Anatomy of a Prenatal Visit

Doctor checking pregnant woman's blood pressure

Ariel Skelley / Blend Images / Getty Images

While every practitioner is different, the basics of the prenatal appointment are usually the same. Some of these will be done in different orders, some at every visit, while others not at every visit. Your first prenatal visit is usually the longest. You may even have things done that are not on this list. The thing to remember is always asking what the test is for, how are the results given, do you have an option for a different test, to skip the test, or wait for a while.

A typical schedule for prenatal care appointments is as follows:

  • 1st Trimester Appointments
  • 2nd Trimester Appointments
  • 3rd Trimester Appointments

Here is what will happen at a typical prenatal appointment with your midwife or doctor:

Give Urine

This is done to check for many different things, usually protein and glucose. These may indicate a problem, or just give us history about what you had for breakfast! Monitoring these over the course of pregnancy helps ensure you and baby's well-being.

Blood Pressure

Having this taken at every visit will give us a baseline for your blood pressure. This will tell us what your normal blood pressure should be, and if it rises, what the rate of rising was. It is not absolute numbers as much as it is the rate of rising when looking at blood pressure as a problem. Sometimes you may come into pregnancy with higher blood pressure already.

Fundal Height

This measures the size of your uterus and is a good estimate of how your baby is growing. It is usually begun around 20 weeks. At this point, the uterus usually measures 20 centimeters from the pubic bone and will stay around the number of weeks you are. The numbers will be given or take about 2 cms and can change as the baby changes position and grows. They might indicate a problem or surprises (twins!) if the numbers change dramatically.

Fetal Heart Rate

If your practitioner uses a doppler this miraculous sound can be heard on average about 12 weeks. Maternal fat stores, positioning of the uterus might get in the way, so don't panic if it takes a bit longer to hear. At around 18 weeks a fetoscope or regular stethoscope will pick up the baby's glorious beats of your baby's heart. Be sure to make a recording for those who can't join you for your appointments.

Nutrition

What have you been eating? How are you feeling? Weight fluctuations... You might need some help in directing your diet. This is a great time to talk about what you're craving and how you're doing with nutrition overall. Be sure to ask for extra help, most practitioners know where to send you if you'd like to talk to a nutritionist.

Health

This seems obvious, but I use it to cover all of the other stuff in pregnancy. Are you tired? Do you have any swelling? Headaches, sinus problems, etc.

Mental Health

How are you adjusting to the pregnancy? How is your family reacting? Are you preparing for a baby? Are you experiencing any issues with prenatal depression? (Be honest!)

Social Behavior

Are you smoking, drinking, taking drugs? Are you around people who smoke? How is work? Are you sleeping well?

Questions?

What questions do you have about future visits, things that have come up, the future?

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.