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Prenatal care: 1st trimester visits

Pregnancy and prenatal care go hand in hand. During the first trimester, prenatal care includes blood tests, a physical exam, conversations about lifestyle and more.

Prenatal care is an important part of a healthy pregnancy. Whether you choose a family physician, obstetrician, midwife or group prenatal care, here's what to expect during the first few prenatal appointments.

The 1st visit

When you find out you're pregnant, make your first prenatal appointment. Set aside time for the first visit to go over your medical history and talk about any risk factors for pregnancy problems that you may have.

Medical history

Your health care provider might ask about:

• Your menstrual cycle, gynecological history and any past pregnancies
• Your personal and family medical history
• Exposure to anything that could be toxic
• Medications you take, including prescription and over-the-counter medications, vitamins or supplements
• Your lifestyle, including your use of tobacco, alcohol, caffeine and recreational drugs
• Travel to areas where malaria, tuberculosis, Zika virus, mpox — also called monkeypox — or other infectious diseases are common

Share information about sensitive issues, such as domestic abuse or past drug use, too. This will help your health care provider take the best care of you — and your baby.

Your due date is not a prediction of when you will have your baby. It's simply the date that you will be 40 weeks pregnant. Few people give birth on their due dates. Still, establishing your due date — or estimated date of delivery — is important. It allows your health care provider to monitor your baby's growth and the progress of your pregnancy. Your due date also helps with scheduling tests and procedures, so they are done at the right time.

To estimate your due date, your health care provider will use the date your last period started, add seven days and count back three months. The due date will be about 40 weeks from the first day of your last period. Your health care provider can use a fetal ultrasound to help confirm the date. Typically, if the due date calculated with your last period and the due date calculated with an early ultrasound differ by more than seven days, the ultrasound is used to set the due date.

Physical exam

To find out how much weight you need to gain for a healthy pregnancy, your health care provider will measure your weight and height and calculate your body mass index.

Your health care provider might do a physical exam, including a breast exam and a pelvic exam. You might need a Pap test, depending on how long it's been since your last Pap test. Depending on your situation, you may need exams of your heart, lungs and thyroid.

At your first prenatal visit, blood tests might be done to:

• Check your blood type. This includes your Rh status. Rh factor is an inherited trait that refers to a protein found on the surface of red blood cells. Your pregnancy might need special care if you're Rh negative and your baby's father is Rh positive.
• Measure your hemoglobin. Hemoglobin is an iron-rich protein found in red blood cells that allows the cells to carry oxygen from your lungs to other parts of your body. Hemoglobin also carries carbon dioxide from other parts of your body to your lungs so that it can be exhaled. Low hemoglobin or a low level of red blood cells is a sign of anemia. Anemia can make you feel very tired, and it may affect your pregnancy.
• Check immunity to certain infections. This typically includes rubella and chickenpox (varicella) — unless proof of vaccination or natural immunity is documented in your medical history.
• Detect exposure to other infections. Your health care provider will suggest blood tests to detect infections such as hepatitis B, syphilis, gonorrhea, chlamydia and HIV , the virus that causes AIDS . A urine sample might also be tested for signs of a bladder or urinary tract infection.

Tests for fetal concerns

Prenatal tests can provide valuable information about your baby's health. Your health care provider will typically offer a variety of prenatal genetic screening tests. They may include ultrasound or blood tests to check for certain fetal genetic problems, such as Down syndrome.

Lifestyle issues

Your health care provider might discuss the importance of nutrition and prenatal vitamins. Ask about exercise, sex, dental care, vaccinations and travel during pregnancy, as well as other lifestyle issues. You might also talk about your work environment and the use of medications during pregnancy. If you smoke, ask your health care provider for suggestions to help you quit.

Discomforts of pregnancy

You might notice changes in your body early in your pregnancy. Your breasts might be tender and swollen. Nausea with or without vomiting (morning sickness) is also common. Talk to your health care provider if your morning sickness is severe.

Other 1st trimester visits

Your next prenatal visits — often scheduled about every four weeks during the first trimester — might be shorter than the first. Near the end of the first trimester — by about 12 to 14 weeks of pregnancy — you might be able to hear your baby's heartbeat with a small device, called a Doppler, that bounces sound waves off your baby's heart. Your health care provider may offer a first trimester ultrasound, too.

Your prenatal appointments are an ideal time to discuss questions you have. During your first visit, find out how to reach your health care team between appointments in case concerns come up. Knowing help is available can offer peace of mind.

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• Lockwood CJ, et al. Prenatal care: Initial assessment. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• Prenatal care and tests. Office on Women's Health. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests. Accessed July 9, 2018.
• Cunningham FG, et al., eds. Prenatal care. In: Williams Obstetrics. 25th ed. New York, N.Y.: McGraw-Hill Education; 2018. https://www.accessmedicine.mhmedical.com. Accessed July 9, 2018.
• Lockwood CJ, et al. Prenatal care: Second and third trimesters. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization. http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/. Accessed July 9, 2018.
• Bastian LA, et al. Clinical manifestations and early diagnosis of pregnancy. https://www.uptodate.com/contents/search. Accessed July 9, 2018.

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• Pregnancy Development

Pregnancy Ultrasounds Week by Week

When do you get ultrasounds during pregnancy, and why are they usually done? Here's what expectant parents should know about these important prenatal scans.

Why Do People Get Pregnancy Ultrasounds?

First trimester ultrasounds, second trimester ultrasound, third trimester ultrasound, baby ultrasounds for special situations, how many ultrasounds during pregnancy are safe, how much does an ultrasound cost.

During a pregnancy ultrasound, your health care provider or a skilled technician uses a plastic transducer to transmit high-frequency sound waves through your uterus. These sound waves send signals back to a machine that converts them into images of your baby.

Most pregnant people have only a couple of ultrasounds throughout their prenatal care, but some get them more frequently. Read on for a breakdown of the most common types of pregnancy ultrasounds, when you might get them, and what to expect during the prenatal scans.

According to the American College of Obstetricians and Gynecologists (ACOG), health care providers may use baby ultrasounds for the following reasons:

• Monitoring your baby's growth and development
• Detecting congenital anomalies
• Guiding chorionic villus sampling (CVS) or amniocentesis
• Helping predict your due date
• Determining whether you're carrying multiples
• Showing the position of your placenta
• Estimating your baby's size
• Measuring amniotic fluid
• Revealing your baby's genitals

How Many Ultrasounds Will You Get?

Uncomplicated pregnancies typically have fewer ultrasounds than high-risk pregnancies, but how many you receive over the course of your pregnancy will vary. Factors influencing the number of ultrasounds you'll receive include your preference, your provider's standard protocol, ultrasound machine access, medical history, and pregnancy complications.

GETTY IMAGES

Not everyone receives a first-trimester ultrasound during pregnancy. That said, a health care provider may sometimes use them for determining viability, dating the pregnancy, or ruling out suspected complications.

Early pregnancy (6–8 weeks)

Your first ultrasound, also known as a fetal ultrasound or sonogram, could occur as early as six to eight weeks into your pregnancy. In addition to a pregnancy test , some health care providers use ultrasounds to confirm that you're expecting.

According to the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), early pregnancy ultrasounds can do the following:

• Confirm viability
• Establish gestational age
• Determine the number of fetuses
• Determine if multiples share a placenta and amniotic sac

But not everyone will get this early scan. ISUOG does not recommend routine early pregnancy ultrasounds unless there's a clinical indication of a complication. For example, some health care providers will only conduct early ultrasounds for certain high-risk pregnancy conditions like bleeding and abdominal pain, or to rule out ectopic pregnancy, congenital disorders, or miscarriage.

