

Your blood will be drawn at the end of your appointment to check for things like your blood type, Rh factor, blood count, HIV status and immunities.

Lastly, you’ll be told to make your next prenatal appointment.

This is usually done at the front desk, but your provider may set up your next appointment while you’re still in the exam room.

Here is the typical prenatal care schedule for a normal (i.e., uncomplicated) pregnancy:

• Weeks 4-28: every four weeks
• Weeks 28-36: every two weeks
• Weeks 36-birth: every week

The standard schedule is only a general guideline and might look different for you.

Your prenatal care schedule can increase in frequency if you:

• Have a medical history that requires extra monitoring
• Have a high risk pregnancy
• Experience a complication anytime during your pregnancy

The best way to prepare for your first prenatal visit is by gathering all the information you would need to answer all of their questions.

Before heading to your first prenatal visit, make sure you prepare all of the following information:

• Your insurance cards and ID: If a co-payment is required, make sure to have the money together.
• The first day of your last menstrual period: If you don’t know the first day of your LMP, you can give a rough estimate. Or let them know your conception date if you’ve been tracking your fertility. An ultrasound can be used to calculate an estimated due date.
• Your medical history: This includes your gynecological, reproductive, surgical and mental health history
• The medical history of you and your partner’s immediate family: It would be beneficial to have your partner with you, if possible.
• All of the medications you are currently taking: Including prescription, OTC, vitamins, supplements and herbal supplements (e.g., teas, pills, powders, liquids, patches, topical creams, etc) It’s BEST to put all of your medications into a large ziplock bag to bring with you. It will be easier for your provider to know what’s safe or unsafe for you to take during pregnancy.
• Previous or current substance use: This includes tobacco, cannabis, alcohol, vaping products and other illegal or recreational drugs.
• Social history and lifestyle habits: Your career, hobbies, diet, exercise, emotional support system, housing situation, domestic violence history, etc.
• Any questions you may have: Find out all the essential to ask at your first prenatal visit here .

There are 50+ questions you can ask at your first prenatal appointment , but here are a few to get you started:

• How often will I have my prenatal appointments?
• How much weight in total should I gain during my entire pregnancy? How much weight should I be gaining each week?
• How can I help support my baby’s development?
• What lifestyle changes do I need to make during my pregnancy?
• Is there a nurse line to call if I have questions or concerns?
• When should I go straight to the emergency room? (e.g., heavy bleeding, severe cramping, fainting, etc.)
• Are my prescribed and OTC medications safe for me to use during my pregnancy?
• What changes do I need to make to my diet during my pregnancy?

How to make the most of your prenatal appointments

Did you know that getting regular prenatal care from the start of your pregnancy increases health outcomes for you and your baby ( source )?

Prenatal care is SO IMPORTANT for managing the health of your pregnancy, reducing your risks for complications, early detection and treatment of complications and much more!

• Go to all of your prenatal visits: Don’t skip your appointments even if you have a normal, low-risk pregnancy. If you can’t make it to your appointment, call to reschedule but try your best to make it to each appointment.
• Prepare to give a urine sample at each appointment: I would drink water before each of my prenatal visits to make sure I had urine to collect.
• Prepare to have your blood pressure taken at each visit: You might be having your BP taken outside of the exam room, so wear something that will make it easy for you to expose your arm to get a proper BP measurement.
• Wear clothes that allow easy access to your belly: Fetal dopplers, fundal height measurements and checking for baby’s position all require easy access to your belly. I’d skip the maxi dresses, rompers, jumpers and go for T-shirts instead.
• Keep important info within easy reach: This includes your provider’s name and number, other emergency contact info, signs and symptoms to report ASAP and other helpful reminders on your fridge, mirror or anywhere else you think would be good for you
• Prepare your questions beforehand: Write down all of your questions, as they come up, in a notes app on your phone or in a notebook you won’t forget to put in your purse. That way you don’t leave your appointment to then realize you forgot to ask the question(s) you wanted to ask.
• Have your partner or support person go with you, if possible: Especially during the first prenatal visit when questions are being asked about past medical history and family medical history. If they can’t make it, ask if you are able to do a video call. Another tip: if your partner has to take off of work to make it to your prenatal visit, ask the receptionist for a letter for your partner to have proof for their employer. Also, the BIG VISITS to attend are the first prenatal visit, 12 week visit, 20 week anatomy scan (where you can find out the gender!) and one or two late pregnancy appointments nearing your due date.
• Have your insurance cards and ID ready to present to the receptionist when checking in to your appointment. And know beforehand if you have any co-pays to make because if you do, you’ll be expected to pay the day of your visit.

There you have it, mama! Now you know what to expect at your first prenatal visit, how to prepare, what questions to ask and how to make the most of your prenatal appointments. And then some!

I hope you found this post to be really helpful to you and, if so, I hope you share this post with all of your friends!

Seriously—knowing just what to expect, how to prepare and even what questions to ask at your first prenatal visit can really help to get rid of some of those jitters.

Your turn! When is your first prenatal visit and what have you been doing to prepare for it? What tips or info did you find the most surprising or helpful in this post? Let me know in the comments!

Enjoy your first prenatal visit, mama!

Pin to share!

• Alhusen, J. L., Ray, E., Sharps, P., & Bullock, L. (2015). Intimate partner violence during pregnancy: maternal and neonatal outcomes . Journal of women’s health (2002), 24(1), 100–106. https://doi.org/10.1089/jwh.2014.4872
• https://americanpregnancy.org/resources/pregnancy-calculator/
• https://www.thehotline.org/plan-for-safety/create-a-safety-plan/
• https://www.marchofdimes.org/find-support/topics/pregnancy/abuse-during-pregnancy

Last Updated on April 10, 2024 by Olivia

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What to Expect at Your First Prenatal Visit

March 26, 2024

Maternal Health , OB-GYN

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 .

Prepping for Your First Prenatal Visit? Ask Your Doc These Questions

Table of Contents

Questions about your body and your health, questions about your doctor & delivery.

Early pregnancy often feels very abstract—all you have to show for it are two pink lines on a stick . Once you call your doctor’s office to tell them you’re pregnant (the receptionist is probably the first person you’ll tell besides your partner), they probably won’t have you come in until you’re somewhere between seven and ten weeks along. This is to ensure your appointment is far enough along to hear a heartbeat, but it also means you’ll have a lot of time to prep for that exciting and nerve-wracking first prenatal appointment, where it all starts to feel a little more real.

So how do you prepare for your first prenatal appointment? There’s not a ton you need to do, but there are a few things that will help ensure it goes as smoothly as possible. First, think about when your last period started—your pregnancy begins on the first day of your last period (so for the first two-ish weeks of your official pregnancy, you actually aren’t pregnant—weird).  

You’ll also want to inventory any medications or supplements you take and think about anything from your medical history that may not be clearly outlined in your chart. For example, maybe your mom gave birth prematurely, you have irregular periods, or you’ve had a previous chemical pregnancy. But most of all, you’ll want to prep some questions to ask at your first prenatal visit. While your mind is spinning with excitement and your growing to-do list, we’re here to help you check off that last box. 

You don’t need to ask all of these questions at your first appointment—you can pick and choose which are most relevant to you and decide what you need to know now versus what can wait for your next appointment. But it’s good to look over all of them, so you can be prepared to get answers, especially for things that are non-negotiables for you. For example, if you’re hoping for a VBAC (vaginal birth after cesarean) and your doctor or hospital is hesitant to do them, it’s probably time to look for a new provider. And the earlier you can do that, the better.

Read on for a comprehensive look at the questions you may want to consider asking at your first prenatal appointment, whether it’s your first pregnancy or your fifth.

How should I think about my exercise routine during my pregnancy? 

If your doctor so far has been Google, you will know that there are conflicting takes about basically every type of exercise and pregnancy . ( No hot yoga during pregnancy! But do all the exercise you normally do! ). So, it’s helpful to get a medical professional’s insight on how much you should be exercising and how your routine should or shouldn’t change. 

What should I know about sex during pregnancy?

Your doctor’s advice may change by trimester, but it’s good to start having the conversation early. They’ll probably tell you anything goes (as long as you’re comfortable), but in cases where there’s a history of certain conditions like placental issues or pre-term labor, your doctor may want you to exercise caution or abstain (sorry!).

Based on my medical history, does it appear that I’m at risk for any complications?

It’s better to have all the information you need upfront, right? For example, certain things like having frequent migraines, diabetes, or polycystic ovary syndrome may put you at an increased risk of preeclampsia 1   . Your doctor will be able to give you the broad strokes during this first visit of what you should and—even more importantly—shouldn’t worry about based on your history. 

