PRENATAL CHECKUPS

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PRENATAL CHECKUPS: MONTH BY MONTH WHAT TO EXPECT WHEN SEEING YOUR DOCTOR

First Month
Second Month
Third Month
Fourth Month
Fifth Month
Sixth Month
Seventh Month
Eighth Month
Ninth Month

The usual schedule of prenatal visits to your practitioner is monthly for the first twenty-eight weeks, every two weeks from twenty-eight to thirty-six weeks, and weekly thereafter until delivery. The frequency and complexity of these visits may vary, according to your practitioner's philosophy, your previous obstetrical history, and any special needs you and your baby may have. Your obstetrician or midwife will use the office visits to monitor the changes you and your baby are experiencing. Most of these changes are normal. Other changes may signal a concern that needs to be addressed. In most cases, these concerns can be dealt with or corrected early on so your chances of delivering a healthy baby are great.

While there are no guarantees in life, taking good care of yourself is one way to take care of your preborn baby. Regular prenatal visits help to ensure that your self-care is on target and that your baby is growing, as she should.

FIRST MONTH VISIT TO YOUR HEALTHCARE PROVIDER

0-4 WEEKS
On your first visit to your healthcare provider plan to have:

Confirmation of pregnancy
A general medical history and previous obstetrical history if you have one
A general physical exam, including an internal exam
Blood tests: hemoglobin and hematocrit, blood typing, rubella titer, hepatitis B screen (HIV screen, venereal disease screen, and sickle cell screen are optional)
Examination and possible cultures for vaginal infections
Pap smear
Possible blood test for genetic diseases if your history warrants
Urinalysis to test for infection, sugar, and protein
Weight and blood pressure check
Counseling on proper nutrition and avoiding environmental hazards
An opportunity to discuss your concerns

SECOND MONTH VISIT TO YOUR HEALTHCARE PROVIDER

5-9 WEEKS
During this month's visit you may have:

An examination of your abdomen
An examination of the size and height of uterus
A hemoglobin and hematocrit check for anemia
Nutritional counseling
Weight and blood pressure check
Urinalysis to test for infection, sugar, and protein
An opportunity to discuss your concerns

THIRD MONTH VISIT TO YOUR HEALTHCARE PROVIDER

10-14 WEEKS
During this month's visit you may have:

Examination of your abdomen to feel the top of the uterus
Examination of the size and height of uterus
Hemoglobin and hematocrit
Urinalysis to test for infection, sugar, and protein
Weight and blood pressure check
Possibly hearing baby's heartbeat with a doppler device
Discussion of tests if needed: ultrasound, chorionic villus sampling, amniocentesis, and prenatal screening for genetic problems
Exam for swelling of hands and legs or fluid retention
An opportunity to discuss your concerns

FOURTH MONTH VISIT TO YOUR HEALTHCARE PROVIDER

15-19 WEEKS
During this month's visit you may have:

Examination of the size and height of uterus
Examination for swelling varicose veins, and rashes
An opportunity to hear baby's heartbeat
Opportunity to possibly see baby move and all the organs that are now developed on ultrasound, if indicated
A triple screen test for possible prenatal genetic defects
Weight and blood pressure check (expect a more rapid weight gain over the next three months)
Urinalysis to test for infection, sugar, and protein
Ultrasound in many practices is now a routine around 15-19 weeks to screen for possible birth defects, number of babies, placental location, and dating of baby's age.
An opportunity to discuss feeling baby move, which you may have already
An opportunity to discuss your concerns

FIFTH MONTH VISIT TO YOUR HEALTHCARE PROVIDER

20-24 WEEKS
During this month's visit you may have:

Examination for the size and height of uterus
An abdominal exam
Examination of your breasts and skin
Examination for swelling of hands, legs, and enlargement of veins
Weight and blood pressure
Urinalysis to test for infection, sugar, and protein
An opportunity to hear baby's heartbeat
An opportunity to see baby on ultrasound, if indicated
An assessment of fetal activity -- how often your baby moves and what it feels like
An opportunity to discuss your concerns

SIXTH MONTH VISIT TO YOUR HEALTHCARE PROVIDER

24-28 WEEKS
During this month's visit you may have:

Examination of the size and height of uterus
Weight and blood pressure check
Urinalysis to test for infection, sugar, and protein
Oral glucose tolerance test, screening for gestational glucose intolerance, if indicated
Vaginal culture, screening test for beta strep infection, if indicated
An opportunity to hear your baby's heart beat
An opportunity to see your baby growing on ultrasound, if indicated
An opportunity to discuss your concerns

SEVENTH MONTH VISIT TO YOUR HEALTHCARE PROVIDER

28-32 WEEKS
During this month's visit you may have:

Examination of the size and height of uterus
Examination of your skin for rashes, enlarging veins, and swelling
Weight and blood pressure check
Urinalysis to test for infection, sugar, and protein
Hemoglobin and hematocrit, if indicated
Review of your diet, an opportunity to discuss your weight, if necessary.
An opportunity to hear baby's heartbeat
An opportunity to see on ultrasound how baby has grown (if indicated)
An opportunity to discuss your concerns

During month seven and eight your healthcare provider may want to check you twice a month.

EIGHTH MONTH VISIT TO YOUR HEALTHCARE PROVIDER

32-36 WEEKS
During this month's visit you may have:

Examination of the size and height of uterus
Examination of your skin for rashes, enlarging veins, and swelling
Weight and blood pressure check
Urinalysis to test for infection, sugar, and protein
Hemoglobin and hematocrit, if indicated
Review of your diet, an opportunity to discuss your weight, if necessary.
An opportunity to hear baby's heartbeat
An opportunity to see how baby has grown on ultrasound, if indicated
An opportunity to discuss your concerns

During month seven and eight your healthcare provider may want to check you twice a month.

NINTH MONTH VISIT TO YOUR HEALTHCARE PROVIDER

36-40 WEEKS
During this month your healthcare provider may check you weekly. During this month's visit you may have:

Examination of the size and height of uterus
Palpation of your uterus to determine position of baby
An internal exam, if indicated
Weight and blood pressure check
An ultrasound exam if needed to determine the size and position of your baby
Urinalysis to test for infection, sugar, and protein,
An opportunity to discuss when to call your practitioner if labor begins
An opportunity to discuss the difference between Braxton-Hicks contractions and the "real" ones
An opportunity to discuss signs that labor has begun
An opportunity to discuss when to go to the hospital or birth center
An opportunity to discuss your birth plan, including labor assistants, avoiding episiotomy, or special birth requests
An opportunity to discuss other concerns

If your weekly or twice weekly visits drag on, your healthcare provider may discuss what to do when you're "overdue". You may have weekly ultrasound examinations to assess the volume of the amniotic fluid, a biophysical profile, or discussion of possible induction of labor at some point. If you are overdue your healthcare provider will counsel you on worrisome signs to watch for. Frequency and content of healthcare provider visits during the final month depends greatly on your particular obstetrical situation.

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