In early pregnancy, ultrasound is usually done transvaginally, which gives the clearest picture of your uterus and embryo at this early stage. In this case, the provider will place a thin wand-like transducer probe—which transmits high-frequency sound waves through your uterus—into your vagina. The sound waves bounce off the fetus and send signals back to a machine that converts these reflections into a black-and-white image of your uterus.

Although the heart structures aren't yet fully developed at six weeks gestation, it's possible to see the electrical impulses of their developing heart (sometimes referred to as embryonic cardiac activity ).

Nuchal translucency ultrasound (10–13 Weeks)

A nuchal translucency (NT) ultrasound occurs around weeks 10 to 13 of pregnancy. According to ACOG , this ultrasound measures the space at the back of a fetus' neck. Abnormal measurements can indicate Down syndrome and other congenital disabilities of the heart, abdomen, and skeleton. In addition to an abdominal ultrasound, an NT screening includes measuring hormones and proteins with a blood test.

A nuchal translucency ultrasound is optional for everyone who is pregnant. Sometimes, people choose to have this ultrasound to alleviate concerns about their baby's health. Other times, your health care provider might recommend it if you're at risk of complications or have a family history of congenital disorders.

In addition to screening for anomalies, this pregnancy ultrasound can offer the same information as an earlier scan, including an estimated due date , your baby's "crown-rump length" (measurement from head to bottom), the number of babies in the womb, and fetal cardiac activity.

The second trimester is the most common time for a routine prenatal ultrasound. The anatomy scan, a thorough scan of your baby's developing body and organs, is offered to every pregnant person.

Anatomy scan (18–22 Weeks)

According to ACOG, this detailed pregnancy ultrasound generally happens between weeks 18 and 22 in the second trimester. It's the most thorough check-up your baby will have before they're born.

During the anatomy scan, also called a level II ultrasound, the health care provider will check your baby's heart rate and look for abnormalities in their brain, heart, kidneys, and liver, says Jane Chueh, M.D., director of prenatal diagnosis and therapy at Lucile Children's Hospital Stanford , in Palo Alto, California.

They'll also count your baby's fingers and toes, examine the placenta, and measure the amniotic fluid level. And they'll probably be able to see your baby's genitals to guess your baby's sex , although it's not a slam dunk. If you don't want to know about your baby's genitalia, be sure to inform the technician ahead of time.

Editor's Note

Even though people often look forward to this pregnancy ultrasound to learn their baby's gender, it's important to note that gender is a personal identity that exists on a spectrum, can change over the course of a person's lifetime—and most importantly—is something that a person defines for themselves. Sex is assigned at birth based on the appearance of a baby's genitalia. While sex assigned at birth often matches a person's gender (called cisgender), sometimes it does not.

Many parents-to-be don't need an ultrasound in the third trimester. But if your pregnancy is considered high-risk—or if you didn't get a screening during the first or second trimester—it may be recommended.

For example, if you have high blood pressure, bleeding, low levels of amniotic fluid, preterm contractions , or are over age 35, your doctor may perform in-office, low-resolution ultrasounds during some of your third-trimester prenatal visits for reassurance, says Dr. Chueh.

In addition, if an earlier scan found your placenta was near or covering the cervix ( called placenta previa ), you'll require additional ultrasounds to monitor its location.

Your health care provider may recommend an ultrasound during pregnancy outside of the situations mentioned above. For example, ultrasounds might be indicated if you have certain health conditions that warrant specific monitoring or if you have a procedure that uses ultrasound guidance.

Doppler ultrasound

Doppler ultrasound is a special imaging test showing blood moving through vessels. In pregnancy, a Doppler ultrasound can help determine if your baby's blood is circulating properly. According to a Cochrane review , Doppler ultrasound in high-risk pregnancies may reduce the risk of perinatal death and obstetric interventions.

Your health care provider may recommend fetal Doppler ultrasound in the following circumstances:

• You have diabetes
• You have high blood pressure
• You have heart or kidney problems
• The placenta does not develop properly
• Suspected fetal growth problems

Handheld fetal heart rate monitors also utilize Doppler technology. Health care providers commonly use these devices to monitor your baby's heartbeat during prenatal exams and labor. While these are available over the counter, the Food and Drug Administration (FDA) advises against using them at home due to lack of oversight and unnecessary ultrasound exposure.

Guiding ultrasounds

Your health care provider may also order other pregnancy tests that require ultrasounds for guidance. These might include chorionic villus sampling (CVS) or amniocentesis, which screen the baby for congenital disorders. Fetal echocardiograms, which show the baby's heart rate and detect anomalies, also use ultrasound technology.

Ultrasound is considered safe for you and your baby when used for medical purposes. Although ultrasounds require no radiation, only a trained professional who can accurately interpret the results should perform them. Your technician should have education in obstetrical ultrasound, preferably at a center accredited by the American Institute of Ultrasound in Medicine .

Some medical practices offer 3D (high quality and lifelike) and 4D (moving picture) ultrasounds, which may help doctors detect specific fetal abnormalities and congenital disorders. However, these exams are also available at fetal portrait studios in places like shopping malls.

Experts discourage these "keepsake" ultrasounds since untrained personnel may give out inaccurate information, says Michele Hakakha, M.D., an OB-GYN in Beverly Hills and author of Expecting 411: The Insider's Guide to Pregnancy and Childbirth .

Plus, according to the FDA , although ultrasounds are safe in medical settings, they might heat tissues or produce bubbles (cavitation) during use if not performed correctly. Experts aren't sure about the long-term effects of heated tissues or cavitation, especially when not medically indicated. Therefore, the FDA advises that people use ultrasound scans judiciously—only when there is a medical need, based on a prescription, and performed by appropriately-trained health care providers.

Ultrasounds aren't cheap ; they can cost hundreds or thousands of dollars, depending on your location and health care provider. However, most health insurance plans will cover the cost of prenatal ultrasounds (at least partially) if they are for medical purposes. Always ask your health care provider and insurance company if you're unsure how much you will need to pay.

Ultrasound Exams , ACOG, 2021

Pregnancy Ultrasound Evaluation . StatPearls [Internet] . 2023.

ISUOG Practice Guidelines: performance of first-trimester fetal ultrasound scan . Wiley’s Obstetrics and Gynaecology. 2012

Role of ultrasound in the evaluation of first-trimester pregnancies in the acute setting . Ultrasonography . 2020.

Prenatal Genetic Screening Tests . American College of Obstetricians and Gynecologists . 2020.

Sonography 3rd Trimester and Placenta Assessment, Protocols, and Interpretation . StatPearls [Internet] . 2023.

Fetal and umbilical Doppler ultrasound in high-risk pregnancies . Cochrane Database of Systematic Reviews 2017, Issue 6. Art . 2017.

Ultrasound Imaging . U.S. Food and Drug Administration . 2020.

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• First Ultrasound in Pregnancy: What It Reveals and Its Importance

When you embark on a journey through pregnancy, especially a high-risk pregnancy , your first ultrasound is far more than a thrilling first look at your baby — it stands as a vital milestone in your prenatal care. This initial screening gives you and your obstetrician critical insights into your baby’s health and development.

It’s a crucial step in navigating the complexities of a high-risk pregnancy, offering essential guidance for what lies ahead. Understanding its significance is not just important; it’s imperative for you as an expectant parent and those who support and care for you. Here, we delve into what you can expect from this crucial procedure and how it shapes the course of your pregnancy journey.

Understanding the First Ultrasound in Pregnancy

Your first ultrasound is a pivotal moment, serving as a window into your womb and providing a glimpse of the developing life within. This crucial scan is more than just an opportunity to see your baby for the first time; it plays an integral role in assessing the pregnancy’s progression and sets the tone for future prenatal care. Let’s explore what this involves and why it’s so important.