How long can I travel? And can I go on an international trip?

I had to reschedule a trip to Mexico when I was pregnant with my son because my doctor felt it was planned for a time that was too late in my pregnancy. I’m very glad I asked at that first appointment and had plenty of time to make changes.

What symptoms are not considered normal and warrant an immediate call to your office?

Many women (myself included) will have the urge to call their doctor over every little cramp and twinge. While you should feel empowered to ask your doctor anything and everything, there are some pregnancy symptoms they will definitely want you to contact them about, like bleeding or pain. They can also give you guidelines on the things you might experience that could cause you concern, especially if this is your first, but that are perfectly normal during pregnancy. 

What medicine can I take?

You may be surprised by which medications are pregnancy-safe and which are not. You can (and probably should) Google before you take any medication, but the internet can be a confusing place, so it’s good to have a doctor’s sign-off, especially on any regular meds you take.

What foods do I really need to avoid? What is okay in moderation?

If you’re like me, you’ll have lots of questions like, “I know sushi is generally a ‘no,’ but what if it’s from a high-quality restaurant? And do I really need to give up Brie?” Your doctor will be able to give you guidelines on the foods that could put you and your baby at risk of listeria or toxoplasmosis (aka definitely don’t eat), and the ones that are on the avoid list, but that, if they do make you sick, will be no worse for you than it would be if you weren’t pregnant. 

What beauty products should I steer clear of? 

Sorry, but your retinol will probably have to take a backseat. Your doctor will explain any skincare ingredients to avoid and sneaky places they may be hiding.

Can I clean a litter box? Garden? Dye my hair?

There are a variety of activities that everyone talks about avoiding during pregnancy. Take a look at your normal habits and ask your doctor about anything that you’re concerned about. They can give you guidelines on what you do and don’t need to change. 

What is your stance on the occasional drink?

If you survey your parent friends, you’ll probably find that some completely avoided alcohol for all 40 weeks, while others had an occasional beer or glass of wine later in pregnancy. (French women, yada yada). Depending on how by the book your doctor is, they may give you the ACOG answer 2   (there is no safe amount of alcohol during pregnancy) or something a little more nuanced about how it’s impossible to study alcohol and pregnancy, so they don’t know for sure. Either way, it’s a good idea to get their opinion before you make the decision that’s right for you.

What are weight gain expectations for this pregnancy? Does it change if I didn’t shed all the weight from the first pregnancy?

Your doctor will be able to address all your questions about weight and pregnancy, including any complications associated with gaining too little or too much. The first appointment is a good time to set expectations for future conversations about weight, whether it’s not wanting to know the number on the scale (something I’m really glad I asked for) or opting out of weight checks altogether.

What can I do for constipation and hemorrhoids?

Just trust me, you’re going to want to know.

What do you recommend I do to prepare for birth?

Sure, this is your first appointment, but it’s never too early to start getting ready for the big day. Your doctor may recommend specific books, exercises, Instagram accounts they like, or even a doula or birth class. It’s a good idea to start figuring out your options early so that you have plenty of time to do the birth-prep exercises or start interviewing doulas. 

What is the best way for me to contact you with non-urgent questions?

You’re going to have a lot of questions, and not all of them need to be answered right away. Does your doctor like to be messaged through the patient portal? Would they prefer you leave a message with the receptionist? How long should you expect to wait to get an answer? And what should you do for urgent questions?

Does your doctor have any travel planned?

Now’s the time to find out if your doctor has an African safari planned around your due date. If they do have vacation or extended time off on the calendar during your pregnancy, it’s important to know who you’ll see instead and what the practice’s plans are for coverage.

Who will deliver my baby if you are not on call?

So much of having a good birth experience is feeling comfortable with your team. For that reason, it can be nice to get to know the other doctors in the practice who could potentially deliver your baby or at least familiarize yourself with who it could be.

How much past 40 weeks will you allow me to go?

Doctors have many different stances on how long past 40 weeks they’ll allow patients to go, so this question is important to ask. Some research shows 3   that inducing after 41 weeks lowers the risk of stillbirth and other complications, like meconium aspiration (when babies breathe in their waste). Some will insist on inducing earlier than 41 weeks, and some may let you go up to 42 weeks. It’s good to know their policy regardless, but if you have a specific preference, you will want to make sure your doctor’s policies are in alignment.

What is your policy on _______?

Pick and choose the questions on policies that are meaningful for you here. Some doctors, for example, are not trained on instrument-assisted deliveries, so in the event that you would need one (if you fatigue from pushing or the baby is in distress), you’d instead have an emergency C-section. (I did not think to ask this question myself, but I will if I have future pregnancies, as my son was born assisted by vacuum when his heart rate began to drop). Some situations to consider asking about: 

Scheduled c-sections

Pain management

Episiotomies

Intermittent vs continuous monitoring

Instrument-assisted deliveries (forceps or vacuum)

VBACs (This will only be relevant to you if you’ve previously had one or more caesareans and are hoping for a vaginal delivery)

What is the cadence of my appointments?

Your ob-gyn practice may set up all your appointments, or at least all of them through 20 weeks, at that very first prenatal appointment. Generally, you’ll go monthly up until about 28 weeks, then every other week until 36 weeks when you begin weekly appointments. But this is a good time to let the office know if a certain day or time doesn’t work for you and how they handle scheduling. 

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Expectful uses only high-quality sources, including academic research institutions, medical associations, and subject matter experts.

National Institutes of Health .  " Who is at risk of preeclampsia? " ,  https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/risk#:~:text=Preeclampsia%20is%20also%20more%20common,diabetes%2C%20and%20sickle%20cell%20disease. .

The American College of Obstetrics and Gynecologists .  " Alcohol and Pregnancy " ,  https://www.acog.org/womens-health/infographics/alcohol-and-pregnancy .

Institute for Quality and Efficiency in Health Care .  " Pregnancy and birth: When does labor need to be induced? " ,  Sep 24, 2008 ,  https://www.ncbi.nlm.nih.gov/books/NBK279570/#:~:text=In%20other%20words%3A%20The%20research,aspiration%20(breathing%20in%20meconium). .

Grace Gallagher, MFA, Hunter College

Grace Gallagher is a freelance writer based in Portland, Oregon. Her work focuses on parenting, health, and beauty and has appeared in Parents, Romper, Pregnancy & Newborn, Shape, InStyle, and more.

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What to expect at your first prenatal appointment

Regular visits with a clinician are an important part of staying healthy during your pregnancy. Your first prenatal appointment will likely be the longest. After all, there’s a lot of information you’ll want to share.

Be sure to schedule your first prenatal appointment as soon as you know you’re pregnant. You’ll see your clinician between weeks 7 and 12 of your pregnancy.

To prepare for your first appointment, make a list of any questions you have. Don’t hesitate to let your clinician know if you have any worries or challenges. You should also write down all the medications you take, including over-the-counter drugs and supplements.

What happens at your first appointment

A clinician will perform a physical exam that includes a breast exam, pelvic exam, and Pap test if you’re due for one. You’ll also talk about your personal medical history. Your clinician will ask about your family health history as well.

Your clinician will discuss how to stay healthy throughout your pregnancy. This includes information about your physical and emotional well-being. A clinician can share information about nutrition and exercise, along with tips for gaining weight in a healthy manner. You’ll also learn about breastfeeding and how it can help give your baby a great start in life.

The first ultrasound

Many people look forward to their first ultrasound, which usually happens at the initial prenatal visit. This ultrasound gives you the opportunity to hear your baby’s heartbeat. It’ll be fast — about 100 to 160 beats per minute!

An ultrasound gives your clinician a better idea about your due date. It also helps them see how healthy your placenta is, determine your baby’s position in your uterus, and check to see if you’re having more than one baby.

The first ultrasound is usually performed vaginally. A clinician will insert a thin device into your vagina to collect ultrasound images. You may be able to see your baby’s developing body, including dots where their eyes and nose will form. You might also be able to see the short stubs that will eventually become their arms and legs.

This article has been created by a national group of Kaiser Permanente ob-gyns, certified nurse-midwives, pediatricians, lactation consultants and other specialists who came together to provide you with the best pregnancy, birth, postpartum, and newborn information.

Some of the content is used and adapted with permission of The Permanente Medical Group.

• First trimester
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First Prenatal Visit: What Happens & How to Prepare

The first prenatal care visit is an exciting time but you may not know what to expect or how to prepare. Here’s an overview of what to expect.

