The first prenatal visit can be both an exciting yet scary time for a woman. This doctor visit is usually the longest appointment during the pregnancy and can be one of the most important as well.
If a woman does not a medical history that requires closer supervision, like previous miscarriages or fertility treatments, the first prenatal appointment is usually scheduled when the woman is between seven to 10 weeks pregnant. This is because before six and seven weeks gestation the baby's heart beat is not yet seen on ultrasounds. If a woman does have a medical history that warrants closer supervision a doctor's appointment is usually set up when the woman is between five and seven weeks pregnant.
Although not every doctor will have the exact same procedures and steps during a prenatal checkup, there are basic things that a woman can expect at her first prenatal visit.
Recording Prenatal Medical History
Some doctors will simple have the woman fill out a form on her medical history by herself while others will have the woman go over questions with a nurse or medical assistant. A woman should always tell the complete truth about her medical history since it can affect her unborn baby.
Some of the topics that will be asked of the pregnant woman about her medical history include things like past pregnancies, sexually transmitted diseases, past surgeries, heart disease, genetic disorders, diabetes, allergies, drugs and alcohol, and any other conditions or diseases that the woman may have had. One should never be ashamed to tell the truth as these questions are asked for the health of the baby and the pregnant woman.
If this is not the first pregnancy, the woman may not have to answer these questions again as she can state nothing has changed since the last pregnancy. Also, a more extensive questionnaire will be included about the past pregnancies such as if they were carried to full term, what type of birth it was and if any fertility treatments were used.
Calculating a Due Date
At the first prenatal visit a woman will be provided with her due date from the doctor. One should always remember that a due date is actually an estimated time of arrival. A full term baby can arrive anywhere between 37 weeks and 41 weeks.
The pregnant woman provides the doctor or nurse with the first day of her last menstrual period so that her due date can be calculated. Although not all women ovulate on day 14 of their cycle, most doctors will still use Nagele's rule to calculate the due date. Some doctors will change the due date after performing an ultrasound.
To use Nagele's rule to come up with an estimated due date add seven days to the first day of the last menstrual period, subtract three months and then add one year. For example if the woman's last menstrual period started on June 10, 2009, her due date would be March 17, 2010.
First Prenatal Examination
Most doctors will perform a full gynecological exam at the first prenatal visit. This includes a breast and pelvic examination as well as basic vital signs like blood pressure and heart rate. Usually before the woman even enters the exam room she is taken to get her weight and height done and vital signs taken.
The doctor then performs a breast examination, if one has not been done in the past year. Then a full pelvic and abdominal examination is done by the doctor. This may or may not include a Pap smear depending on when the woman's last one was done. The doctor will check the uterus for size to see if it matches the due date as well as for any abnormalities. Depending on how many weeks the woman is the baby's heart rate may or may not be able to be picked up by a Doppler from outside the abdomen.
If the baby's heart beat can't be picked up yet, most doctors will perform a trans-vaginal ultrasound to see the baby's heart beat. The ultrasound can also be used to measure the baby to check to see if the estimated due date is correct.
At this time a woman can request a prescription for prenatal vitamins and discuss any questions she has or any issues she wants to address.
During every prenatal visit, a urine sample will be collected to test for different things. The urine is tested for any bacteria as well as protein and sugar, which can be signs of diabetes or dehydration.
Laboratory Tests Performed at First Prenatal Visit
Blood tests are also done during the first prenatal visit. The blood is tested for a variety of things such as the woman's complete blood count, hemoglobin and hematocrit (which are related to anemia), blood type, sexually transmitted diseases such as HIV and syphilis, and Rh factor. The doctor will report back to the woman at the next prenatal visit or call the woman for any pressing issues once the lab results are back.
The first prenatal visit can be overwhelming for a woman, especially if it is her first pregnancy. By going into the appointment prepared, a woman is more likely to get all her fears eased and questions answered because she knows what is going to happen and what she needs to know.
Sources:
www.americanpregnancy.org (accessed 5/26/10)
www.babycenter.com (accessed 5/26/10)
Tiffany Brunskole - Tiffany is a freelance writer and web marketer. She has over three years of experience writing quality content for the web. She spends ...
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