What is an Ultrasound?

A fundamental aspect of prenatal care, ultrasound technology employs high-frequency sound waves to create detailed images of the uterus’s interior. This technology is a cornerstone in visualizing the developing fetus, enabling healthcare professionals to evaluate the health of the pregnancy. 

Safe and non-invasive, ultrasounds have been a mainstay in medical practice, trusted for their reliability and safety. They are known to be free from any risks to both the expectant mother and the fetus, making them an indispensable tool in prenatal healthcare. This process allows for real-time visualization of the fetus, the uterus, and the placenta, providing crucial information about the baby’s development and the environment it’s growing in.

In essence, the first ultrasound acts as a critical navigational tool in your pregnancy journey. It provides essential insights and paves the way for informed, proactive prenatal care. Understanding its significance and the reasons behind its timing can help alleviate anxieties and prepare you for the beautiful journey ahead of parenthood.

Key Insights from the First Ultrasound

The first ultrasound is a revealing window into the womb, offering critical insights about the developing fetus. This early peek provides crucial information that shapes the course of prenatal care, making it much more than a mere initial encounter with the unborn child. From confirming the pregnancy to detecting fetal anomalies, each aspect of this ultrasound carries significant importance.

Confirming the Pregnancy and Estimating Gestational Age

One of the most pivotal roles of the first ultrasound is to confirm the pregnancy. It allows us to visually confirm the embryo’s presence in the uterus and check for a heartbeat, which is a significant indicator of pregnancy health. Additionally, the ultrasound aids in accurately estimating the gestational age of the fetus. This estimation is critical for predicting the due date and planning for the pregnancy’s future stages.

Identifying Multiple Pregnancies

Detecting the number of fetuses early in the pregnancy is critical. This aspect of the ultrasound is particularly important in planning and managing the prenatal care journey.

• Determining the Number of Fetuses: The ultrasound can reveal whether there are multiple fetuses, such as in cases of twins or triplets.
• Implications for Prenatal Care: Multiple pregnancies demand enhanced surveillance and care due to increased risks, such as preterm labor and gestational diabetes, necessitating a more specialized approach to prenatal care.

Understanding whether you’re expecting one baby or more is vital in tailoring your prenatal care to meet the specific needs of your pregnancy.

Checking for Fetal Anomalies

The first ultrasound is instrumental in screening for fetal anomalies. Even at this early stage, it can provide vital clues about the baby’s development.

• Early Detection of Anomalies: Anomalies such as neural tube defects, cardiac issues, and skeletal abnormalities can be detected, enabling prompt attention and care.
• Informed Decision-Making: This early insight allows expectant parents and healthcare providers to make informed decisions, preparing them for any additional care or interventions that may be necessary.

This ultrasound serves as a preliminary check, setting the course for proactive and informed prenatal care.

Assessing Placental Health and Position

Another crucial aspect of the first ultrasound is evaluating the placenta’s health and position, which is essential for both the baby’s and the mother’s well-being.

• Placental Health Check: The ultrasound can assess the placenta’s development and its attachment site in the uterus.
• Implications for Pregnancy: Healthy placental development and positioning are essential; abnormalities or unusual placements can lead to complications like placenta previa or placental abruption.

This assessment is crucial in preempting and managing potential placental issues, contributing to a safer pregnancy for both mother and baby.

The first ultrasound is a foundational tool in prenatal care, offering invaluable insights that shape the management of the pregnancy. It’s a vital step in ensuring the health and well-being of both the mother and the developing fetus, providing a clear path forward in the pregnancy journey.

Preparing for Your First Ultrasound

As you prepare for your first ultrasound, it’s natural to feel both excitement and nervousness. This initial ultrasound is a significant step in your pregnancy journey, offering you the first glimpse of your baby and crucial information about your pregnancy. Let’s explore what you can expect and how to make the most of this appointment.

What to Expect During the Appointment

As you prepare for your first ultrasound, it’s helpful to understand what the experience entails to ease any nerves. Typically, this involves a transabdominal ultrasound, where a small handheld device, called a transducer, is moved gently across your belly. This non-invasive procedure is designed to create clear images of your baby, offering valuable insights to both you and your healthcare provider. 

The appointment usually lasts about 20 to 30 minutes, providing the sonographer ample time to gather all necessary images. To aid in obtaining the best possible images, it’s often recommended to have a full bladder, which helps in lifting the uterus for clearer visualization of the fetus. This first ultrasound marks a special moment in your pregnancy journey; providing the first visual connection with your baby and understanding what to expect can help make this a more comfortable and memorable experience.

Questions to Ask Your Healthcare Provider

Your first ultrasound appointment is also a prime opportunity for you to engage with your healthcare provider and clarify any questions or concerns you might have.

• Inquiring About Developmental Progress: Feel free to ask about how your baby is developing and what can be seen at this stage of the pregnancy.
• Clarifying the Due Date: This is a good time to discuss the estimated due date based on the ultrasound findings.
• Addressing Health Concerns: Don’t hesitate to bring up any health concerns or symptoms you’re experiencing. It’s important to communicate openly for the best prenatal care.
• Having a list of questions ready can help you make the most of this appointment, ensuring you leave with a clear understanding of your pregnancy’s progress and what to expect in the coming weeks.

As you prepare for your first ultrasound, remember that this appointment is an important milestone. It not only offers you a heartwarming first look at your baby but also provides essential information that guides the course of your prenatal care. Embrace this moment with knowledge and confidence, knowing you’re taking an active role in your pregnancy journey.

Beyond the First Ultrasound: Ongoing Prenatal Care

Embarking on your prenatal care journey, remember it’s a path that unfolds well beyond the initial excitement of the first ultrasound. This ongoing process is a blend of constant vigilance and care, ensuring your and your baby’s health and well-being.

The Journey of Prenatal Care

Prenatal care is an ongoing, dynamic journey marked by regular appointments that are crucial for monitoring your and your baby’s health.

• Role of Regular Check-Ups: These check-ups are pivotal for tracking changes in your health and responding swiftly to any concerns that arise, ensuring your well-being and that of your baby.
• Importance of Follow-Up Ultrasounds: Subsequent ultrasounds provide deeper insights into your baby’s growth, catching any potential issues early on.
• Timely Addressing of Concerns: This regular monitoring allows for immediate attention to any concerns, keeping you reassured and your pregnancy on a healthy track.

This journey is key to a smooth and informed pregnancy, providing peace of mind and ensuring that you’re well-prepared for your baby’s arrival.

Integrating Ultrasound Findings with Overall Health Care

The insights from your first and later ultrasounds play a crucial role in shaping your overall prenatal care.

• Customizing Your Care Plan: Results from ultrasounds are used to personalize your care, addressing the unique needs of your pregnancy.
• Making Informed Health Decisions: These findings are critical for your healthcare providers to make informed decisions about your care, adapting to the changing needs of your pregnancy.
• Ensuring Comprehensive Care: This integrated approach means every aspect of your and your baby’s health is considered, offering you the best possible care throughout your pregnancy.

Integrating these ultrasound findings ensures a holistic approach to your prenatal care, focusing on your and your baby’s overall well-being.

The first ultrasound in your pregnancy journey is more than a memorable moment; it’s a crucial step that lays the groundwork for your entire prenatal care. Its significance in shaping your pregnancy’s medical management cannot be overstated. By understanding and valuing the insights it provides, you can navigate this journey with confidence and assurance, knowing that every step is taken to ensure the best outcomes for both you and your baby.