• Written by Genevieve Howland
• Updated on May 24, 2019

From the time you pee on that pregnancy test to actually going to your first prenatal visit seems like an eternity. It. is. BRUTAL! I remember calling my midwife all giddy when I told her that I was pregnant and she said “I’ll see you in 10 weeks.” TEN WEEKS?!?! Are you crazy? What if something happens to the baby? What happens if I mess something up? What? Wha? Wha?

Then I remembered to breath… and I realized that there really isn’t anything a midwife could do to “save” my baby in these very precious early weeks. And so I surrendered. And waited. And wondered. What do I need to bring to my first prenatal visit? Can I prepare in any way? And what exactly goes on during the first prenatal visit?

Here’s what you can expect and how you can prepare.

When is my first prenatal visit?

Typically women see their healthcare provider for prenatal care between 8 and 12 weeks. If you are seeing a midwife they may suggest you wait until 10 – 12 weeks for your first appointment. This is because this is about the time when you can hear your baby’s heartbeat on a doppler. Don’t be sad or scared if they still can’t find the heartbeat, as it is really more like 12-14 weeks for a definite reading.

Many OBs and even family doctors expect you to schedule your first prenatal care appointment much earlier than this though.

An ultrasound can pick up a heartbeat as early as 6-7 weeks, and some women are led to believe that an early ultrasound is necessary for a healthy pregnancy. This analysis shows that routine ultrasound does not improve perinatal outcomes while this analysis shows no improvement in maternal outcomes.

Here’s a post dedicated to the risks vs. rewards of baby ultrasounds .

Another reason that some doctors want you to schedule an earlier appointment is for a full pelvic exam. The reasoning is that, for some women, prenatal care is their first or only chance to see a doctor and undiagnosed STDs can be dangerous for the baby.

Your provider may also take the opportunity to do a pap smear to check for cervical cancer. However, vaginal exams do carry a small risk of infection, so if you are relatively healthy and don’t have a history of ectopic pregnancy or other serious concerns, then you are probably fine to wait until around 12 weeks.

What should I expect at my first prenatal visit?

What happens during the first visit will vary from provider to provider, but for the most part you can expect to do four main things.

1. Build a relationship

One of the advantages to using midwives is that you have continuity of care, meaning that the midwife you see at each (or most) appointments will be the one who attends your birth. Even in a larger office with multiple midwives, at least each appointment was nice and long with plenty of time to talk and bond with these awesome ladies. By the end of my pregnancy, I knew I was in good hands no matter which midwife was on call and this is a very good feeling!

At the first prenatal visit you can get to know your midwife or doctor, learn about her background, and begin to build a relationship of trust. You can ask questions and get information on good books to read or specialists you may want to see during your pregnancy, such as a chiropractor or lactation consultant .

If you are using a family doctor, then you may have a similar continuity of care. With OBs in hospitals you aren’t likely to be able to choose the OB that attends your birth, so a prenatal visit won’t always focus on this kind of relationship building.

2. Assess your health

Your midwife will ask about your health history, family health history, and present health to get a baseline for what is normal for you. She will counsel you on nutrition, exercise and holistic healing and wellness. She will address common pregnancy complaints and offer holistic, natural remedies.

She will also ask if you are having unusual symptoms that may be a sign of something serious. Headaches are common in early pregnancy, but can also be a very early sign of preeclampsia. Your midwife will want to know if you are having headaches or other symptoms and will keep a record of them.

3. Routine tests

Your midwife will order a different blood tests that will tell her your blood type, red and white blood cell counts, hematocrit, hemoglobin, and platelet count. Your midwife needs to know your blood type for your safety, but the other tests should be optional.

These blood tests will also tell your midwife if you are Rh positive or negative. If you are positive (or you are negative and your partner is negative) you have nothing more to do. If you are negative and your partner is positive or you don’t know, your midwife may discuss your receiving an Rhlg shot to prevent any complications.

Your midwife will also tests for various Sexual Transmitted Diseases like syphilis, gonorrhea, chlamydia, which could harmfully affect your pregnancy if not treated. She will also take your blood pressure, pulse, weight, and check the baby’s heartbeat if you are ok using a doppler, which contains ultrasound waves. I chose to use the doppler for the first appointment so I could really believe I was pregnant and then waited till 20 weeks to use the fetoscope for the baby’s heartbeat.

She may palpate your abdomen to check the fundal height (a measure of the size of your uterus). She will rule out any medical problems that may affect your pregnancy and assess whether a homebirth or birth center birth is safe for you (it usually is).

You will also be asked to test your urine for the presence of protein (a sign of toxemia), sugar (a sign of gestational diabetes), or bacteria (a sign of Group B Strep positive). You will pee into a cup and dip a test strip in. Depending on the brand of test strips you will read it after 60 second or immediately. You will do this test at every appointment until birth.

4. Paperwork

At your first prenatal visit you will probably have some paperwork to sign and your midwife or doctor’s office will probably need a copy of your health insurance card. Many midwives will give you an estimate costs for your pregnancy and birth care, so you are both on the same page in terms of cost.

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How can I prepare for my first prenatal visit?

Prepare your questions.

Your first prenatal care appointment may be the first time you meet your midwife or doctor, so it’s a good idea to have questions prepared in order to get a feel for your provider’s background and philosophy. If you are seeing a doctor, ask what her thoughts are about: labor induction , ultrasounds, the glucola drink, treating GBS+ during birth, and natural childbirth in general. You can use these questions as a guide to see if your healthcare provider is a good fit for you.

If you’ve already interviewed your practitioner, you still may have some questions about what to expect during your pregnancy, what symptoms or concerns you may have, or how many weeks pregnant you may be.

I wrote down questions beforehand so that I wouldn’t forget anything during the actual appointment (between excitement, nervousness and pregnancy brain , I had a feeling I would forget a thing or two!)

Gather health info

Ask family members about pregnancy related health concerns that may run in the family. Write down any patterns of health you notice. Also take note of your partner’s family health history, especially genetic diseases. My mom had two c-sections so I wanted to get my midwife’s thoughts on if she thought I could have a vaginal birth.

Write down any past gynecological history, like an abnormal pap smear or a previous pregnancy or miscarriage. Write down any medications you are taking.

If you don’t know your due date, use our due date calculator before your appointment. If you do know your due date and want to know when you most likely conceived, use our reverse due date calculator . And here’s an article for you if you’re unsure  how many weeks pregnant you are .

Do your research for prenatal care

Do your best to pick the practitioner who is right for you. But if you go to your first visit and don’t like him or her, remember that you can change at any time! My dear friend changed her care at 34 weeks! And she was so happy that she did.

Your midwife needs to know your blood type for your safety, but the other tests should be optional. A good practitioner will let you know at each appointment what tests or procedures will be coming up at the next appointment so you can have time to research and decide what’s best for you.

A good practitioner should also be able to guide you and answer any questions you have about tests and procedures.

Best wishes for your first prenatal visit!

The first prenatal care visit is an amazing and nerve-wracking time. You may get to hear the heartbeat for the first time! That’s why I would encourage your partner to come along for that first prenatal visit. Hearing your child’s heartbeat for the first time, together as parents, is truly a special and sacred moment. Plus, you now have more “proof” that you really are pregnant.

Knowing what to expect and how to prepare should ease your mind and let you enjoy the excitement of your pregnancy!

• https://www.emedicinehealth.com/complete_blood_count_cbc/article_em.htm
• Beech, BL. Ultrasound unsound? Association for Improvements in the Maternity Services. 1996

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• How Accurate Are Pregnancy Tests?
• When Will My Baby Be Born? How Accurate Is Your Due Date?
• See 4 Comments

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About the author.

Genevieve Howland is a childbirth educator and breastfeeding advocate. She is the bestselling author of The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth and creator of the Mama Natural Birth Course . A mother of three, graduate of the University of Colorado, and YouTuber with over 130,000,000 views, she helps mothers and moms-to-be lead healthier and more natural lives.

Meghan Quinn Jan 18 at 10:57 pm

Thank you for this info on what to expect! It eases my mind a bit.

Taylor Bishop Oct 26 at 11:22 am

I just wanted to thank you for going over what to expect for a prenatal visit. I didn’t know that it could be beneficial to maybe schedule this maybe 6-7 weeks in a pregnancy. My sister has been thinking of getting pregnant, so this could be good for her to know in the future.

Kendal Mar 12 at 8:52 pm

Thank you–I just had my first prenatal appointment, and this was really helpful! So glad I found your blog at the right time! I also was having trouble believing I was really pregnant, so it was relieving to see you wrote that same thought, and it helped me not feel so bad about also wanting the doppler to hear the heartbeat. Amazing!!

