You're pregnant! Now what?

Becoming pregnant is an important time in a woman’s life. Virtually all components of her life will be affected and she will have many changes that will require planning and adjustments. A caring and committed healthcare team can help the pregnant woman with many of the challenges she may face.

When the woman discovers she is pregnant she will typically make an appointment with her healthcare provider to begin prenatal care. This appointment should occur sometime in the first eight weeks as measured from the last menstrual period. The first or second prenatal visit will be one of the longest, and will include a detailed health history, a physical exam, lab tests, and calculation of the due date.

Your healthcare provider will obtain a comprehensive health history, including information about your family’s and the baby’s father’s health as well. Be prepared to discuss any previous or current health issues such as previous surgeries, chronic illnesses or medication use.

After your health history is obtained, you will have a complete physical exam with blood and urine tests and a pelvic exam which will probably include a Pap smear for cervical cancer screening.

The day your baby is due is called the estimated date of delivery (EDD) or the “due date.” A full-term pregnancy lasts 40 weeks from the first day of your last menstrual period. The 40 weeks of pregnancy are divided into three trimesters with each trimester lasting about 12–13 weeks.

At one of the first visits childbirth education will be discussed. Your health care provider will provide information about preparation classes, such as the classes offered at Winnie Palmer Hospital.

Comprehensive prenatal care not only involves education, but also lab tests, physical exams, and imaging exams. The routine lab tests performed on all pregnant women are as follows:

1. Blood type and antibody screen and Rh type. These are blood tests that determine if your baby may be at risk for anemia even before birth. Also, if you are Rh negative you may receive a shot during and after pregnancy to prevent you from forming antibodies that could harm your next pregnancy.
2. Hematocrit and hemoglobin. These are blood tests that determine if you are anemic.
3. Rubella (German measles) immunity.
4. Glucose test that may follow a sweet drink that you are given in the office or lab.
5. Sexually transmitted diseases —You will be tested for certain sexually transmitted diseases, including syphilis, human immunodeficiency virus (HIV), and hepatitis B virus, gonorrhea, and chlamydia. You may be tested for other sexually transmitted diseases if you are at high risk.
6. Urine
7. Other tests depending on your risk once your history is taken
8. Later in pregnancy, between week 35 and week 37, you will be screened for group B streptococci (GBS) by culture

Another routine test that is used is ultrasound, which uses sound wave to ‘see’ the baby. This works much like a ‘fish-finder’ that can be found on fishing boats.

Some of the uses of ultrasound in pregnancy are as follows:

1. Confirm the pregnancy and make sure the pregnancy is in the uterus
2. Screen for birth defects
3. Estimate the baby’s gestational age and perform a general check of the baby’s organs and features
4. Show the location of the placenta, the amount of amniotic fluid and presentation of the baby
5. Estimate the weight of the baby

Prenatal visits are spaced out during pregnancy, and usually women will have around 13 visits. Throughout the visits, pregnancy questions will be addressed, advice given and plans secured.