It’s clear that the first ultrasound is just the beginning of a detailed and attentive prenatal journey. Each appointment, each ultrasound, forms a crucial part of the tapestry of your pregnancy, ensuring the health and well-being of you and your baby. For expert care and compassionate guidance throughout this incredible journey, contact Roswell OB/GYN . 

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What to expect at your first prenatal appointment

Your kickoff prenatal visit sets the stage for the rest of your pregnancy. Here's what to expect at this information-packed first appointment and how you can prepare.

When to schedule your first prenatal visit

When will your first appointment be, what happens at the first prenatal visit, how to prepare for your first prenatal appointment, what questions to ask at the first prenatal visit.

As soon as you get a positive result on a home pregnancy test , book an appointment with an obstetrician, family physician, or midwife . Depending on the practice, it's normal for another provider in the office, like a nurse practitioner or physician assistant, to handle your first visit.

If you haven't yet chosen a healthcare provider for your pregnancy, that's okay. It's still important to see someone now to start your prenatal care. You can always switch to another provider later. 

Many healthcare providers will schedule your first visit for when you're about 8 weeks pregnant . Some will see you sooner, particularly if you have an existing health condition, had problems with a pregnancy in the past, or are having new or severe symptoms such as vaginal bleeding or abdominal pain .

If you're taking any medications or think you may have been exposed to a hazardous substance, let your provider know as soon as possible.

The first visit will probably be the longest of your prenatal appointments (unless you have complications with your pregnancy along the way). At this and all future visits, don't be afraid to raise any questions or concerns you've been wondering about – it helps to keep a running list between appointments.

Here's what your provider will likely do during your first prenatal visit.

Take your health history. Your provider will ask questions about your gynecological health, personal medical history, and lifestyle habits. Topics commonly covered include:

• Whether your menstrual cycles are regular and how long they tend to last
• The first day of your last period (to determine your due date )
• Symptoms or problems you've noticed since your last period, whether they're related to pregnancy or not
• Current or past gynecological conditions, including sexually transmitted infections
• Details about previous pregnancies
• Current or past diseases and conditions
• Past surgeries or hospitalizations
• Mental health difficulties and diagnoses
• Whether you are being or have been abused , or have another situation that could affect your safety or emotional well-being
• Smoking, drinking, and drug use
• Medications, supplements, vitamins, and herbal drugs you take
• Drug allergies

Your healthcare provider will also ask about your family medical history. Many genetic issues and birth defects are at least partly hereditary, so learning about your family history helps your medical team keep an eye out for potential issues. Let your provider know whether a relative in your or your partner's family has a chromosomal or genetic disorder, had developmental delays, or was born with a structural birth defect.

It's also important to mention any potential exposure to toxins, especially if you live or work near toxic materials.

Check you out and run some tests. You can expect a number of standard exams and tests at your first prenatal visit. Some healthcare providers will do an ultrasound , but if you don't have any medical problems or concerns, it may not be part of the routine. Here's what's typical:

• A thorough physical exam
• A pelvic exam, including a Pap smear (unless you've had one recently) to check for infections such as chlamydia and gonorrhea or abnormal cells that could indicate cervical cancer
• A urine sample to test for urinary tract infections and other conditions

Your provider will also order blood tests to:

• Identify your blood type and Rh status
• Look for anemia
• Check for HIV, syphilis, hepatitis B and, in certain cases, hepatitis C
• Determine immunity to rubella (German measles) and chickenpox

Discuss any high-risk pregnancy concerns. Many people are considered to have high-risk pregnancies , meaning there's a higher-than-average chance of health issues during pregnancy, labor, and birth. High-risk groups include those who:

• Become pregnant for the first time at age 35 or older
• Become pregnant for the first time before age 18
• Have certain medical issues that develop during pregnancy, such as preeclampsia and gestational diabetes
• Have certain preexisting health problems, such as high blood pressure , thyroid disease , or type 1 or type 2 diabetes

High-risk pregnancies need extra care. While many potential complications are treatable or temporary, some can be dangerous to both you and your baby. Your provider will talk through the risks at your first visit and throughout your pregnancy – and don't be afraid to ask questions at any point.

Explain your options for prenatal genetic testing. Your provider will offer you various prenatal screenings that can give you information about your baby's risk for birth defects and chromosomal conditions. These tests include:

• Noninvasive prenatal testing (NIPT) , also called cell-free fetal DNA testing. Performed at 9 weeks or later, it's used to examine the little bits of your baby's DNA present in your blood.
• A first trimester screen, also called a first-trimester combined test. Typically done between weeks 11 and 13, it consists of a blood test and a type of ultrasound called a nuchal translucency .
• A carrier screening if you haven't had one already. It's a simple blood or saliva test done to see whether your baby is at risk for any of 100 genetic disorders such as cystic fibrosis, sickle cell disease, thalassemia, and Tay-Sachs disease.

Finally, if you're high-risk, there are invasive genetic diagnostic tests that can tell you for sure whether your baby has Down syndrome or certain other conditions. These tests include chorionic villus sampling (CVS) , generally performed at 10 to 13 weeks, and amniocentesis , usually done at 16 to 20 weeks.

CVS and amniocentesis are invasive and may carry a small risk of miscarriage , so women who choose to have these procedures are usually those with a higher risk for genetic and chromosomal problems. Some moms-to-be choose to wait for the results of screening tests before deciding whether to have one of these diagnostic tests.

For more information, your provider can refer you to a genetic counselor .

Give you advice and let you know what's ahead. Your healthcare provider will give you information about eating well , foods to avoid , healthy weight gain , and prenatal vitamins . They'll also give you a heads-up about the common discomforts of early pregnancy and let you know which pregnancy symptoms require immediate attention .

Your emotional health is very important. Your provider may screen you for signs of depression during pregnancy . But don't wait to be asked. If you're feeling depressed or anxious, let your provider know so they can refer you to someone who can help.

The dangers of smoking , drinking alcohol, using drugs, and taking certain medications will be a topic of discussion, as well. If you need help quitting smoking or any other substance, your provider can recommend a program or counselor.

Other topics include the do's and don'ts of exercise , travel , and sex during pregnancy ; environmental and occupational hazards that can affect your baby; and how to avoid certain infections, such as toxoplasmosis . Your provider will also discuss recommended vaccinations , like the flu shot and the COVID-19 vaccine .

To help your visit go as smoothly as possible, try taking the following steps.

Review your medical history. Brush up on your health status so you can better answer questions. This includes information about your:

• Overall physical and mental health
• Current and past diseases, conditions and other health issues
• Current medications, including prescriptions, supplements, vitamins and herbal supplements and teas
• Fertility and pregnancy history
• Family medical history
• Partner's medical history

If possible, bring documentation along, such as immunization records or a list of your medications. You may even want to bring a baggie containing the medications themselves.

Take your partner, a family member, or friend. Another person can write down notes, ask questions, and provide emotional support during this information-dense first visit.

Get there on time or a little early. This can be helpful for filling out forms and reviewing your insurance. Make sure to bring your insurance information and cash or a credit card for any necessary co-pays.

Just as your provider will ask you questions at your first prenatal visit, it's a good idea to come prepared with a list of questions for your provider. Ask anything – and don't be shy. Again, try to keep a running list in the weeks before the appointment, so nothing important slips your mind.

Here are some questions to consider if your provider doesn't bring up the topic first.

