Here’s what to expect during your first prenatal appointment

Your pregnancy test is positive. You not-so-patiently wait for your ob-gyn’s office to open, and then make the call, thinking about how many questions you have. But then the receptionist schedules your appointment four weeks from now.

This is common. Some ob-gyns will want to see you right away, especially if you’re considered high risk due to certain health problems, advanced maternal age or a history of miscarriage. Your ob-gyn can help you determine if you’re high risk. For non-high-risk pregnancies, many ob-gyns ask that you wait to be seen until the second month, six to eight weeks after the start of your last period, or once you’ve had two missed periods.

Still, it’s important to make the call right away, as some ob-gyns book up quickly. And seeking care, guidance and support from your ob-gyn is an important step. Here, we’ll share how to prepare, questions you should ask and what to expect at your first ob-gyn appointment. Don’t have an ob-gyn? We’ll help you with that, too.

How to prepare for your first prenatal appointment

Your first prenatal appointment will likely be the longest appointment of your pregnancy. It’s a fact-finding mission,¹ and your ob-gyn will ask you as many questions as you will probably ask them.

Knowing the answers to the questions ahead of time will help you better prepare. Of course, this isn’t a full list, just a few thought starters:

• Write down all the medicines, vitamins, herbs and supplements you take, including their full names and dosages.²
• Be prepared to talk about your physical and mental health. Do you have any allergies? Are you caught up on all your immunizations? Have you had any major surgeries or illnesses, and if so, when? Have you ever been treated for depression or anxiety? Sometimes reviewing your old medical records can help jog your memory.
• If your obstetrician is also your gynecologist, you may not need to discuss your gynecological history. But if you’re seeing a midwife or someone new, be prepared to talk about how old you were when you first started your period, what your cycle is like, any sexually transmitted infections and diseases,³ previous pregnancies or losses, gynecological surgeries and more.
• Put together a family medical history that includes your family (parents, grandparents and siblings) and, if applicable, your partner and your partner’s family. If you’re using donated sperm and/or egg, obtaining the donor’s medical history can be helpful, too.

Be honest, especially when asked about consumption of drugs, alcohol and tobacco. Knowing the full situation will help your ob-gyn provide the best care for you and your baby. Don’t be afraid to open up about anxiety and stress as well. Learning the more intimate parts of your personal story will help your ob-gyn guide you to resources and support.

What if you don’t have an ob-gyn? Here’s how to find one 

Do you have a positive pregnancy test but no ob-gyn? Don’t worry. Call your primary care doctor and let them know you’re pregnant. They can advise you on first steps and provide a referral, which some insurance plans require. 

Your insurance is another thing to consider. It’s important to understand how your insurance works and how to find someone who is considered in-network, which typically will help keep costs down. You may consider asking family or friends for recommendations. You may think about a midwife versus an ob-gyn. If you have your heart set on a particular hospital for delivery, make sure the provider you choose is affiliated with that hospital. Consider convenience, both in hours of operation and location — you will have lots of appointments these next few months. Read bios, interviews and reviews online. If you have particular wants, needs or wishes, such as a natural birth, a VBAC (vaginal birth after a cesarean) or the presence of a doula, make sure the practice you choose will honor them.

Finally, know that it’s OK to change your mind. It’s important to have an honest, open and professional-yet-caring relationship with your provider. If something feels off, try someone else.

Questions to ask at your first prenatal visit

One of the best ways to busy yourself while waiting for your first prenatal appointment is to make a list of questions to ask. Keep a pad of paper in your purse or use your smartphone to jot down questions as you think of them. Here are some to consider:

• What diet recommendations and restrictions do I have?^2,4
• How many calories should I consume, and how much weight should I gain?²
• Is there anything in the medical histories I’ve shared that is concerning?
• Are the medicines, vitamins or supplements I’m taking OK? For future ailments, what am I allowed to take, and what should I avoid?²
• Do you recommend any tests or screenings? If so, when?⁵
• Is exercise OK?¹
• Is sex OK?
• Can I continue caring for my pets just as I always have?⁶
• Do I need to worry about chemicals or toxins in my line of work?
• Will I have any travel restrictions, and if so, when?
• Can I dye my hair? Are massages OK? What about spray tans and pedicures?⁷
• Will you be my ob-gyn throughout my pregnancy, or will I rotate through all the ob-gyns in the practice? Will you deliver my baby, or will the ob-gyn who is on call deliver?
• If I have a question or concern, is it better to email or call? If I have an urgent concern after hours, what should I do?
• How often do you need to see me?
• What symptoms are considered normal? When should I worry?
• When should I start prenatal classes, and do you have any you recommend?
• I’m worried about [my partner/work/childcare/transportation/affording a baby]. What should I do?

What will happen during your first prenatal exam?

You will be doing a lot of talking and a lot of listening. Sometimes the amount of information can feel overwhelming. Consider bringing someone with you to take notes, ask questions or simply hold your hand.

Typically, the first thing your ob-gyn will do is confirm your pregnancy with a urine or blood test.

You’ll also have a physical exam.^1,8 A nurse or ob-gyn will check your height, weight and blood pressure. You’ll then have a thorough health screening, checking everything from your thyroid, heart and lungs to your breasts, abdomen and skin. You’ll typically have a pelvic exam and a Pap smear if you’re due for one.

Depending on your current health, medical history and ob-gyn, you may have additional testing done, in the office or at a lab, and at any point in the pregnancy, including during your first appointment. These include a CBC (complete blood count), blood type (including an Rh [Rhesus] factor test), urinalysis and urine culture. These lab tests look for things like anemia, blood clotting issues, hepatitis B and C, sexually transmitted infections, high levels of blood sugar, urinary tract infections or disease, rubella and HIV.3 Your ob-gyn may also discuss genetic carrier screening.^5,9

Your first prenatal appointment is a fact-finding mission, and your ob-gyn will ask you as many questions as you will probably ask them.

You may be eager to hear or see the heartbeat. Using a transvaginal ultrasound, a heartbeat can be seen and heard as early as six to seven weeks. Not all women receive a transvaginal ultrasound. In fact, many women only have one transabdominal ultrasound around 18 to 22 weeks. Some ob-gyns will use a fetal Doppler, a test that uses sound waves to hear the baby’s heartbeat, but it can be difficult to hear anything prior to 13 weeks. If it’s early and you can’t hear a heartbeat, don’t panic. You may not be as far along as you thought, or factors like your BMI, a tilted uterus or the position of your placenta may make the heartbeat more difficult to hear early on.¹⁰

Finally, your ob-gyn will give you an estimated due date (EDD). This is determined by the first day of your last menstrual period and/or an ultrasound. According to The American College of Obstetricians and Gynecologists, only about one in 20 women will give birth on her due date.11 But having an EDD provides a useful pregnancy timeline.

 

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