Sarah F. Feb 24 at 11:39 am

My first prenatal appointment led me to calling a local birth center for a meet and greet. My doctor, who I adore, suddenly became very pushy about flu shots. My (shy and quiet) husband had to argue with her about why I don’t get flu shots because after I told her I didn’t want it (they make me horribly sick, and I’d already been sick with bronchitis for 6 weeks), she ordered it anyway, until the husband put his foot down for me. I was on edge about hospital delivery before I even became pregnant, but it worries me that I couldn’t get my own doctor to listen to me over a flu shot. And there was no conceivable way for me to meet with more than 2 of the midwives and none of the OBs before I deliver in August! Hopefully everything clicks at the birth center and I can deliver there. Everyone I know who’s gone there has been thrilled with the care, and the hospitals around here seem quite notorious for C-sections. I wish my doctor had made me feel more confident, but I’m so much more comfortable with the idea that birth is normal and not a medical emergency.

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What to Expect From Your Prenatal Care Appointments

Verywell / Michela Buttignol

• Your First Appointment
• Your Second Appointment
• 14-16 Weeks
• 18-22 Weeks
• 22-26 Weeks
• 28-36 Weeks
• 36-40 Weeks
• 40-42 Weeks

The test is positive, morning sickness has kicked in, and your pregnancy journey has just begun! Finding out you're expecting brings so many emotions, from giddiness and excitement to nervousness and hesitation. There's also one burning question that pops up, especially if this is your first pregnancy: What happens next?

Along with nine months of bodily changes, baby kicks, and bouts of heartburn come the super important (and super frequent) prenatal care appointments. Your OB/GYN's office might feel like a second home by the end of your pregnancy, but it's for a good reason!

Each stage of pregnancy comes with its own milestones, challenges, and safety precautions. Every prenatal appointment along the way ensures you and your baby stay on track and healthy. Here, we will break down what to expect at each round of prenatal appointments, including what your healthcare provider is looking for, what precautions you need to take, and which tests may be recommended.

Your First Prenatal Care Appointment

This is a big one! Your first prenatal care appointment is certainly the most exciting, and its timing can vary based on the practice. You should call your provider as soon as you find out you are pregnant to determine the best time to come in, which is typically between 6 and 10 weeks.

Andrea Chisholm, MD, a board-certified obstetrician and gynecologist with over 20 years of clinical experience, explains that during your first appointment, your OB/GYN will discuss your medical history (including your partner and family history) and give you a physical exam. You will also undergo a number of routine prenatal lab tests, where they will screen for infectious diseases (such as HIV, hep B/C, and syphilis), STIs, and immunity to rubella and chickenpox.

During your first visit, you may or may not get an ultrasound depending on your provider or risk factors determined from your medical history. Your provider will check your blood pressure, may perform a pap smear or pelvic exam, and discuss a prenatal game plan for the coming months, including a potential due date , which prenatal vitamins to take, and any necessary lifestyle and dietary changes.

"This is [also] the appointment where your OB provider will decide if any additional early testing or intervention is needed," says Dr. Chisholm.

Your Second Prenatal Care Appointment

From weeks 4 to 28 of pregnancy, you will visit your OB/GYN once a month, so your second visit will be four weeks from your initial visit.

Dr. Chisholm explains that if your initial prenatal visit was prior to 10 weeks, then your OB/GYN will listen for fetal heart tones during the second visit. They will continue to check the baby's heartbeat at every appointment after 10 weeks. (Arguably the best part of every visit!)

There may be more discussion about genetic testing at this appointment and your urine may be screened to watch for infection. Your weight and blood pressure will be checked, which is something you can come to expect from every prenatal appointment moving forward.

14 to 16 Weeks Prenatal Care Appointments

Welcome to the second trimester! Between 14 and 16 weeks, you'll undergo the usual blood pressure and weight-gain check, and your doctor will monitor your baby's heartbeat. Dr. Chisholm explains that there may be continued discussion about genetic testing and a possible screening for neural tube defects with an AFP (or alpha-fetoprotein test ).

"If you are at an increased risk for gestational diabetes your provider may [also] suggest an early glucose challenge test," she says.

18 to 22 Weeks Prenatal Care Appointments

Between 18 and 22 weeks of pregnancy, you will likely get the ultrasound you've been so anxiously awaiting—the anatomy scan! This is where you can find out the sex of the tiny human you've been growing for the past few months. For some, this may be the first ultrasound since becoming pregnant.

Around 20 weeks of pregnancy, your healthcare provider will begin to measure your belly to check your baby’s growth (or the uterine fundal height). They do this by measuring from the top of the pubic bone to the top of the uterus, which helps ensure your baby's growth is on track for how far along you are. You can expect this at every appointment moving forward.

22 to 26 Weeks Prenatal Care Appointments

Dr. Chisholm explains that between 24 and 28 weeks of pregnancy, you can expect a glucose challenge screening test , which screens for gestational diabetes. You will be asked to drink a sweet liquid (glucose), wait one hour, and then have your blood drawn. The blood test examines how well your body processes sugar.

If you test positive during the test, you will be asked to do a second, longer test (three hours), called the glucose tolerance test. If you receive abnormal results, you will likely be diagnosed with gestational diabetes , and your provider will lay out a treatment plan.

28 to 36 Weeks Prenatal Care Appointments

Hello, third trimester! Your prenatal visits will now increase to every two weeks until you hit the 36-week mark. Your OB/GYN will continue to check your blood pressure, weight, and baby's heartbeat, but will also focus on your baby's position ( head-down versus breech ).

Your provider may also give you a Tdap vaccination during this time, which protects you and your baby against pertussis (or whooping cough), which can be very dangerous for an infant.

Around 35 weeks, you will also be tested for Group B streptococcus, a bacteria that can cause severe infections in newborns if not treated during labor. If you test positive, don't worry! The test simply shows that you have the bacteria in your body, not that it will cause illness in you or your baby. This can be treated with antibiotics during labor to ensure a safe delivery.

36 to 40 Weeks Prenatal Care Appointments

Once you hit 36 weeks pregnant (the home stretch!), you will start having weekly OB visits until delivery day. During the last few weeks of visits, your OB will start checking your cervix to see if dilation is taking place. They will also be able to determine whether your baby is in the head-down position and ready for labor. You will go over any final preparations, how to time your contractions, and when it's time to call your healthcare provider.

40 to 42 Weeks Prenatal Care Appointments

There are times when a baby may take longer than anticipated to make their big debut. Most times, your healthcare provider will allow the pregnancy to take its course until you reach 41 weeks, after which they will begin running tests to make sure the baby is okay. If your little one is active, healthy, and the amniotic fluid amount is sufficient, they may decide to wait it out until labor begins.

On the other hand, if you are approaching 42 weeks pregnant with no signs of active labor, induction may be the best option to secure the health of you and your baby. Once you reach this point, the placenta may stop working as well as it should, causing a decrease in oxygen and nutrients for the baby. Your OB/GYN may choose to start the induction process to get labor moving, or a C-section may be needed if there is fetal distress or labor is not starting or progressing as it should.

A Word From Verywell

While you've gotten a general run-down of each prenatal appointment, it's important to keep in mind that every pregnancy is different. Remember to bring any questions you have to each doctor's visit, and don't be afraid to ask them! Your OB/GYN is there to guide you every step of the way and ensure you and your baby receive the absolute best care, treatment, and delivery possible.

March of Dimes. Prenatal care checkups .

M Health Fairveiw. What to expect before, during and after your first prenatal appointment .

Nemours Children's Health. Intrauterine Growth Restriction (IUGR) .

American Pregnancy Association. Glucose tolerance test .

Nemours Children's Health. Group B Strep and pregnancy .

Mount Sinai. When you pass your due date .

By Alex Vance Alex Vance is a freelance writer covering topics ranging from pregnancy and parenting to health and wellness. She is a former news and features writer for Moms.com and Blog Writer for The HOTH. Her motherhood-related pieces have been published on Scary Mommy, Motherhood Understood, and Thought Catalog.

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What To Expect at Your First Ultrasound During Pregnancy

When do you get an initial glimpse of the fetus? Here’s when you get your first pregnancy ultrasound and what happens during it.

When Should You Get Your First Ultrasound?

What should i expect at my first ultrasound, what your provider is looking for at your first ultrasound, how to prepare for a pregnancy ultrasound.

Getty Images/7postman

That first ultrasound during pregnancy can cause various emotions. No matter what you're feeling, you can typically expect it sometime in the first trimester . A first ultrasound can confirm pregnancy, help determine the fetus' gestational age, and estimate a due date. But for others, the first pregnancy ultrasound is the anatomy scan, which is performed around 20 weeks.