• How much weight gain is healthy for me? The first prenatal visit is a great opportunity to learn about how your body will change. It's also a good time to ask about nutrition, including which foods to prioritize in your diet.
• What are the foods I should avoid ? Raw fish and unpasteurized cheeses are long-established no-no's for pregnant people, but ask your provider for a full list of what to skip, since the accepted wisdom has changed over the years. Ask about caffeine and alcohol, too. Coffee is typically alright in limited doses, but no amount of alcohol is considered safe when you're having a baby.
• Are prenatal supplements a good choice? Your provider will likely recommend a prenatal vitamin containing folic acid and iron, both of which are needed more during pregnancy.
• Can I exercise? What about sex? With some exceptions, both are usually okay when you're pregnant. They're important to discuss, however, since certain conditions may complicate matters.
• Is it safe to keep working? If you have a physically or emotionally demanding job , you may want to ask how you can ease the effects on your body and mind.
• Is travel okay? While planes, trains, and automobiles are typically safe well into pregnancy, people with particular complications may need to limit or avoid traveling.
• Which medications are safe to take? Ask about your current prescriptions, herbal products, teas, supplements, and any over-the-counter drugs you may use, such as pain relievers and cold medicines. Non-steroidal inflammatory drugs (NSAIDs) like ibuprofen and naproxen are not recommended, for example.
• What are common symptoms of pregnancy? Your provider can tell you what to expect and how to cope. Remember to ask what symptoms are uncommon, too, and what red flags to watch for.
• What should I do in an emergency? Find out who to contact and where to go if you begin to experience new, unusual, severe, or long-lasting symptoms.
• Who will treat me over the course of my pregnancy? If your provider is part of a group practice, you may see other members of the group during appointments. They may even deliver your baby.
• Do you recommend taking prenatal classes? Whether they're in a hospital, at a university, online, or somewhere else, prenatal classes can be invaluable learning experiences for parents-to-be. On top of the usual childbirth classes you hear about, you can also find courses in everything from stress management to good nutrition and even breastfeeding.

Last but not least, ask about your next visit and schedule the appointment before leaving the office. Until your 28th week of pregnancy, you'll likely see someone every four weeks or so.

You may also want to ask whether future visits will be in-person or virtual. Certain practices offer virtual visits for low-risk patients, those whose providers aren't close by, or even higher-risk patients that need to be evaluated more often.

Was this article helpful?

Prenatal visits: What to expect and how to prepare

Chorionic villus sampling (CVS)

NIPT (Noninvasive prenatal testing)

What happens at second trimester prenatal appointments

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

March of Dimes. 2017. Prenatal Care Checkups.  https://www.marchofdimes.org/pregnancy/prenatal-care-checkups.aspx Opens a new window  [Accessed March 2024]

MedlinePlus. 2022. Prenatal care in your first trimester.  https://medlineplus.gov/ency/patientinstructions/000544.htm Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Prenatal care: 1 st  trimester visits.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044882 Opens a new window  [Accessed March 2024]

American Pregnancy Association. (2021). Your First Prenatal Visit.  https://americanpregnancy.org/healthy-pregnancy/planning/first-prenatal-visit/ Opens a new window  [Accessed March 2024]

Kids Health. 2022. Prenatal Visits: First Trimester.  https://kidshealth.org/en/parents/tests-first-trimester.html Opens a new window  [Accessed March 2024]

Mount Sinai. 2021. Prenatal care in your first trimester.  https://www.mountsinai.org/health-library/selfcare-instructions/prenatal-care-in-your-first-trimester Opens a new window  [Accessed January 2024]

Centers for Disease Control and Prevention. 2022. Recommended Clinician Timeline for Screening for Syphilis, HIV, HBV, HCV, Chlamydia, and Gonorrhea.  https://www.cdc.gov/nchhstp/pregnancy/screening/clinician-timeline.html Opens a new window  [Accessed March 2024]

Alabama Perinatal Excellence Collaborative. 2015. APEC Guidelines for Routine Prenatal Care.  http://apecguidelines.org/wp-content/uploads/2016/07/Routine-Prenatal-Care-6-30-2015.pdf Opens a new window  [Accessed March 2024]

Kids Health. 2019. Toxoplasmosis.  https://kidshealth.org/en/parents/toxoplasmosis.html Opens a new window  [Accessed March 2024]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2017. What is a high-risk pregnancy?  https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/high-risk Opens a new window  [Accessed March 2024]

Kids Health. 2022. What's a “High-Risk” Pregnancy?  https://kidshealth.org/en/parents/high-risk.html Opens a new window  [Accessed March 2024]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2018. What are some factors that make a pregnancy high risk?  https://www.nichd.nih.gov/health/topics/high-risk/conditioninfo/factors Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Prenatal Tests.  https://www.marchofdimes.org/pregnancy/prenatal-tests.aspx Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2022. Carrier Screening.  https://www.acog.org/womens-health/faqs/carrier-screening Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Chorionic Villus Sampling.  https://www.marchofdimes.org/pregnancy/chorionic-villus-sampling.aspx Opens a new window  [Accessed March 2024]

Office on Women's Health. 2021. Prenatal care and tests.  https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests Opens a new window  [Accessed March 2024]

MedlinePlus. 2021. What is noninvasive prenatal testing (NIPT) and what disorders can it screen for?  https://medlineplus.gov/genetics/understanding/testing/nipt/ Opens a new window  [Accessed March 2024]

Voyage Healthcare. 2021. Prenatal Care Overview.  https://www.voyagehealthcare.com/how-to-make-the-most-of-your-first-prenatal-visit-guide Opens a new window  [Accessed March 2024]

Gifford Health Care. Undated. Preparing for Your Appointment.  https://giffordhealthcare.org/patients/preparing-for-your-appointment/ Opens a new window  [Accessed March 2024]

Mayo Clinic. 2023. Pregnancy nutrition: Foods to avoid during pregnancy.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20043844 Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2023. Nutrition During Pregnancy.  https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Prenatal vitamins: Why they matter, how to choose.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-vitamins/art-20046945 Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2022. Exercise During Pregnancy.  https://www.acog.org/womens-health/faqs/exercise-during-pregnancy Opens a new window  [Accessed March 2024]

Mayo Clinic. 2022. Sex during pregnancy: What's OK, what's not.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/sex-during-pregnancy/art-20045318 Opens a new window  [Accessed March 2024]

Kids Health. 2022. Sex During Pregnancy.  https://kidshealth.org/en/parents/sex-pregnancy.html Opens a new window  [Accessed March 2024]

American College of Obstetricians and Gynecologists. 2023. Travel During Pregnancy.  https://www.acog.org/womens-health/faqs/travel-during-pregnancy Opens a new window  [Accessed March 2024]

March of Dimes. 2020. Over-the-counter medicine, supplements and herbal products during pregnancy.  https://www.marchofdimes.org/pregnancy/over-the-counter-medicine-supplements-and-herbal-products.aspx Opens a new window  [Accessed March 2024]

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Ultrasound During Pregnancy

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Prenatal care in your first trimester

Trimester means "3 months." A normal pregnancy lasts around 10 months and has 3 trimesters.

The word prenatal means before birth. The first trimester starts when your baby is conceived. It continues through week 14 of your pregnancy. Your health care provider may talk about your pregnancy in weeks, rather than in months or trimesters.

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 or seen on ultrasound until at least 6 to 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, use tobacco, drink alcohol or take drugs
• Whether you or your partner have genetic disorders or health problems that run in your family

You will have many visits to talk about a birthing plan. You can also 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 , exercising, getting adequate sleep, and making lifestyle changes while you are pregnant
• Common symptoms during pregnancy such as fatigue, heartburn, and varicose veins
• How to manage morning sickness
• What to do about vaginal bleeding during early pregnancy
• What to expect at each visit

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 OK to bring your partner or labor coach with you.

