Prenatal care: The first visit

As soon as you think you're pregnant, schedule your first prenatal appointment. Set aside ample time for the visit. You and your health care provider have plenty to discuss! You might want to include your partner in the appointment as well.

Medical history

Your health care provider will ask many questions, including details about:

• Your menstrual cycle and gynecological history
• Past pregnancies
• Your personal and family medical history
• Medication use, including prescription and over-the-counter medications or supplements
• Your lifestyle, including your use of tobacco, alcohol and caffeine

Be sure to mention even sensitive issues, such as domestic abuse, abortion or past drug use. Remember, the information you share will help your health care provider take the best care of you — and your baby. If there's any part of your medical history that you don't want to share with your partner or other loved ones, mention it to your health care provider privately.

Due date

Few women actually give birth on their due dates. Still, establishing your due date — or estimated date of delivery — is important. An accurate due date allows your health care provider to monitor your baby's growth and the progress of your pregnancy, as well as schedule certain tests or procedures at the most appropriate 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 will use a fetal ultrasound to help confirm the date.

Physical exam

Your health care provider will check your weight and height and use this information to calculate your BMI. He or she will use your BMI to determine the recommended weight gain you need for a healthy pregnancy.

Your health care provider will measure your blood pressure, heart rate and breathing rate and do a complete physical exam. He or she will check for any undiagnosed medical conditions.

Your health care provider will also examine your vagina and the opening to your uterus (cervix). Changes in the cervix and in the size of your uterus can help confirm the stage of your pregnancy. You might need a Pap test to screen for cervical cancer as well, depending on how long it's been since your last screening.

Lab tests

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

• Check your blood type. This includes your Rh status. Rhesus (Rh) factor is an inherited trait that refers to a specific protein found on the surface of red blood cells. Your pregnancy needs 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, and to carry carbon dioxide from other parts of your body to your lungs so that it can be exhaled. Low hemoglobin is a sign of anemia — a lack of healthy red blood cells.
• 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 might suggest blood tests to detect various other infections, such as hepatitis B, syphilis, gonorrhea or chlamydia, and HIV, the virus that causes AIDS. A urine sample will be tested for signs of infection.

Screening tests for fetal abnormalities

Prenatal tests can provide valuable information about your baby's health. Your health care provider might offer ultrasound, blood tests or other screening tests to detect fetal abnormalities.

Lifestyle issues

Your health care provider will discuss the importance of proper nutrition and prenatal vitamins. Your first prenatal visit is a good time to discuss exercise, sex during pregnancy and other lifestyle issues. You might also discuss your work environment and the use of medications during pregnancy.

If you smoke, ask your health care provider for suggestions to help you quit.

Normal Discomforts of Pregnancy

You might notice many changes in your body early in your pregnancy. Your breasts might be tender and swollen. Nausea with or without vomiting, called morning sickness, also is common. Talk to your healthcare provider if your morning sickness is severe.