Many parents-to-be are understandably filled with questions about their first pregnancy ultrasound. For starters, an ultrasound is a painless diagnostic test that most people receive at least once during routine prenatal care. High-frequency sound waves travel into the uterus, then bounce back off the embryo or fetus as vibrations. The echoes are translated into electrical signals that are projected as black-and-white pictures on a monitor. The images display the fetus's soft tissues and organs. A pregnancy ultrasound is considered a safe procedure for you and the fetus.

You may also be wondering when you should get your first ultrasound, how it will feel, and what providers are looking for. Experts break down your most pressing questions.

The timing of your first pregnancy ultrasound will depend on things like your age, your medical history, your cycle regularity and last menstrual period (LMP), your health care provider's preference, and any risks they feel you may be facing during the pregnancy. For many people, a first ultrasound is performed at around 8 weeks. But it may also be performed later on.

An early scan (6 to 8 weeks)

Many providers schedule their patients' first ultrasound around 6 to 8 weeks into the pregnancy, which could be during the first prenatal visit. Others will only arrange for an ultrasound that early if the pregnancy is considered high-risk, whether because of age, current medical symptoms (bleeding, abdominal pain), or a history of miscarriage , congenital abnormalities, or pregnancy complications.

At this time, the embryo is tiny , and your uterus and fallopian tubes would be closer to your birth canal than to your abdomen, so a transvaginal ultrasound is clearest. Your provider will typically look for cardiac activity, forecast a due date, check for multiples, and viability. An ultrasound at this time can also be used to screen for an ectopic pregnancy, a rare condition in which the fetus grows in the fallopian tube instead of the uterus.

The dating ultrasound (10 to 13 weeks)

Ultrasounds conducted around 10 weeks capture the baby's growth. The ultrasound technician will measure the length of their body from crown to rump, which serves as a marker of gestational age (and better predicts a due date).

"This helps us determine if the size of the fetus matches up with the size it should be based on the patient's last menstrual period," says Michele Hakakha, MD, an OB-GYN in Beverly Hills and the co-author of Expecting 411. "A smaller crown-rump length may signal an embryo that is not developing normally and may have a chromosomal problem ." It could also mean your estimated due date based on your last menstrual period was off, which is common for people with irregular cycles .

During this period, you may be offered a nuchal translucency (NT) test, which evaluates your child's risk of chromosomal abnormalities and certain congenital heart disorders. This two-part exam includes a blood test that measures the level of specific hormones and proteins in your body and an ultrasound that assesses thickness at the back of the baby's neck (increased thickness indicates that they may be at risk for Down syndrome, trisomy 18, and other genetic disorders). The NT ultrasound is a personal choice. It’s always best to discuss the pros and cons with your health care provider.

The anatomical survey (18 to 20 weeks)

By 20 weeks, most pregnant people will have already had their first ultrasound, but in some cases, the 20-week ultrasound, also known as the anatomy scan, is the first. This routine ultrasound is fairly comprehensive. "We look at about 35 elements, including the brain, heart, kidneys, limbs, face, sex, and more," says Jane Chueh, MD, director of prenatal diagnosis at Lucile Packard Children's Hospital Stanford in Palo Alto, California.

The fetus will have measurements taken of the diameter and circumference of their head, the circumference of their abdomen, and the length of their femur bone. Ultrasounds can't detect all medical and genetic issues, but they can highlight physical characteristics that are suggestive of potential disorders.

Additional ultrasounds

There are instances where a person may need extra ultrasounds, such as if there are issues with the cervix, amniotic fluid, or the placenta location or size. You may also need growth ultrasounds to ensure the fetus is staying on its growth curve if you are a pregnant person with diabetes, preeclampsia , hypertension, or placenta or uterus issues.

Most people will have their first ultrasound in their prenatal care provider's office or a local hospital, though there are also freestanding facilities that offer them. There are two types of pelvic ultrasounds that a pregnant person can have: a transvaginal ultrasound or a transabdominal ultrasound. Which method is used will depend on how far along the pregnancy is.

Transvaginal ultrasound

Given early in pregnancy, transvaginal ultrasounds use a wand-shaped probe (a transducer covered with a latex sheath and lubricant) that is inserted inside the vagina. It offers a very detailed look at the embryo and helps health care providers assess how far along a pregnancy is. To get a good picture, the ultrasound technician may move the device, but any discomfort should be minimal. At this point, the embryo is very small and located deep in the pregnant person's pelvis; since sound waves can't pass through bones, a technician may approach the uterus through the cervix. This exam may also be used later in pregnancy if the person expecting develops placenta previa (a condition in which the placenta covers the cervical opening) or the provider needs to measure the cervix itself.

Transabdominal ultrasound

A transabdominal ultrasound is a non-invasive type of ultrasound that tends to be more common after 11 to 12 weeks of pregnancy . The technician moves the transducer along a pregnant person's abdomen, applying a small amount of pressure as they go. The transducer transmits sound waves that create a picture of the fetus inside the body, and it may be rotated at different angles to get a complete picture. If you're ticklish, you might find yourself challenged by this procedure. Breathe deeply and try to relax!

Early ultrasounds are typically looking for the following:

• Pregnancy viability 
• Number of fetuses
• Size of the fetus
• Due date confirmation

After you make an ultrasound appointment, your health care provider may give you an instruction sheet telling you what to do next. People who are less than 14 weeks pregnant are usually asked to fill their bladders to capacity before the exam. Sound waves travel better through liquid, and a full bladder improves the quality of the ultrasound. As the pregnancy progresses, this is not as essential because the uterus and fetus become so large—but even then, some providers still ask patients to come to the ultrasound appointment with bladders full.

Otherwise, if you'll be having an abdominal rather than a transvaginal ultrasound, you might consider wearing a two-piece outfit that provides easy access to your tummy—and one that you won't mind getting a little ultrasound gel on (Don't worry: It'll come out in the wash).

Benefits and risks of ultrasound in pregnancy . Semin Perinatol . 2013.

Sonography 1st Trimester Assessment, Protocols, and Interpretation . StatPearls . 2022.

Ectopic Pregnancy, Ultrasound . StatPearls . 2023.

The role of ultrasound in the diagnosis of fetal genetic syndromes . Best Pract Res Clin Obstet Gynaecol . 2014.

Role of ultrasound in the evaluation of first-trimester pregnancies in the acute setting . Ultrasonography . 2020.

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• > Prenatal Visit Schedule: What To Expect During Each Appointment

Prenatal Visit Schedule: What To Expect During Each Appointment

Prenatal care is an important part of a healthy pregnancy and allows your doctor to regularly monitor you and your baby . But what should you expect when it comes to your prenatal visit schedule?

Basically, you’ll visit your doctor once a month at the beginning of your pregnancy and then once a week at the end of your pregnancy. That said, it’s important to schedule your first prenatal visit as soon as you see a positive pregnancy test!

In this article, the experts at Mustela discuss how your prenatal visit schedule will most likely look and what to expect during each appointment.

Prenatal Visit Schedule: First Trimester

This is such an exciting time in your life! When you saw the positive pregnancy test , you were probably four to six weeks pregnant, so go ahead and call your doctor to schedule your first appointment.

During the first trimester , you will have your initial prenatal visit, and then your doctor will schedule your visits every four weeks or once a month.

Check with the doctor or staff for a printout of your prenatal visit schedule.

What To Expect At Your First Appointment

Your first prenatal visit will be around six to nine weeks and will most likely be the lengthiest of all your appointments, so block out a good bit of time on your calendar.

Your doctor will ask a good bit of detailed questions and perform a pretty thorough check. Let’s take a look at what they’ll do during this appointment.

Medical History

Your doctor will ask questions about your:

• Last menstrual cycle so they can give you a due date
• Gynecological history
• Obstetrical history (any past pregnancies)
• Personal and family medical history
• Supplements or medicines you’re taking (if any)
• Lifestyle (use of tobacco products, alcohol, and caffeine; eating and exercising habits)
• Recent travel adventures
• Feelings of depression or anxiety (if any)

Your doctor will order various lab work to check your blood for:

• Blood type and Rh status
• Hemoglobin levels
• Infections such as hepatitis B, syphilis, gonorrhea, chlamydia, and HIV
• Thyroid levels
• Any other important screenings

Physical Exam

To give you and your baby the best care, your doctor will need to do a thorough physical exam, which most likely will also include a Pap smear to detect any abnormal cervical cells.

Your doctor’s observation also includes:

• Checking your blood pressure
• Measuring your height and weight to determine your recommended weight gain for a healthy pregnancy
• A breast exam
• A pelvic exam
• Screening your heart, lungs, and thyroid

Discuss any pregnancy discomforts , such as nausea and fatigue, with your doctor. Be honest with your doctor so they can take care of you and your baby to the best of their knowledge.