During your visits, your doctor or midwife will:

• Check your blood pressure.
• Check for fetal heart sounds.
• Take a urine sample to test for sugar or protein in your urine. If either of these is found, it could mean that 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. It is OK to talk about them even if you do not feel that they are important or related to your pregnancy.

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 should have an ultrasound done in the first trimester to get an idea of your due date. The first trimester ultrasound will usually be a vaginal ultrasound.

Genetic Testing

All women are offered genetic testing to screen for birth defects and genetic problems, such as Down syndrome or brain and spinal column defects.

• If your doctor thinks that you need any of these tests, talk about which ones will be best for you.
• Be sure to ask what the results could mean for you and your baby.
• A genetic counselor can help you understand your risks and test results.
• There are many options now for genetic testing. Some of these tests carry some risks to your baby, while others do not.

Women who may be at higher risk for these genetic problems include:

• Women who have had a fetus with genetic problems in earlier pregnancies
• Women, age 35 years or older
• Women with a strong family history of inherited birth defects

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

• A blood test is also done.
• Together, these 2 measures will tell if the baby is at risk for having Down syndrome.
• If a test called a quadruple screen is done in the second trimester, the results of both tests are more accurate than doing either test alone. This is called integrated screening. If the test is positive, an amniocentesis or cell-free DNA test may be recommended.

Another test, called chorionic villus sampling (CVS) , can detect Down syndrome and other genetic disorders as early as 10 weeks into a pregnancy.

A newer test, called cell free DNA testing, looks for small pieces of your baby's genes in a sample of blood from the mother. This test is newer, but offers a lot of promise for accuracy without risks of miscarriage. It may reduce the need for an amniocentesis, and so is safer for the baby.

There are other tests that may be done in the second trimester .

When to Call the Doctor

Contact your provider if:

• You have a significant amount of nausea and vomiting.
• You have bleeding or cramping.
• You have increased discharge or a discharge with odor.
• You have a fever, chills, or pain when passing urine.
• You have any questions or concerns about your health or your pregnancy.

Alternative Names

Pregnancy care - first trimester

Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In:.Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: Elsevier; 2021:chap 5.

Hobel CJ, Williams J. Antepartum care. In: Hacker N, Gambone JC, Hobel CJ, eds. Hacker & Moore's Essentials of Obstetrics and Gynecology . 6th ed. Philadelphia, PA: Elsevier; 2016:chap 7.

Magowan BA, Owen P, Thomson A. Antenatal and postnatal care. In: Magowan BA, Owen P, Thomson A, eds. Clinical Obstetrics and Gynaecology . 4th ed. Philadelphia, PA: Elsevier; 2019:chap 22.

Symonds I. Early pregnancy care. In: Symonds I, Arulkumaran S, eds. Essential Obstetrics and Gynaecology . 6th ed. Philadelphia, PA: Elsevier; 2020:chap 18.

Williams DE, Pridjian G. Obstetrics. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine . 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 20.

Review Date 4/19/2022

Updated by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Related MedlinePlus Health Topics

• Prenatal Care

What to expect at your first prenatal appointment

When to schedule your first prenatal visit.

A s soon as you get a positive result on a home pregnancy test , book an appointment with an obstetrician, family physician, or midwife . Depending on the practice, it's normal for another provider in the office, like a nurse practitioner or physician assistant, to handle your first visit.

If you haven't yet chosen a healthcare provider for your pregnancy, that's okay. It's still important to see someone now to start your prenatal care. You can always switch to another provider later. 

When will your first appointment be?

Many healthcare providers will schedule your first visit for when you're about 8 weeks pregnant . Some will see you sooner, particularly if you have an existing health condition, had problems with a pregnancy in the past, or are having new or severe symptoms such as vaginal bleeding or abdominal pain .

If you're taking any medications or think you may have been exposed to a hazardous substance, let your provider know as soon as possible.

What happens at the first prenatal visit?

The first visit will probably be the longest of your prenatal appointments (unless you have complications with your pregnancy along the way). At this and all future visits, don't be afraid to raise any questions or concerns you've been wondering about – it helps to keep a running list between appointments.

Here's what your provider will likely do during your first prenatal visit.

Take your health history. Your provider will ask questions about your gynecological health, personal medical history, and lifestyle habits. Topics commonly covered include:

• Whether your menstrual cycles are regular and how long they tend to last
• The first day of your last period (to determine your due date )
• Symptoms or problems you've noticed since your last period, whether they're related to pregnancy or not
• Current or past gynecological conditions, including sexually transmitted infections
• Details about previous pregnancies
• Current or past diseases and conditions
• Past surgeries or hospitalizations
• Mental health difficulties and diagnoses
• Whether you are being or have been abused , or have another situation that could affect your safety or emotional well-being
• Smoking, drinking, and drug use
• Medications, supplements, vitamins, and herbal drugs you take
• Drug allergies

Your healthcare provider will also ask about your family medical history. Many genetic issues and birth defects are at least partly hereditary, so learning about your family history helps your medical team keep an eye out for potential issues. Let your provider know whether a relative in your or your partner's family has a chromosomal or genetic disorder, had developmental delays, or was born with a structural birth defect.

It's also important to mention any potential exposure to toxins, especially if you live or work near toxic materials.

Check you out and run some tests. You can expect a number of standard exams and tests at your first prenatal visit. Some healthcare providers will do an ultrasound , but if you don't have any medical problems or concerns, it may not be part of the routine. Here's what's typical:

• A thorough physical exam
• A pelvic exam, including a Pap smear (unless you've had one recently) to check for infections such as chlamydia and gonorrhea or abnormal cells that could indicate cervical cancer
• A urine sample to test for urinary tract infections and other conditions

Your provider will also order blood tests to:

• Identify your blood type and Rh status
• Look for anemia
• Check for HIV, syphilis, hepatitis B and, in certain cases, hepatitis C
• Determine immunity to rubella (German measles) and chickenpox

Discuss any high-risk pregnancy concerns. Many people are considered to have high-risk pregnancies , meaning there's a higher-than-average chance of health issues during pregnancy, labor, and birth. High-risk groups include those who:

• Become pregnant for the first time at age 35 or older
• Become pregnant for the first time before age 18
• Have certain medical issues that develop during pregnancy, such as preeclampsia and gestational diabetes
• Have certain preexisting health problems, such as high blood pressure , thyroid disease , or type 1 or type 2 diabetes

High-risk pregnancies need extra care. While many potential complications are treatable or temporary, some can be dangerous to both you and your baby. Your provider will talk through the risks at your first visit and throughout your pregnancy – and don't be afraid to ask questions at any point.

Explain your options for prenatal genetic testing. Your provider will offer you various prenatal screenings that can give you information about your baby's risk for birth defects and chromosomal conditions. These tests include:

• Noninvasive prenatal testing (NIPT) , also called cell-free fetal DNA testing. Performed at 9 weeks or later, it's used to examine the little bits of your baby's DNA present in your blood.
• A first trimester screen, also called a first-trimester combined test. Typically done between weeks 11 and 13, it consists of a blood test and a type of ultrasound called a nuchal translucency .
• A carrier screening if you haven't had one already. It's a simple blood or saliva test done to see whether your baby is at risk for any of 100 genetic disorders such as cystic fibrosis, sickle cell disease, thalassemia, and Tay-Sachs disease.

Finally, if you're high-risk, there are invasive genetic diagnostic tests that can tell you for sure whether your baby has Down syndrome or certain other conditions. These tests include chorionic villus sampling (CVS) , generally performed at 10 to 13 weeks, and amniocentesis , usually done at 16 to 20 weeks.

