Your First Prenatal Visit: What to Expect

Katie GriffinOnline Childbirth Classes for Natural Birth, Pregnancy

Your First Prenatal Visit What to Expect

Yesterday I made my first visit to the OB with this new pregnancy, and I figured I’d use it as an opportunity to help you all know what to expect at your first prenatal visit!

When is first prenatal visit?

I’ve given birth to each of my 5 children in a different state with a different provider. Each office has offered different guidance about when to come in for the first prenatal visit, ranging from 6 to 12 weeks from my last menstrual period (LMP).

First prenatal visit 6 weeks – 12 weeks 

Like many of you who are pregnant with your first baby, I scheduled my appointment with my first baby shortly after I found out I was pregnant and actually came in for my first prenatal visit when I was 8 weeks pregnant. I’d say that 8 weeks pregnant is a pretty good standard.

With this pregnancy, I was a bit of a slacker and called to schedule my appointment at 8 weeks but couldn’t get in until I was 12 weeks pregnant due to availability.

What happens at first prenatal visit?

peeing-in-a-cup-at-first-prenatal-visit

Of course each office will have a slightly different routine, but here’s generally what you can expect to do at your first prenatal visit:

1. Pee in a cup.

How To Pee In a Cup! 

If you’ve never done this before, read this post about how to provide a clean catch urine sample.  Plan to give a urine sample at each prenatal visit.

When I checked in, the front desk handed me a ID label to stick on the urine cup.  They directed me to provide the urine sample right away, and then I came back to the waiting room to wait for the nurse to call me back to the exam room. Other offices just have you write your name on the cup with a marker.  When you’re done, you open the little metal door in the wall and place your urine sample inside.  

What Do They Check In the Urine Sample?

The nurse will retrieve the urine sample and examine it for excess protein.  This can indicate high blood pressure or a urinary tract infection.  They also look for excess glucose, which can indicate gestational diabetes.  In this first visit, they did a pregnancy test, too — happy to report it was positive!

2. Check your vital signs.

At this point, most offices are going to check your blood pressure and weight.  Notice that I didn’t take a picture of this one.  There are some things I’m just not interested in sharing with the world.

nurse-intake-during-first-prenatal-visit

3. Nurse intake.

Once I was brought back to a room, I sat with the nurse and answered questions for her while she went through my chart. We discussed how many pregnancies I’d had, how many live births, how many miscarriages, etc.   She also asked me for a list of any medications I take, and if I have specific issues I’d like to discuss with the doctor or midwife.  The nurse also gave me a packet with information about the practice, the hospital, and a bunch of paperwork that I need to fill out for my next visit.

Share Your Medical History

This is an important time to share your medical history or any health conditions that might affect your pregnancy.  Be sure to let the nurse know about medical conditions such as:

  • Past miscarriages
  • Diabetes
  • Seizures
  • Depression or anxiety
  • High blood pressure
  • Allergies
  • Prior surgeries
  • Problems with anesthesia
listening-for-heartbeat-using-a-doppler-first-prenatal-visit

4. Check for the heartbeat!

A doppler unit can be used to check the fetal heartbeat starting at around 10-12 weeks of pregnancy.  So, if you have your first prenatal visit at 8 weeks, plan to skip this part of the visit.  

In my case, I’m 12 weeks pregnant and requested to see if they could find the heartbeat.  I’ve had miscarriages in the past and wanted some assurance that this little baby was actually alive and well.  And I suppose I wanted some validation for the nausea and exhaustion!  If you’re wondering if they found a heartbeat, you’ll just have to watch the video to find out…Oh, the suspense!!

talking-with-doctor-at-first-prenatal-appointment

5. Meet with the doctor or midwife.

As the nurse left the room, she instructed me to take off everything from the waist down. She did leave me with a sheet to cover up with, although it’s pretty impossible to avoid the bum draft when you can’t wrap the sheet around you well enough.  Giving birth changes your outlook on modesty…these visits help ease you in a bit!  

A minute later the doctor came in, reviewed my chart, and asked me questions about my past pregnancies and births.  He shared lots of great info about how to enjoy a safe and health early pregnancy.  Topics included prenatal vitamins, foods to avoid, exercise, medicines to avoid, etc.

Questions to Ask at the First Prenatal Visit

This is a great time to start establishing rapport with your healthcare provider.  Ask them questions, be friendly, get to know them!  These are the people you are inviting to help you give birth to your baby, so you want to put in the effort now to have a good relationship.  So start asking questions!  (Meanwhile, I’m still hanging out half-naked, covered by a sheet.  I wouldn’t mind doing that portion of the visit while I’m still clothed.  But, I digress.)

A few good questions to ask at the first prenatal visit include:

  • What are reasons that I would need to call the doctor’s office?
  • Who do I call if I have questions or concerns?
  • Do I have any restrictions on exercise or sex?
  • When am I due for important prenatal tests?
  • At this practice, will I rotate my visits through all the doctors/midwives?  Which doctor/midwife will attend my birth?
  • What hospital(s) do you deliver at?
  • Are there any safe over-the-counter medications that I can take, or ones I should be certain to avoid?
  • Is there a specific prenatal vitamin you recommend?

If you’re planning to have a natural birth, a few other important questions to ask include:

  • What’s the general feeling in this practice about natural childbirth?  Do many of your clients have natural births?
  • What percentage of your clients have c-sections?
  • How common are labor inductions?  What are the reasons that you typically induce labor?
  • What do you do to help prevent tearing during birth?
  • How do the doctors in this practice feel about doulas?
  • If I don’t have an epidural, am I able to push in whatever position feels best to me?

Pelvic Exam With Pap Smear

Next, the doctor called a nurse into the room, and he proceeded with the pelvic exam.  At this practice, they do a gonorrhea and chlamydia text, which is just a simple cervical swab.  Then he felt for the size of my uterus by pressing one hand on the cervical area and other on my abdomen.  They also do a pap smear, if you haven’t had one recently.  (The pap smear looks for cells that might indicate cervical cancer.) And that was that!  The pelvic exam was done!

drawing-labs-at-first-prenatal-appointment

6. Give a blood sample.

Lastly, I was sent to the phlebotomist’s room to draw blood for testing.  The phlebotomist, who didn’t want to be in the picture, assures me that I’m way too smiley for someone who’s about to get their blood taken.  What can I say, I’m just so excited to be pregnant!!!

Blood Test at First Prenatal Visit

They test for a whole slew of things with this first blood test.  These tests typically include:

  • Complete blood count (CBC) – tests to see if you’re anemic
  • Blood type and rhesus status
  • MMR titers
  • Hepatitis B antigen
  • Rubella immunity
  • HIV and syphillis test

7.  Set your next appointment.

Last but not least, I headed to the check-out desk and set up my next prenatal visit.  At my practice the second visit is a 13-week ultrasound where they assess the baby for size, and ultimately try to establish an accurate due date for the baby.  As you’ll learn in your Kopa Birth® online childbirth class, ultrasounds late in pregnancy are significantly less accurate at determining the baby’s size.  So an early ultrasound is more effective for establishing the due date.  If you have concerns about early ultrasounds, discuss your concerns with your doctor or midwife.

Till next time!  Enjoy your pregnancy!

Katie

(This post has been updated from its original publishing date in 10/2016)

Katie headshot

Katie Griffin is a Registered Nurse, Lamaze & CAPPA Certified Childbirth educator, and the mother of 5 children.  She is also the instructor for the KOPA PREPARED Online childbirth course series.

Kopa Birth’s online birthing classes allow you to prepare for a natural hospital birth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class and start preparing for your natural birth!