What to Expect at Prenatal Care Appointments

If you're pregnant, especially if it's for the first time, you may be wondering what will happen at your prenatal care appointments with your doctor or midwife. Here's a rundown of everything you can expect at each appointment, including tests and exams.

1
Your First Prenatal Care Appointment

Mixed race nurse taking patient's blood pressure
Ariel Skelley/Blend Images/Getty Images

Your first prenatal appointment will probably be your longest one. Here you will give your doctor, midwife, or nurse your complete health and pregnancy history. This information is important because it will give your practitioner a good idea of how healthy you are and what type of problems you are most likely to experience during your pregnancy. You will learn what your estimated due date is as well.

There are many areas that may be checked during your physical exam, including:

  • Pelvic exam
  • Pap smear
  • Breast exam
  • Blood work
  • Pregnancy test
  • Ultrasound (if you're having pain or bleeding or underwent fertility treatments)
  • Blood pressure
  • Weight
  • Urine screen for protein and sugar

You will probably be seen for your first appointment between 8 and 10 weeks gestation, though you may be seen earlier if you're having problems or if it's your doctor or midwife's policy.

2
Your Second Prenatal Care Appointment

Your second prenatal appointment is usually done about a month after your first appointment unless you're having problems or are requesting specific prenatal testing that is best performed in a specific time range. Here is what will most likely happen during this visit:

  • Blood pressure check
  • Urine screen for sugar and protein
  • Record your weight
  • Listen to a fetal heartbeat using a Doppler
  • Additional testing as needed

Your baby's first heartbeat will usually be heard with a Doppler between 8 and 12 weeks gestation. If you have trouble hearing the baby's heartbeat, you will probably be asked to wait until your next visit when your baby is a bit bigger. Sometimes an ultrasound will be ordered.

Optional Testing

These tests are optional but may be requested by you or recommended by your doctor or midwife:

  • Nuchal fold test (screening for Down syndrome)
  • Chorionic villus sampling (CVS) (diagnostic test for many genetic diseases)
  • Early amniocentesis (diagnostic test for many genetic diseases)

Be sure to discuss all of your options regarding these tests, including the risks and benefits, how the test results are given, and whether the test is a screening test or a diagnostic test.

3
Your Third Prenatal Care Appointment

Towards the third prenatal visit, you're most likely around 14 to 16 weeks pregnant. You're generally feeling better and the most dangerous part of pregnancy is over. You are now probably feeling more confident in your pregnancy and sharing your good news. It has been about a month since you've seen the midwife or doctor. Here's what this appointment may look like:

  • Urine sample to screen for sugar and protein
  • Check your blood pressure
  • Record your weight
  • Listen for baby's heartbeat
  • Measure your abdomen, called "fundal height," to check baby's growth

Optional Testing

You may also have the following prenatal testing done if you request it:

  • Neural tube defect (NTD)/Down syndrome screening by way of maternal blood work (several tests can be used including  alpha-fetoprotein (AFP), triple screen, and quad screen)
  • Amniocentesis (diagnostic test for many genetic diseases)

4
Your Fourth Prenatal Care Appointment

You are most likely between 16 to 20 weeks at this point, and it has been about a month since your last appointment. You probably feel like you've grown a lot since your last appointment and you may now be wearing maternity clothes and possibly even feeling your baby move. Here's what this visit may involve:

  • Urine sample to screen for sugar and protein
  • Record your weight
  • Listen for baby's heartbeat
  • Measure your fundal height to check baby's growth
  • Check your blood pressure

Optional Testing

You may also have a mid-pregnancy ultrasound screening if you request it or if it's your doctor or midwife's policy:

5
Your Fifth Prenatal Care Appointment

Between 18 to 22 weeks you'll likely have your fifth prenatal care visit. Here's what this appointment may involve:

  • Record your weight
  • Urine sample to screen for sugar and protein
  • Listen to baby's heartbeat
  • Measure your fundal height to check baby's growth
  • Check your blood pressure
  • Check for swelling in your hands and feet

