Prenatal care in your first trimester

Your First Prenatal Visit

You should schedule your first prenatal visit soon after you learn that you are pregnant. Your doctor or midwife will:

• Draw your blood.
• Perform a full pelvic exam.
• Do a Pap smear and cultures to look for infections or problems.

Your doctor or midwife will listen for your baby’s heartbeat, but may not be able to hear it. Most often, the heartbeat cannot be heard until at least 6 - 7 weeks.

During this first visit, your doctor or midwife will ask you questions about:

• Your overall health
• Any health problems you have
• Past pregnancies
• Medicines, herbs, or vitamins you take
• Whether or not you exercise
• Whether you smoke or drink alcohol
• Whether you or your partner have genetic disorders or health problems that run in your family

You will have many visits to talk about birthing plan, but you can discuss it with your doctor or midwife at your first visit.

The first visit will also be a good time to talk about eating healthy, exercise, and lifestyle changes you will need to make while you are pregnant. You will also be given prenatal vitamins with iron if you are not already taking them.

Follow-up Prenatal Visits

In your first trimester, you will have a prenatal visit every month. The visits may be quick, but they are still important. It is okay to bring your partner or labor coach with you.

During your visits, your doctor or midwife will:

• Weigh you
• Measure your abdomen to see if your baby is growing as expected
• Check your blood pressure
• Take a urine sample to test for sugar or protein in your urine. If you have either, it could mean you have gestational diabetes or high blood pressure caused by pregnancy.

At the end of each visit, your doctor or midwife will tell you what changes to expect before your next visit. Tell your doctor if you have any problems or concerns. Speak up even if you do not feel they are important or do not relate to your pregnancy.

Lab Tests

At your first visit, your doctor or midwife will draw blood for a group of tests known as the prenatal panel. These tests are done to find problems or infections early in the pregnancy.

This panel of tests includes, but is not limited to:

• A complete blood count (CBC)
• Blood typing (including Rh screen)
• Rubella viral antigen screen (this shows how immune you are to the disease Rubella)
• Hepatitis panel (this shows if you are positive for hepatitis A, B, or C)
• Syphilis test
• HIV test (this test shows if you are positive for the virus that causes AIDS)
• Cystic fibrosis screen (this test shows if you are a carrier for cystic fibrosis)
• A urine analysis and culture

Ultrasounds

An ultrasound is a simple, painless procedure. A wand that uses sound waves will be placed on your belly. The sound waves will let your doctor or midwife see the baby.

You may have an ultrasound done in the first trimester if there are problems, or if there are questions about your due date.

Genetic Testing

Women who are 35 or older, or who have health problems, may need certain tests. There are two tests that can be done in the first trimester to check for Down syndrome and other genetic disorders.

In one test, your health care provider can use ultrasound to measure the back of the baby’s neck. This is called nuchal translucency.

• A blood test is also done.
• Together, these two measures will tell if the baby is at risk for having Down syndrome. 

Another test is called chorionic villus sampling (CVS)-1-3406].It can detect Down syndrome and other genetic disorders as early as 10 weeks into a pregnancy.

If your doctor or midwife thinks that you need one of these tests, talk about which one will be best for you. Be sure to ask about risks of the tests, and what the results could mean for you and your baby.

When to Call your Doctor or Midwife

• If there are any signs or symptoms that are not normal
• Before you start any new medications, vitamins, or herbs
• If you have bleeding or cramping
• If you have increased vaginal discharge or a discharge with odor
• If you have a fever, chills, or pain when passing urine
• If you have any questions or concerns

Update Date: 6/15/2012

Updated by: Melanie N. Smith, MD, PhD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.