CVS and amniocentesis are invasive and may carry a small risk of miscarriage , so women who choose to have these procedures are usually those with a higher risk for genetic and chromosomal problems. Some moms-to-be choose to wait for the results of screening tests before deciding whether to have one of these diagnostic tests.

For more information, your provider can refer you to a genetic counselor .

Give you advice and let you know what's ahead. Your healthcare provider will give you information about eating well , foods to avoid , healthy weight gain , and prenatal vitamins . They'll also give you a heads-up about the common discomforts of early pregnancy and let you know which pregnancy symptoms require immediate attention .

Your emotional health is very important. Your provider may screen you for signs of depression during pregnancy . But don't wait to be asked. If you're feeling depressed or anxious, let your provider know so they can refer you to someone who can help.

The dangers of smoking , drinking alcohol, using drugs, and taking certain medications will be a topic of discussion, as well. If you need help quitting smoking or any other substance, your provider can recommend a program or counselor.

Other topics include the do's and don'ts of exercise , travel , and sex during pregnancy ; environmental and occupational hazards that can affect your baby; and how to avoid certain infections, such as toxoplasmosis . Your provider will also discuss recommended vaccinations , like the flu shot and the COVID-19 vaccine .

How to prepare for your first prenatal appointment

To help your visit go as smoothly as possible, try taking the following steps.

Review your medical history. Brush up on your health status so you can better answer questions. This includes information about your:

• Overall physical and mental health
• Current and past diseases, conditions and other health issues
• Current medications, including prescriptions, supplements, vitamins and herbal supplements and teas
• Fertility and pregnancy history
• Family medical history
• Partner's medical history

If possible, bring documentation along, such as immunization records or a list of your medications. You may even want to bring a baggie containing the medications themselves.

Take your partner, a family member, or friend. Another person can write down notes, ask questions, and provide emotional support during this information-dense first visit.

Get there on time or a little early. This can be helpful for filling out forms and reviewing your insurance. Make sure to bring your insurance information and cash or a credit card for any necessary co-pays.

What questions to ask at the first prenatal visit

Just as your provider will ask you questions at your first prenatal visit, it's a good idea to come prepared with a list of questions for your provider. Ask anything – and don't be shy. Again, try to keep a running list in the weeks before the appointment, so nothing important slips your mind.

Here are some questions to consider if your provider doesn't bring up the topic first.

• How much weight gain is healthy for me? The first prenatal visit is a great opportunity to learn about how your body will change. It's also a good time to ask about nutrition, including which foods to prioritize in your diet.
• What are the foods I should avoid ? Raw fish and unpasteurized cheeses are long-established no-no's for pregnant people, but ask your provider for a full list of what to skip, since the accepted wisdom has changed over the years. Ask about caffeine and alcohol, too. Coffee is typically alright in limited doses, but no amount of alcohol is considered safe when you're having a baby.
• Are prenatal supplements a good choice? Your provider will likely recommend a prenatal vitamin containing folic acid and iron, both of which are needed more during pregnancy.
• Can I exercise? What about sex? With some exceptions, both are usually okay when you're pregnant. They're important to discuss, however, since certain conditions may complicate matters.
• Is it safe to keep working? If you have a physically or emotionally demanding job , you may want to ask how you can ease the effects on your body and mind.
• Is travel okay? While planes, trains, and automobiles are typically safe well into pregnancy, people with particular complications may need to limit or avoid traveling.
• Which medications are safe to take? Ask about your current prescriptions, herbal products, teas, supplements, and any over-the-counter drugs you may use, such as pain relievers and cold medicines. Non-steroidal inflammatory drugs (NSAIDs) like ibuprofen and naproxen are not recommended, for example.
• What are common symptoms of pregnancy? Your provider can tell you what to expect and how to cope. Remember to ask what symptoms are uncommon, too, and what red flags to watch for.
• What should I do in an emergency? Find out who to contact and where to go if you begin to experience new, unusual, severe, or long-lasting symptoms.
• Who will treat me over the course of my pregnancy? If your provider is part of a group practice, you may see other members of the group during appointments. They may even deliver your baby.
• Do you recommend taking prenatal classes? Whether they're in a hospital, at a university, online, or somewhere else, prenatal classes can be invaluable learning experiences for parents-to-be. On top of the usual childbirth classes you hear about, you can also find courses in everything from stress management to good nutrition and even breastfeeding.

Last but not least, ask about your next visit and schedule the appointment before leaving the office. Until your 28th week of pregnancy, you'll likely see someone every four weeks or so.

You may also want to ask whether future visits will be in-person or virtual. Certain practices offer virtual visits for low-risk patients, those whose providers aren't close by, or even higher-risk patients that need to be evaluated more often.

• First Trimester
• OB-GYN & Prenatal Care

What to Expect at the First Prenatal Visit

You got a positive pregnancy test —congratulations are in order! Now it’s time to plan your first prenatal visit. You might be feeling nervous (or is that morning sickness already?!), and you probably have lots of questions, but not to worry—your provider will be there every step of the way. In the meantime, you might want to brush up on what to expect at your first pregnancy appointment. Ready for answers? We’ve consulted with ob-gyns on all the important info.

When Should You Schedule Your First Prenatal Visit?

After you get that positive test, you can take a day or two to soak in the news and celebrate, but it’s a good idea to book that first prenatal visit with your chosen ob-gyn or midwife pretty soon after. (If you haven’t picked a provider yet , you’ll want to get on that ASAP!)

Andrea Braden , MD, IBCLC, an ob-gyn and founder of the lactation company Lybbie , advises to “be on the safe side and give the office a call as soon as you find out you’re pregnant.”

When Will Your First Prenatal Visit Happen?

It’s ideal to schedule your first prenatal visit for when you’re around 7 to 8 weeks pregnant, says Braden. Doctors recommend this timing because that’s when an ultrasound can likely detect baby’s heartbeat . (The earliest a fetal heartbeat can be detected is around week 6, according to Cleveland Clinic .)

If you’ve had complications in an earlier pregnancy, you may want to go in earlier than 7 to 8 weeks. “Sometimes we want to watch these early pregnancies closer because with a history of complications, you have an increased risk of having complications in a subsequent pregnancy,” notes Braden.

On the other hand, if you miss the 7-to-8-week mark, Braden says the goal would be to get you in before 12 weeks, when the first trimester ends. “After that point, just get in as soon as you can because there will be some catching up to do!” she adds.

How Can You Prepare for Your First Pregnancy Appointment?

Want a handy checklist for your first prenatal appointment? Here’s what you need to prepare, according to the experts.

• The date of your last menstrual period (LMP). During your first pregnancy appointment, your ob-gyn will compare the LMP to an ultrasound to determine your due date , says Braden. “If the last period was irregular or unpredictable, sometimes you need to know the first day of the period before that one,” she adds.
• Your medications and medical history. Gather a list of medications and dosages to bring to your provider to discuss their safety during pregnancy, advises Michael Platt-Faulkner , DO, an ob-gyn at St. Elizabeth Physicians in Northern Kentucky. “Writing down any significant personal medical or surgical history and family history of genetic diseases is also helpful information for your visit,” he adds.
• Your pharmacy information. Your doc might prescribe prenatal vitamins or other medications, depending on your medical history, so make sure you have a convenient pharmacy in mind.
• Any questions about symptoms or other concerns. Those first-trimester symptoms—nausea, fatigue, peeing all the time—can cause anxiety. Plus, figuring out what to eat (and not to eat) and questions like “ Can I have coffee while pregnant? ” can be confusing. Platt-Faulker suggests writing all your questions and concerns down for your provider, so you don’t forget them in the heat of the moment.
• Somewhere to track the rest of your pregnancy appointments. “There will be a lot of information coming at you,” says Braden. “You want to have a place to write down future appointments and take any notes.”

