Like many things during pregnancy, the first prenatal appointment is no doubt the subject of lots of excitement and probably a little bit of apprehension. Fear not! The Twin Docs are going to tell you everything you need to know about the first prenatal visit so that you sail through it like a pro! So, here is a run-down of what to expect:
1). A detailed medical history
When we say detailed, we really mean detailed. There are lots of things in your medical history (medical conditions, current medications, possible genetic conditions, environmental exposures) that could affect you, your pregnancy, and your baby, and the best way to predict these and prevent any potential problems is to simply ask a ton of questions.
Answering these questions can take a lot of time, so plan at least an hour for this first visit. So, what are some things your doctor will want to know?
- Prior pregnancies and outcomes: This includes miscarriages, abortions, term, and preterm deliveries.
- Any medical conditions that you have or have had in the past.
- Any current or past medications.
- Any prior surgeries.
- All vaccines received as well as those not received.
- What type of work you do and where you live: This is important to screen for potential environmental exposures.
- Safety concerns (domestic violence, seatbelts, guns in the home, etc.).
- The presence of pets or exposure to other animals.
- Your partner’s personal and family medical history including potential genetic disorders, heart defects, or brain/spinal cord conditions.
2). Lots of tests
Just when you think you are home free and finally finished answering all of those medical questions, it’s time for a bunch of lab test. So, what tests can you expect?
- A PAP smear: If you are not current on your PAP, your doctor or midwife will probably want to do one. Cervical pre-cancer and cancer are thankfully rare, but they should definitely still be screened for and what better time than during your first visit when an exam with the speculum is going to be performed anyway?
- Cervical cultures: All people are screened at the first visit for STIs (sexually transmitted infections) because undiagnosed STIs can cause a multitude of problems including miscarriage, preterm labor, and even neonatal blindness.
- Lots and lots of blood work: Make sure you drink plenty of water before your first visit because you will have up to 7 tubes of blood drawn. I know it sucks, but all of these tests serve a particular and important purpose. Some of the labs that will be checked include Your blood type, an anemia screen, tests to see if you are immune to infections like the chickenpox and German measles, screens for infections like HIV, hepatitis and syphilis, and a screen to see if you are a carrier for sickle cell disease.
3). Determine your due date
I’m sure your doctor isn’t the only person who wants to know when to expect your bundle of joy. There are a few ways that they can determine your due date. Using the first day of your last period, your doctor can use Nagel’s rule to estimate your due date.
All you have to do is take the first day of your last normal period, add a year, subtract three months, and then add seven days and voila, that’s your due date. If you don’t know when your last period started, your doctor may order or perform an ultrasound. The earlier the ultrasound, the more accurate the due date.
4). Prescription for Prenatal vitamins and other medications
Prenatal vitamins and DHA/omega-3 fatty acids: If you haven’t already started taking a prenatal vitamin over-the-counter (spoiler alert, OTC prenatal vitamins are just as good as prescription vitamins), your doctor will probably prescribe one for you.
Many prenatal vitamins come with supplemental DHA/Omega-3 fatty acids. If your vitamin does not come with this supplement, consider purchasing it separately over the counter. DHA/Omega-3 fatty acids play an essential role in your baby’s neurodevelopment (brain development) and the development of good eyesight.
Depending upon your medical history, your doctor may change your current medications or prescribe other medications for you. Make sure that you discuss any medications that you are currently taking with your doctor (including other vitamins and supplements) to determine which are appropriate to continue and which may need to be stopped or substituted.
If you want more where this came from, be sure to check out our book Everything You Ever Wanted To Know About Pregnancy But Were Too Afraid or Embarrassed To Ask, available in print or electronic versions on Amazon. You can also check out our mobile apps for Apple and Android in the Apple App and Google Play stores.
If you have a specific pregnancy-related question, you can submit it to BlackDoctor.org using the hashtag #EverythingPregnancy, and we will try to answer it during our next Facebook live or in a future blog.
Idries J. Abdur-Rahman, MD, FACOG
Obstetrician/Gynecologist
TwinDoctorsTV