Antenatal care and Ultrasound scans

Throughout your pregnancy you will have regular checks with your OB-GYN or nurse-midwife. It’s important that you attend all your checks so that any problems can be picked up as early as possible.

 
Assuming you and your baby are healthy and your pregnancy is straightforward, expect to see your OB-GYN or nurse-midwife every four weeks until you’re around 28 weeks pregnant; then every two weeks up to week 36. After this point you’ll be seen weekly.

Your first prenatal check

Getting your pregnancy care sorted out should be number one on your to-do list. Schedule your first prenatal check in the first six to eight weeks of your pregnancy. It’ll be the longest prenatal checkup you have through your pregnancy assuming you have no complications.

During that first visit, your OB-GYN or nurse-midwife will:

- Take a medical history, asking you about any medical conditions you or other family members may have, medications you may be taking, allergies and past hospitalizations, as well as any gynecological problems, sexually-transmitted diseases, and previous pregnancies or miscarriages. She’ll also ask if you smoke or drink alcohol, if you’ve been exposed to harmful toxins and whether you’re in an abusive relationship or under excessive stress.

- Calculate your due date, which is dated from the first day of your last period (why not visit our due date calculator to find out when your baby might be due?).

- Take a blood sample for various checks, including your blood type, Rh status, a range of sexually-transmitted diseases, exposure to diseases suh as Rubella (German measles) and chickenpox, sickle cell anemia if you’re of African or Mediterranean descent, and cystic fibrosis.

- Take a urine sample.

- Carry out a Pap smear to check for signs of cervical cancer.

- Carry out an internal exam.

- Explain the various prenatal screening tests that are available to you. Bear in mind that screening tests aren’t compulsory – some couples choose not to have them if they know they definitely wouldn’t terminate a pregnancy because their baby had a problem. However, even if you do feel this way, a positive test result can at least help you prepare emotionally and practically for the fact there may be something wrong with your baby. It also means your caregivers will be ready to deal with any complications that might arise during your baby’s birth.

She’ll also chat to you about staying well during your pregnancy, advising you on nutrition, including what foods to avoid; exercise; and normal pregnancy symptoms such as morning sickness and any more serious symptoms that might mean you need medical attention.

Routine checks

During your second trimester (weeks 13-28) you’ll likely see your OB-GYN or nurse-midwife once a month unless you have a medical condition or complications in your pregnancy that mean you need to be seen more often. In these visits, she’ll:

- Ask how you’re feeling, both physically and emotionally, and check on any symptoms you may have had, such as swelling in your ankles.

- Record your weight.

- Check your blood pressure (high blood pressure can signal pre-eclampsia, a potentially serious complication that can strike in late pregnancy).

- Check your urine for protein – if present, this could also indicate you have pre-ecampsia or a urinary tract infection. A high level of sugar in your urine could indicate gestational diabetes.

- Check your baby’s heartbeat with a hand-held ultrasound device – you should be able to hear it from around 13 weeks and you’ll be amazed at how fast it beats!

- Feel your bump to check your baby’s size and position. From mid-pregnancy she will measure the distance from your pubic bone to the top of your uterus – this is called the fundal height, and the measurement should roughly equate with how many weeks pregnant you are.

- Remind you what prenatal tests are available depending on what stage you’re at. These include screening tests, such as blood tests and scans; and diagnostic tests, such as CVS and amniocentesis. Read gurgle’s article which scans or tests show up abnormalities? for more information on what the tests involve and when you can have them.

- In your late second trimester or early third you’ll be screened for gestational diabetes.

- Around weeks 35-37 you’ll be screened for Group B strep. This bacteria is present in the vagina and intestines of up to 40 percent of women and can be passed on to your baby during the birth, potentially making him extremely ill. If you test positive, you’ll be given antibiotics via IV during your labor.

Having a scan

If you are offered a second trimester scan (see which scans or tests show up abnormalities?) it’s worth having it, even if you’ve made the decision to opt out of other tests. It checks your baby for abnormalities and means you and your partner can prepare emotionally if your baby has a problem. It also means your caregivers can be ready to offer your baby any medical care he needs after he’s born.

Ultrasound scans work by bouncing sound waves off your baby to create an image on the screen. During the scan, the sonographer smears lubricating gel on your bump to help the soundwaves conduct better, and then glides a handheld instrument called a transducer over your skin. Alternately, a vaginal transducer may be used, although this tends to work better for scans in early pregnancy.

Seeing your baby for the first time is emotional and exciting! You’ll probably see him doing tumbles, kicks and waves, and you’ll be surprised at how fast and furiously his heart beats (roughly 120-160 beats per minute compared with your 100 beats per minute). A word of warning: your baby’s gender can usually be identified during this scan so warn the sonographer if you don’t want to know, just in case she lets something slip!

Parents often worry if ultrasound scans are safe for unborn babies. Numerous studies have not indicated any harmful effects, but the American College of Obstetricians and Gynecologists recommends scans be given only when medically necessary, so you may not be offered one if you’re low risk.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.