Some doctors also do an ultrasound during the first trimester to confirm or date your pregnancy. (Your first prenatal visit will vary based on the specific policies of your doctor’s office.)

What To Expect At Your 12-Week Appointment

You're nearing the end of your first trimester! During this appointment, you can expect your doctor to check the following:

• Weight and blood pressure
• Urine for sugar and protein levels
• Your baby’s heartbeat (This will be the first time you’ll hear it!)
• Size of your uterus
• Hands and feet for any swelling

Prenatal Visit Schedule: Second Trimester

Assuming you have a healthy pregnancy and no further examinations are necessary, this is what your prenatal visit schedule will look like during your second trimester :

• Four-month appointment (around 16 weeks)
• Five-month appointment (around 20 weeks)
• Six-month appointment (around 24 weeks)

What To Expect During Routine Appointments

Many of your appointments from here on out will look similar regarding what your doctor will check for. During these visits, you can expect your doctor to look at:

• Your baby’s heartbeat
• Your fundal height (The size of your uterus is used to assess fetal growth and development. Your doctor will get this measurement by measuring the length from the top of your uterus to the top of your pubic bone. This measurement should match how many weeks you are. Example: If you’re 20 weeks pregnant, your fundal height should equal 20 centimeters.)
• Hands and feet for swelling
• Any symptoms you’ve been experiencing

At this point in your pregnancy, you may notice your skin becoming dry and starting to stretch a bit. Don’t worry; it’s completely normal!

To tackle dry skin, try Mustela’s Stretch Marks Cream . This velvety, hard-working cream delivers immediate moisture and comfort to your skin!

And our Stretch Marks Oil treats recently formed stretch marks. It’s a fast-absorbing oil that hydrates your skin throughout your pregnancy!

What To Expect During Your 20-Week Sonogram:

Sometime around your 20-week appointment, your doctor will schedule an ultrasound to determine the gender of your baby! During this sonogram, your sonographer will take a look at:

• Baby’s size and all their major organs
• Amniotic fluid
• Location of placenta

Your sonographer passes this information to your doctor to give them a clear picture (literally!) of the overall health of your baby and your pregnancy.

Prenatal Visit Schedule: Third Trimester

During your third trimester , your prenatal visits will be every two weeks until the last month of your pregnancy, when you’ll have them every week. So that means your prenatal visit schedule will look like this:

What To Expect At Your Seventh- and Eighth-Month Visits

During your seventh and eighth months of pregnancy, expect your doctor to check the following:

• Urine for sugar and protein
• Your fundal height (top of your uterus)
• Size and position of your baby
• Feet and hands for swelling
• Varicose veins in your legs
• Glucose screen test (read below for more information)
• Group B strep test (read below for more information)
• Blood test for anemia
• Any symptoms you’ve been having

Glucose Screen Test

This test is used to determine if you have gestational diabetes. Once you arrive at your doctor’s office, be prepared to have your blood drawn first.

Next, you’ll drink a very sugary drink that tastes like flat orange soda. Some women enjoy the taste, while others feel a little queasy afterward!

After you consume the entire drink, you’ll wait one hour before having your blood drawn again. If your blood work comes back with elevated numbers, your doctor will order the next level of tests, which is used to officially diagnose gestational diabetes.

Should you need to take the second test (no studying required!), you’ll have to fast before the appointment. Just like with the initial round of tests, your doctor will draw your blood first and then have you consume the drink.

The only difference is this time, your blood will be drawn every hour for three hours. Be prepared to stay in your doctor’s office for three to four hours.

If the results from this test also come back elevated, your doctor will discuss management techniques for gestational diabetes.

But don’t let this information worry you. Most women who monitor their blood sugar levels and work closely with their doctor have perfectly normal pregnancies and healthy babies!

Group B Strep Test

Group B Strep (GBS) is bacteria that can be found in the vaginas of healthy women. (It’s not related to strep, the throat infection.)

If you are a carrier of GBS, your baby can catch the infection during delivery when they pass through the birth canal. While this bacteria isn’t harmful to you, it can be dangerous for your baby.

To check for GBS, your doctor will perform a test just like they would a Pap smear. If the test shows that you’re a carrier, you’ll receive antibiotics through an IV once you’re in labor. This way, you won’t pass the infection to your baby!

You’re routinely tested for GBS around the seventh or eighth month of pregnancy so your doctors can be prepared to give you the antibiotics at the onset of labor.

What To Expect During Your Ninth Month

Similar to months seven and eight, your doctor will closely monitor you and your baby during this time. Since you’re getting closer to your due date, expect a few additional observations from your doctor.

During your last month of pregnancy, they will take a look at:

• Your cervix by an internal examination to check for effacement (thinning) and dilation (opening)
• Baby’s heartbeat
• Baby’s size (At this point in your pregnancy, your doctor may give you an estimation of your baby’s weight. They can tell your baby’s presentation: head or bottom first, and their position: front- or rear-facing.)
• Any questions or concerns you may have about delivery

A Beautiful Pregnancy And Beautiful Skin

Throughout these nine months , your prenatal visits are special moments of checking on your sweet little baby. It’s exciting to see your belly grow with each visit! But that also means possible stretch marks.

The good news is that Mustela offers a line of prenatal products, including our Stretch Marks Cream and Bust Firming Serum , to soothe and hydrate your skin while you manage the busyness of your prenatal visit schedule.

Let Mustela help you start your beautiful pregnancy with beautiful skin!

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SARAH INÉS RAMÍREZ, MD, FAAFP

Am Fam Physician. 2023;108(2):139-150

Related AFP Community Blog:   Practice Ancestry-Based Medicine, not Racial Essentialism

Related editorial:   Perinatal Care of Transgender Patients, Adolescent Patients, and Patients With Opioid Use Disorder

Author disclosure: No relevant financial relationships.

Well-coordinated prenatal care that follows an evidence-based, informed process results in fewer hospital admissions, improved education, greater satisfaction, and lower pregnancy-associated morbidity and mortality. Care initiated at 10 weeks or earlier improves outcomes. Identification and treatment of periodontal disease decreases preterm delivery risk. A prepregnancy body mass index greater than 25 kg per m 2 is associated with gestational diabetes mellitus, hypertension, miscarriage, and stillbirth. Advanced maternal and paternal age (35 years or older) is associated with gestational diabetes, hypertension, miscarriage, intrauterine growth restriction, aneuploidy, birth defects, and stillbirth. Rh o (D) immune globulin decreases alloimmunization risk in a patient who is RhD-negative carrying a fetus who is RhD-positive. Treatment of iron deficiency anemia decreases the risk of preterm delivery, intrauterine growth restriction, and perinatal depression. Ancestry-based genetic risk stratification using family history can inform genetic screening. Folic acid supplementation (400 to 800 mcg daily) decreases the risk of neural tube defects. All pregnant patients should be screened for asymptomatic bacteriuria, sexually transmitted infections, and immunity against rubella and varicella and should receive tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap), influenza, and COVID-19 vaccines. Testing for group B Streptococcus should be performed between 36 and 37 weeks, and intrapartum antibiotic prophylaxis should be initiated to decrease the risk of neonatal infection. Because of the impact of social determinants of health on outcomes, universal screening for depression, anxiety, intimate partner violence, substance use, and food insecurity is recommended early in pregnancy. Screening for gestational diabetes between 24 and 28 weeks is recommended for all patients. People at risk of preeclampsia, including those diagnosed with COVID-19 in pregnancy, should be offered 81 mg of aspirin daily starting at 12 weeks. Chronic hypertension should be treated to a blood pressure of less than 140/90 mm Hg.

Family physicians provide family-centered care for individuals and families before, during, and after the birth of a child. Well-coordinated prenatal care that follows an evidence-based, informed process results in fewer hospital admissions, improved education, greater care satisfaction, improved perinatal outcomes, and mitigates pregnancy-associated morbidity and mortality. 1 Family physicians are uniquely positioned to address social determinants of health while ensuring quality of care.