What Happens at Your First Prenatal Visit?

What happens at your first prenatal visit can vary widely depending on your state and the type of practice you’re visiting, says Braden. In some practices, you get both an ultrasound and a consultation during your first pregnancy appointment, while other providers’ offices split up these to-dos.

Here’s generally what to expect at your first prenatal appointment.

Your provider may perform an ultrasound to confirm the pregnancy, help determine your due date, check baby’s heart rate and check for any complications, according to Cleveland Clinic . “Oftentimes, an early-pregnancy ultrasound may use a vaginal probe and can be mildly uncomfortable—which can be helpful to know in order to be best prepared for your visit,” says Platt-Faulkner. By about 12 to 14 weeks of pregnancy, your provider will be able to hear baby’s heartbeat with a small device called a Doppler ultrasound, according to Mayo Clinic .

Medical history

“Your provider will review your pregnancy, medical and surgical histories in detail,” says Platt-Faulkner. “Your ob-gyn will [also] review how any medical diagnoses, pregnancy complications or surgical history may affect your pregnancy.” Your provider will also take a look at your medication list and discuss any pregnancy-related safety concerns with the medications you’re taking. Omoikhefe Akhigbe , MD, an ob-gyn at Pediatrix Medical Group in Maryland, adds that your provider may also discuss whether there are any specialty doctors you should start seeing or continue to see.

Lifestyle discussion

Your provider will discuss the lifestyle choices you plan to make during pregnancy. (Remember that, for starters, that means no smoking or alcohol .) “You’ll learn about foods that are safe to eat in pregnancy and the way to keep yourself healthy,” says Braden. “They will answer questions about exercise, diet, nutrition, rest, common symptoms and how to treat them and what to do if you do have discomfort in pregnancy.”

Genetic testing

At your first pregnancy appointment, your provider might perform or discuss future genetic testing. “There are genetic tests that are time-sensitive and can be done as early as 10 weeks,” says Braden. “There are some that are done with an ultrasound around 12 or 13 weeks pregnant, and some that are done in the second trimester. Depending on your history and what you desire, that’ll likely be brought up.” There are some specific tests your provider may offer based on your age or family history too, she adds.

Blood testing

You’ll likely get blood drawn during your first prenatal visit. You’ll be tested for a variety of conditions, including anemia, hepatitis B, syphilis and HIV, as well as for your blood type and Rh factor .

Urine testing

For starters, your provider might test a urine sample to confirm your pregnancy, as well as to test kidney function and screen for the presence of protein, as noted by the Cleveland Clinic .

Physical exam

You can expect a full physical exam at your first prenatal visit, which may include a pelvic examination and a breast exam. “If you’re due for a pap smear and you’re over 21 years of age, then you can expect that you’ll have a pap smear screening test done for cervical cancer along with an HPV test if indicated,” says Braden. “Typically, we also test for sexually transmitted infections at the time of the first prenatal visit.”

Questions to Ask at Your First Prenatal Visit

You’re likely full of questions—and that’s completely normal! Make sure to write them down—and bring this list to your first prenatal appointment in case you feel like you’re forgetting something.

• Questions about symptoms. Of course, you should bring any questions about symptoms to your appointment. Akhigbe says it’s also important to ask “when and where to call for an urgent question, what constitutes an emergency, what is an urgent question and what is a routine question that could probably wait for normal business hours.”
• Questions about testing. Which tests will you need during pregnancy? What will your insurance pay for? “Ask about common resources to use and where you can find the evidence-based information about your pregnancy and guidelines and information about tests,” advises Braden. A lot of people also want to know when they’ll find out baby’s sex , she adds. (Spoiler alert: With non-invasive prenatal testing (NIPT) , you can find out as early as 10 weeks.)
• Questions about your ultrasound plan. How many ultrasounds will you get? “Sometimes it depends on insurance, sometimes it depends on your medical history and sometimes it depends on your provider. Do they do them in-house or at a different center?” says Braden.
• Questions about lifestyle choices. Your doctor will review information about how to eat a healthy pregnancy diet with you, but if you have any specific concerns—such as about drinking alcohol or eating sushi—be sure to let them know.
• Questions about logistics. You’ve got a long journey ahead of you! Your provider will likely “review their practice structure, visit schedule and confirm the hospital where you’ll deliver,” says Platt-Faulkner. But if they’ve missed anything, Akhigbe recommends asking follow-up logistical questions, like how many providers you’ll see and which doctor is most likely to deliver baby. (Remember, there are no guarantees!)

There’s a lot of information to take in at your first prenatal visit. It might seem overwhelming, so make sure to bring questions, take notes and do whatever else you need to feel comfortable. Bringing your partner or a good friend along for the ride can help ease some nerves too. “If you have a support person that will be going along this journey with you, it’s always great to bring them to this visit if that’s allowed,” says Braden.

While it might feel like a lot to take in, know that your provider is there to make sure you and baby are healthy during your first prenatal visit and throughout your whole pregnancy—and that you’re making a wonderful first step in your pregnancy journey.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

Plus, more from The Bump:

15 Early Signs of Pregnancy

Pregnancy Checklist: Your First Trimester To-Dos

When Do You Start Showing in Pregnancy?

Omoikhefe Akhigbe , MD, is an ob-gyn and medical director at Pediatrix Medical Group in Maryland. She earned her medical degree from Meharry Medical College School of Medicine in Nashville, Tennessee.

Andrea Braden , MD, IBCLC, is an ob-gyn, board-certified lactation consultant and founder of the lactation company Lybbie . She earned her medical degree from the University of South Alabama School of Medicine.

Michael Platt-Faulkner , DO, is an ob-gyn at St. Elizabeth Physicians in Northern Kentucky. He earned his medical degree from the Heritage College of Osteopathic Medicine at Ohio University.

Cleveland Clinic, Fetal Development , March 2023

Cleveland Clinic, Ultrasound in Pregnancy , September 2022

Mayo Clinic, Prenatal Care: 1st Trimester Visits , August 2022

Nemours KidsHealth, Prenatal Tests: First Trimester , July 2022

Cleveland Clinic, NIPT Test , October 2022

Cleveland Clinic, Your First Prenatal Appointment: What to Expect , December 2022

Learn how we ensure the accuracy of our content through our editorial and medical review process .

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Rosatom starts production of rare-earth magnets for wind power generation

November 11, 2020 5:17 pm

T VEL Fuel Company of Rosatom has started gradual localization of rare-earth magnets manufacturing for wind power plants generators. The first sets of magnets have been manufactured and shipped to the customer.

In total, the contract between Elemash Magnit LLC (an enterprise of TVEL Fuel Company of Rosatom in Elektrostal, Moscow region) and Red Wind B.V. (a joint venture of NovaWind JSC and the Dutch company Lagerwey) foresees manufacturing and supply over 200 sets of magnets. One set is designed to produce one power generator.

“The project includes gradual localization of magnets manufacturing in Russia, decreasing dependence on imports. We consider production of magnets as a promising sector for TVEL’s metallurgical business development. In this regard, our company does have the relevant research and technological expertise for creation of Russia’s first large-scale full cycle production of permanent rare-earth magnets,” commented Natalia Nikipelova, President of TVEL JSC.

“NovaWind, as the nuclear industry integrator for wind power projects, not only made-up an efficient supply chain, but also contributed to the development of inter-divisional cooperation and new expertise of Rosatom enterprises. TVEL has mastered a unique technology for the production of magnets for wind turbine generators. These technologies will be undoubtedly in demand in other areas as well,” noted Alexander Korchagin, Director General of NovaWind JSC.

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