Prenatal Care Schedule During Pregnancy

Woman and her midwife at prenatal visit
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After selecting a practitioner, most people want to know what their prenatal care schedule will entail. There are some variances depending on the type of practitioner that you are seeing, where you are located, and the medical complexity that you need in your care.

Generally, the first appointment will take place around 8 weeks, although some practitioners like to wait until 10 to 12 weeks. This is usually your longest appointment because of the prenatal and medical history that is taken. You will be asked questions about your health, your medical history, your menstrual history, your lifestyle, and your family's medical history. This is also a time to ask more questions. A lot of people want to know about nutrition, sexual relations, exercise, and so on. Always feel free to ask your practitioner these questions. You may also ask if they have a question phone line, or have a certain time of day set aside to answer questions that will likely come up between visits.

A typical schedule for prenatal care appointments is:

Clinical Tests

Here are some of the clinical tests that may be performed at the first visit:

  • Pelvic exam (pap smear, bimanual exam, GC)
  • Blood work (Rubella titer, hematocrit/hemoglobin, HIV)
  • Blood pressure
  • Urine screen
  • Weight
  • Breast exam

You will have some of these done at every visit (blood pressure, urine screen, weight, and later they will add a fundal height check and listening for the baby's heartbeat (about 12 weeks is average to hear the heartbeat with a Doppler). You will not have a vaginal exam done every visit. If you do, inquire as to the reason, because this is not generally necessary.

There are a few other routine tests that are done at specific points in your prenatal care:

  • Anatomy ultrasound (around 20 weeks)
  • Glucose challenge test (GCT; this is a diabetes screening test usually done between 24 and 28 weeks)
  • Group B strep screen (GBS; 36 to 37 weeks)

For some women, there will be a reason to do further testing to help ensure a healthy outcome. These may include, but are not limited to:

Appointment Schedule

Your appointments will be scheduled, generally, as follows:

  • Every 4 weeks until 28 weeks of pregnancy
  • Every 2 weeks until 36 weeks of pregnancy
  • Every week until 41 weeks
  • Every few days until you give birth

The most important thing in your prenatal care is that you and your partner feel comfortable and assured by the care you are receiving. If you do not believe that you are getting the medical or emotional care and support that you need, a change of practitioners is not out of the question. A healthy pregnancy is the result of teamwork.

Taking a list of questions with you is also important. Not only will a list help you remember what you wanted to ask, but it will give you a place to write the answers. Your practitioner should give you plenty of time to ask questions. If this is not happening, try to explain to them that you have questions that you need to be answered. If that fails, try asking to be scheduled for extra time to include the questions. Sometimes it is helpful to bring another person with you to hear the answers. You both may interpret the answer differently or they can be there for moral support if you are fearful to ask questions, and they can help you remember the answers.

In addition to the medical exams of pregnancy, you'll want to get to know your doctor or midwife better. This will include learning about office policies, like the call schedule, when to call the office for questions or problems, and other topics. This is a great way to learn about the ideas that your practitioner has for your pregnancy and birth. It can also be where you get filled in on happenings locally, like childbirth classes, preferred doulas, etc. That said, sometimes you find that you are in need of a new practitioner. Maybe you don't see eye to eye with them on important topics, perhaps they retire or you move. Either way, you can switch in pregnancy.

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