Prenatal Care Visits

Initiation of care between six and 10 weeks allows for identification of preexisting conditions that negatively affect maternal-fetal outcomes (e.g., diabetes mellitus, hypertension, obesity) 2 ; however, 22% of pregnant patients do not receive care during this time. 2 The COVID-19 pandemic resulted in a reevaluation of the number of physician visits needed, with an emphasis on increased flexibility, allowing for a combination of virtual and in-person visits depending on risk. 3 Table 1 outlines the components of prenatal care. 1 , 4 – 22 Table 2 provides opportunities for educating pregnant patients during prenatal care visits. 6 , 8 , 14 – 19 , 23 – 29

PHYSICAL EXAMINATION

Weight, height, and blood pressure should be measured at the first prenatal visit. Early identification of periodontal disease and treatment decreases adverse pregnancy outcomes. 7 Treatment may be performed in the second trimester, and emergent treatment may be completed at any time during pregnancy. 7 A bimanual pelvic examination has poor predictive value for clinical pelvimetry and screening for disease (i.e., sexually transmitted infections and cancer) but may be used as a diagnostic aid in patients with a discrepancy between uterine size and gestational age, which warrants ultrasonography assessment. 30 A pelvic examination is also useful in a symptomatic patient for evaluating spontaneous labor (e.g., cervical dilation, rupture of amniotic membranes). The clinical breast examination is a diagnostic aid in the symptomatic patient and addresses breastfeeding concerns or barriers but does not demonstrate benefit in patients already receiving screening mammograms and does not decrease mortality. 31 – 33

MATERNAL WEIGHT GAIN AND NUTRITION

A prepregnancy body mass index (BMI) greater than 25 kg per m 2 is associated with preterm delivery, gestational diabetes, gestational hypertension, and preeclampsia. A BMI greater than 30 kg per m 2 is also associated with an increased risk of miscarriage, stillbirth, and obstructive sleep apnea. 6 Prepregnancy BMI informs the timing of fetal surveillance, nutritional counseling, and goals for gestational weight gain. Table 3 lists general dietary guidelines for pregnant people. 8 , 17 , 34 , 35 For Black and Hispanic people, a prepregnancy BMI greater than 25 kg per m 2 and the associated poor outcomes are worse compared with non-Hispanic White people. 36

PARENTAL AGE AT CONCEPTION

Advanced maternal and paternal age (35 years and older) is associated with poor outcomes (i.e., aneuploidy, birth defects, gestational diabetes, hypertension, intrauterine growth restriction [IUGR], miscarriage, and stillbirth). Activities focused on improving perinatal outcomes for this group, such as a detailed fetal anatomic screening on ultrasonography, may decrease morbidity and mortality. 37

PREGNANCY DATING AND ULTRASONOGRAPHY

Accurate gestational age estimation is critical to quality care because it enables more precise timing of interventions (e.g., aspirin for preeclampsia prevention, steroids for fetal lung maturity), screening tests, and delivery. Up to 40% of people estimate their last menstrual period incorrectly; therefore, ultrasonography is recommended if uncertainty exists and for patients with irregular menstrual cycles, irregular bleeding, and discrepancy between uterine size and gestational age. 1 , 38 Ultrasonography before 24 weeks decreases missed multiple gestations and post-term inductions. 39 Although routine third-trimester ultrasonography may increase detection of IUGR, it does not improve outcomes. 40 If malpresentation is suspected on physical examination, confirmation with ultrasonography is recommended. 4

ALLOIMMUNIZATION

For patients who are RhD-negative and carrying a fetus who is RhD-positive, the alloimmunization risk is 1.5% to 2% in the setting of spontaneous abortion and 4% to 5% with dilation and curettage. The risk is decreased by 80% to 90% with anti-D immune globulin. 41 Testing for the ABO blood group and RhD antibodies should be performed early in pregnancy. A 300-mcg dose of anti-D immune globulin is recommended for RhD-negative pregnant patients at 28 weeks and again within 72 hours of delivery if the infant is RhD-positive. 41

Iron deficiency anemia increases the risk of preterm delivery, IUGR, and perinatal depression. The U.S. Preventive Services Task Force found insufficient evidence to assess the benefits and harms of screening for anemia in pregnancy. 42 Screening is recommended by the American College of Obstetricians and Gynecologists early in pregnancy, with iron treatment if deficient. 43 Intravenous iron should be considered for patients who cannot tolerate oral iron or in whom oral iron has been ineffective at correcting the deficiency. 43 Patients with non–iron deficiency anemia, or if iron repletion is ineffective within six weeks, should be referred to a hematologist for further evaluation. Iron supplementation in the first trimester decreases the prevalence of iron deficiency. 43

INHERITED CONDITIONS

Pregnant patients should be counseled and offered aneuploidy (extra or missing chromosomes) screening in early pregnancy, regardless of age. 44 In the United States, 1 in 150 infants has a chromosomal condition, the most common being trisomy 21 (Down syndrome). 44 Table 4 compares screening tests for Down syndrome. 1 , 45 , 46 If a screening test is positive, amniocentesis at 15 weeks or more or chorionic villous sampling between 11 and 13 weeks is recommended. Both procedures have similar rates of fetal loss. 47 At 35 years of age, the risk of Down syndrome (1 in 294 births) is similar to that of fetal loss from amniocentesis. 47 Serum and nuchal translucency testing can screen for other trisomies, including 13 and 18, the protocols for which have lower sensitivities and higher specificities compared with screening protocols for trisomy 21 because they are rarer. 47

Additional genetic screening should be based on maternal and paternal personal and family histories. Race is a social construct, necessitating a shift in genetic risk stratification from race-based to ancestry-based. Sickle cell disease affects up to 100,000 people in the United States, but its inheritance pattern (1:10) is based on people with African ancestry, which includes much of the world. 48 Cystic fibrosis is inherited mainly by people of European ancestry (1:25), but ignoring the possibility of European ancestry in certain racial and ethnic groups results in an underestimation of its prevalence: African (1:61), Hispanic (1:40), and Mediterranean (1:29). 49

NEURAL TUBE DEFECTS

In the United States, neural tube defects affect approximately 2,600 infants per year, with the highest prevalence in Hispanic populations. 35 , 50 All pregnant patients should be counseled and offered screening with maternal serum alpha fetoprotein. 35 Folic acid, 400 to 800 mcg daily, started at least one month before conception and continued until the end of the first trimester, decreases the incidence of neural tube defects by nearly 78%. 35 Patients taking folic acid antagonists (e.g., carbamazepine, methotrexate, trimethoprim) or who have a history of carrying a fetus with a neural tube defect should take 4 mg of folic acid daily, starting at least three months before conception. 35

THYROID DISORDERS

There is no evidence that screening for thyroid disorders improves pregnancy outcomes. Thyroid-stimulating hormone levels should be measured if there is a history of thyroid disease or symptoms of disease. If the level is abnormal, a free thyroxine test helps determine the etiology. 51 Hypothyroidism complicates 1 to 3 per 1,000 pregnancies and increases the risk of fetal loss, preeclampsia, IUGR, and stillbirth. Hyperthyroidism occurs in 2 per 1,000 pregnancies and is associated with miscarriage, preeclampsia, IUGR, preterm delivery, thyroid storm, and congestive heart failure. 51 The effect of subclinical hypothyroidism on a child's neurocognitive development is not well understood, and the effectiveness of treatment with levothyroxine is unproven. 51

CERVICAL CANCER

Intervals for cervical cancer screening are based on patient age, cytology history, and history of the presence of high-risk human papillomavirus (HPV). Routine screening for people at average risk of cervical cancer should begin at 21 years of age. Screening can be performed with either cytology alone every three years, HPV screening alone every five years, or cytology plus HPV screening every five years starting at 25 years of age. Screening is not indicated for people 65 years and older with negative screening in the previous 10 years, and no history of cervical intraepithelial neoplasia grade 2 or higher in the past 25 years. 52 Colposcopy is indicated when the risk of cervical intraepithelial neoplasia grade 3 is greater than 4%. Surveillance of high-grade lesions should be performed every 12 to 24 weeks. 52 , 53 Although colposcopy and cervical biopsy can be safely performed during pregnancy, endocervical sampling should be deferred until postpartum. 53

Infectious Disease

Bacteriuria.