6
Your Sixth Prenatal Care Appointment

Your next prenatal care appointment will likely be between 22 to 26 weeks of pregnancy. You are probably still being seen monthly. Here's what this appointment may look like:

  • Record your weight
  • Urine sample to screen for sugar and protein
  • Listen to baby's heartbeat
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Check your blood pressure
  • Check for swelling in your hands and feet

7
Your Seventh or Eighth Prenatal Care Appointment

Between 26 to 28 weeks of pregnancy, you'll likely have another prenatal care appointment. Here's what may happen:

  • Record your weight
  • Urine sample to screen for sugar and protein
  • Listen to baby's heartbeat
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Check your blood pressure
  • Check for swelling in your hands and feet

Other Testing and Information

Around this time in pregnancy, you may have other tests ordered. Some may be specific to where you are in pregnancy, like the glucose tolerance test (GTT) used to screen for gestational diabetes, while other tests or procedures are specific to you and your baby, like the RhoGam shot around 28 weeks of gestation for women who are Rh negative. Your doctor or midwife may also give you information on screening for preterm labor on your own.

8
Your Eighth, Ninth, or Beyond Prenatal Care Appointments (Bi-weekly Visits)

Your next appointment will likely be between 28 to 36 weeks of pregnancy. In fact, you're likely to have at least two prenatal visits during this period because you're now being seen every other week. Here's what these appointments may involve:

  • Urine sample to screen for sugar and protein
  • Record your weight
  • Listen for baby's heartbeat
  • Palpate to check baby's position (vertex, breech, posterior, etc.)
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Check your blood pressure
  • Check for swelling in your hands and feet

Other Testing

A screening for Group B strep (GBS) will normally be done between weeks 34 to 36. This involves a rectal and vaginal swab. You will continue to be seen every other week until about the 36th week of pregnancy. At this point, your visits will likely be fairly routine with very few extra tests being performed.

9
Your Prenatal Care Appointments—Weekly Visits

Between 36 to 40 weeks of pregnancy, you're usually seen every week. Here's what these visits may entail:

  • Urine sample to screen for sugar and protein
  • Record your weight
  • Listen to baby's heartbeat
  • Palpate to check baby's position (vertex, breech, posterior, etc.)
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Check your blood pressure
  • Check for swelling in your hands and feet

You will continue to be seen every week until about the 41st week of pregnancy, at which point you may be seen every few days until your baby is born. Your visits are most likely fairly routine with very few extra tests being performed.

Ultrasound

You may also have an ultrasound to determine what position the baby is in at this point. Your doctor will also try to predict the size of your baby, but this is usually not very accurate. Because of this tendency for inaccuracy, it's not a great idea to have an induction of labor based on the predicted size of your baby.

Home Birth

If you're having a home birth, you may have a home visit during this time frame if your midwife doesn't do her normal prenatal visits there. You will be able to give her a tour of your home and answer questions she may have about where everything is located.

10
Your Prenatal Care Appointments—Overdue Pregnancy Visits

At 40 or 41 weeks of pregnancy, you may begin to see your midwife or doctor every few days. Here is what these visits may look like:

  • Record your weight
  • Urine sample to screen for sugar and protein
  • Listen for baby's heartbeat
  • Measure your fundal height to check baby's growth
  • Palpate to check baby's position (vertex, breech, posterior, etc.)
  • Questions about baby's movements
  • Check your blood pressure

Optional Testing

Since you are officially past your due date, your midwife or doctor may want to watch you and your baby more carefully until labor begins. This may include the following tests:

These tests will help determine if your practitioner needs to intervene with an induction of labor for the health of your baby or let your pregnancy continue.

Sources:

Eunice Kennedy Shriver National Institute of Child Health and Human Development. What Happens During Prenatal Visits? U.S. Department of Health and Human Services. National Institutes of Health. Updated January 31, 2017.

Mayo Clinic Staff. Prenatal Care: 1st Trimester Visits. Mayo Clinic. Updated July 31, 2015.