Understanding major health care milestones
It’s one of the very best reasons to visit a doctor: You’re pregnant. And you’re taking the right steps to monitor your health and the health of your growing baby. Check out the major health care milestones along your pregnancy journey below.
Deciding you want to conceive
Congratulations! You’ve decided you want to have a baby. Now’s a great time to visit your Ob/Gyn. Find out whether any medications you’re taking are safe during pregnancy. Ask for help with health challenges, such as giving up smoking or managing diabetes. Your doctor may also recommend prenatal vitamins or booster vaccinations.
If you or your partner is at risk of passing on certain disorders, such as Cystic Fibrosis or Tay-Sachs disease, you should pursue genetic counseling before getting pregnant. Families can prevent transmission of some disorders by using preimplantation genetic diagnosis (PGD) and in vitro fertilization (IVF).
Your first prenatal visit
Once you believe you’re pregnant, make an appointment with your Ob/Gyn to confirm the happy news. Your first visit will include a physical and pelvic exam, Pap test, blood/urine labs, and maybe a flu shot. Your doctor can also answer questions about weight and nutrition.
How many visits?
Your prenatal care provider will likely request that you schedule monthly check-ups until your 28th week of pregnancy, then bi-monthly check-ups until week 36. In the last month, you’ll be visiting your doctor every week.
Your Ob/Gyn will typically perform a first-trimester screening: This includes a blood test and an ultrasound exam called a nuchal translucency scan. It assesses risks for chromosomal disorders and other problems. Women at higher risk of passing on genetic disorders may be offered a “cell-free DNA test” and a chorionic villus sampling (CVS), in which a small sample of cells is removed from the placenta for testing.
You may undergo a blood test called a maternal serum screen—also known as a quad screen or multiple market screen—to check for chromosomal disorders and neural tube defects like spina bifida.
The most famous and common second-trimester test is the 18- to 20-week ultrasound appointment. This checks the health of your baby’s organs and may also reveal the baby’s gender.
Between weeks 14 and 20, mothers age 35 and older and those with genetic risks may undergo an amnio. In this procedure, a thin needle is inserted into the mother’s uterus to withdraw amniotic fluid. Genetic testing is performed on the fluid.
You’ll likely be checked for gestational diabetes. If your pregnancy is considered high-risk, you might need additional tests such as a biophysical profile (BPP) or another ultrasound. Your doctor may also discuss birth classes and delivery planning.
Near the very end
At about week 36 or 37, your Ob/Gyn may perform a Group B streptococcus test. This entails collecting cells through vaginal and rectal swabs to test for the presence of bacteria that can cause infection in the newborn. Mothers who test positive are treated with antibiotics during childbirth to protect the baby.
Labor and delivery
Congratulations: It’s time for your baby to enter the world! While most women have vaginal deliveries, some need to deliver through Cesarean section. Anesthesia is the norm for Cesareans, but more than half of women who deliver vaginally also receive epidural or spinal anesthesia. If your due date passes and you haven’t delivered (39 weeks is full-term), your doctor may talk to you about inducing labor.
Baby’s turn for testing
After delivery, your newborn will undergo a round of blood, hearing and heart screenings. Your pregnancy journey has come to an end, but your baby’s journey is just getting started!
Sources: Office on Women’s Health, U.S. Department of Health and Human Services, March of Dimes.