Asymptomatic bacteriuria complicates up to 15% of pregnancies in the United States, 30% of which progress to pyelonephritis if untreated. 54 All pregnant patients should be screened for bacteriuria at the first prenatal visit. 54 A culture from a midstream or clean-catch sample with greater than 100,000 colony-forming units per mL of a single pathogen is considered positive and treated to decrease the risk of pyelonephritis and subsequent preterm delivery. 54

SEXUALLY TRANSMITTED INFECTIONS

Sexually transmitted infections can affect prenatal outcomes. 55 – 57 Table 5 lists routine screening and treatment for sexually transmitted infections in pregnancy. 55 , 56

Rubella immunity screening during the first prenatal visit is recommended. Postpartum vaccination should also be offered if the patient is not immune to prevent congenital rubella syndrome in subsequent pregnancies. 1 , 58 The presence of rubella immunoglobulin G should be interpreted with caution in patients recently migrating from areas where rubella is endemic because this may indicate a recent infection. 58 Rubella is a live vaccine and should not be administered during pregnancy but is safe during lactation after delivery. 59 , 60

Maternal varicella can result in congenital varicella syndrome (i.e., IUGR and limb, ophthalmologic, and neurologic abnormalities) and neonatal varicella; infection can occur from approximately five days before to two days after birth. A negative history of varicella infection or vaccination warrants serologic testing, and if immunoglobulin G is negative, varicella exposure should be avoided. Postpartum vaccination should be offered. 61

Although tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination is recommended for anyone in close contact with the infant, only antenatal maternal vaccination ensures increased protection against neonatal pertussis. 62 Pregnant patients should receive a Tdap vaccine beginning at 27 weeks to maximize time for passive immunity to the fetus through the placental transfer of maternal antibodies; vaccination is recommended in each subsequent pregnancy. 62

INFLUENZA AND COVID-19

Influenza and COVID-19 infection in pregnancy increase the risk of intensive care unit admission, preterm delivery, stillbirth, and maternal death. 63 , 64 COVID-19 infection almost doubles the risk of developing preeclampsia 64 ; therefore, initiating low-dose aspirin (81 mg daily) starting at 12 weeks should be considered. 5 Pregnant patients and their household contacts should be vaccinated for influenza and COVID-19. 63 , 64

GROUP B STREPTOCOCCUS

In the United States, group B Streptococcus (GBS) is the leading cause of infection in the first three months of life; 25% of all pregnant patients are GBS carriers. 65 , 66 Screening with a vaginal-rectal swab for culture between 36 and 37 weeks is recommended. 67 Intrapartum antibiotic prophylaxis decreases neonatal mortality. Antibiotics are recommended when there is GBS bacteriuria with the current pregnancy, a history of a previous infant affected by GBS (e.g., septicemia, meningitis, pneumonia, death), or unknown GBS status and risk factors (e.g., preterm labor, rupture of membranes more than 18 hours before delivery, GBS in previous pregnancy). 67 Patients with GBS bacteriuria in the current pregnancy are assumed to be colonized and do not need subsequent screening. 67

Social Determinants of Health

Social determinants of health represent up to 80% of the factors that directly affect a person's health. 68 Physicians who provide prenatal care play a critical role in mitigating the burden that social determinants of health play on maternal-child health without compromising the quality of care delivered. 69 An increased burden from social determinants of health increases the risk of depression, anxiety, intimate partner violence, substance use, and food insecurity 70 , 71 ; therefore, universal screening is recommended early in pregnancy.

DEPRESSION AND ANXIETY-RELATED DISORDERS

After the COVID-19 pandemic, rates of perinatal depression and anxiety have increased. People who are non-White, 24 years or younger, or who have 12 years or less of education, lower socioeconomic status, or a history of intimate partner violence or sexual trauma are at higher risk. 11 , 72 , 73 If untreated, depression and anxiety-related disorders increase the risk of preeclampsia, preterm delivery, IUGR, substance use, maternal suicide, infanticide, psychosis, and homicide. 11

INTIMATE PARTNER VIOLENCE

Intimate partner–related homicide is the leading cause of death in the United States in pregnancy. Screening is recommended at the first prenatal visit and once per trimester. 13 Intimate partner violence increases the risk of miscarriage, placental abruption, premature rupture of membranes, IUGR, and preterm delivery. 13 Family physicians should be aware of the signs of intimate partner violence (e.g., frequent sexually transmitted infections, repeated requests for pregnancy tests when pregnancy is not desired, fear of asking a partner to use a condom), the effect of violence on health, and the increased risk of child abuse after delivery. 13

SUBSTANCE USE

Substance use during pregnancy increases the risk of IUGR, preterm delivery, stillbirth, fetal malformations, and maternal death. 74 The use of prescription opioids complicates 7% of pregnancies in the United States; of these, 20% of patients report misuse. 75 Opioid use in pregnancy increased by 131% from 2010 to 2017 in the United States, and the incidence of babies born with withdrawal symptoms in that time increased by 82%. 76 Fetal alcohol exposure is the leading cause of preventable neurodevelopmental disorders in the United States. 14 However, 14% of pregnant patients report current drinking, and 5% report binge drinking in the past 30 days. 77 Exposure to cigarette smoking in utero increases the risk of sudden intrauterine and infant death. 15

FOOD INSECURITY

Maternal food insecurity increases the risk of poor outcomes (e.g., IUGR, preterm delivery, gestational diabetes, hypertension, depression, anxiety). However, few patients disclose this due to concerns about social stigma; therefore, a universal approach to screening is encouraged. The Hunger Vital Sign tool may be used. 12

Complications of Pregnancy

Gestational diabetes.

Gestational diabetes complicates up to 14% of U.S. pregnancies, with up to 67% of patients developing type 2 diabetes later in life. 78 Racial and ethnic minorities are at the highest risk. 79 Gestational diabetes is associated with hypertension, macrosomia, shoulder dystocia, and cesarean deliveries. 80 Screening for undiagnosed type 2 diabetes at the initial prenatal visit is recommended for people at increased risk 80 ( Table 6 5 , 80 ) . Universal screening for gestational diabetes should occur between 24 and 28 weeks with a one-hour (50-g) glucose tolerance test and, if results are abnormal, should be followed by a confirmatory, fasting, three-hour (100-g) test. 80

HYPERTENSION

Blood pressure should be monitored at each prenatal visit, and education should be provided on preeclampsia warning signs. 5 Patients at increased risk of preeclampsia should be screened for thrombocytopenia, transaminitis, and renal insufficiency, including proteinuria, during the first or second trimester and started on prophylactic daily low-dose aspirin (81 mg) between 12 and 16 weeks 5 , 85 ( Table 6 5 , 80 ) . [Updated] Screening for proteinuria in isolation has little predictive value for detecting preeclampsia. 5 Chronic hypertension (hypertension before 20 weeks) is treated to less than 140/90 mm Hg. 81

PRETERM DELIVERY

Preterm delivery (between 20 and 37 weeks) is a significant cause of neonatal morbidity and mortality, complicating 10.5% of U.S. pregnancies. 2 Modifiable risk factors include prepregnancy BMI (less than 18.5 kg per m 2 and greater than 25 kg per m 2 ), substance use, and short interval between pregnancies (i.e., less than 18 months). 82 Several options are available for the prevention of preterm labor in a singleton pregnancy. 82 Patients with a previous preterm delivery before 34 weeks should have a cervical length assessment starting at 16 weeks through 24 weeks. 82 These patients should be treated with progesterone supplementation (vaginal or intramuscular). In the asymptomatic patient with a short cervix and without a history of spontaneous birth before 34 weeks, vaginal progesterone (200 mg) started between 16 and 20 weeks and continued through 36 weeks is recommended. 82

POST-TERM DELIVERY

Stillbirth complicates 3 per 1,000 post-term (42 weeks or greater) pregnancies. 20 Antenatal testing should be initiated at 41 weeks; if the results are not reassuring, induction of labor is recommended. 20 , 21

Cultural Considerations

Maternity care improves outcomes; however, vulnerable populations (i.e., racial, ethnic, and religious minorities) are less likely to engage in care if it is not culturally centered, which acknowledges the effect of culture on health conditions (e.g., depression) and enhances patient-physician trust. 83 Addressing cultural needs (e.g., doula, community health workers, interpreters) throughout pregnancy helps mitigate barriers and improves outcomes.

This article updates previous articles on this topic by Zolotor and Carlough 1 ; Kirkham, et al. 17 ; and Kirkham, et al. 84

Data Sources: A search was completed using the key terms prenatal care, COVID-19, oral health, pelvic examination, prepregnancy body mass index, pregnancy dating and ultrasound, maternal and paternal age and impact on pregnancy outcomes, aneuploidy screening, inheritance patterns of sickle cell disease and cystic fibrosis, anemia, cell-free DNA analysis, thyroid disease, cervical cancer screening, management of abnormal cervical cytology, screening guidelines for sexually transmitted infections in pregnancy, group B Streptococcus screening, social determinants of health and prenatal outcomes, intimate partner violence, polysubstance abuse, food insecurity, maternity care deserts, hypertension in pregnancy, progesterone for preterm birth prevention, post-term delivery, and preconception care. Also searched were PubMed, Essential Evidence Plus, the Cochrane database, U.S. Preventive Services Task Force, American College of Obstetricians and Gynecologists, American Cancer Society, American Family Physician , and reference lists of retrieved articles. Search dates: July 1, 2022; February 19, 2023; and June 16, 2023.

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