Your first prenatal appointment: What to expect
The first prenatal visit is one of the longest appointments a woman will have during pregnancy, with several tests and a lot of important information conveyed.
During pregnancy, you need regular prenatal visits to keep yourself and the pregnancy healthy. These visits are called prenatal care appointments. In these visits, you might meet with an OB/Gyn, a midwife or a nurse practitioner.
During pregnancy, you'll meet with your prenatal care provider every four weeks until you are about 28 weeks (7 months) pregnant. After that, you'll come every two weeks. Then, in your last month of pregnancy, we'll want to see you weekly.
Your first appointment will likely be the longest of the many prenatal visits to come. At that visit, we will discuss your overall health, answer your first round of questions and help you prepare for the next nine months.
Most women make an appointment after they get a positive result from a home pregnancy test. Often, this is one or two weeks after a missed period. Call us at 505-272-2245, and we will schedule your first prenatal appointment between six and eight weeks of pregnancy.
What to Expect
Confirming the Pregnancy
Sometimes, home pregnancy tests give false positives—it says you are pregnant, but you aren't. And unfortunately, approximately one in four pregnancies ends in miscarriage, often early in pregnancy. Before we do any other tests, we'll first confirm your pregnancy with a urine test and blood draw.
Estimating Your Due Date
We’ll also ask about your periods:
- How old you were when they started
- How regular they are
- When your last period started
This information helps us estimate your due date—when we expect the baby to come. The due date is approximately nine months from the first day of your last period.
We’ll also discuss whether you want to continue with the pregnancy. Nearly half of all pregnancies in the U.S. are unplanned. It’s OK to not immediately know how you feel about being pregnant, or what you want to do. At your first prenatal visit, we can talk you through your options. We will support you in whatever you decide.
Personal and Family Medical History
Be prepared to discuss your personal and family medical history. This information helps us determine whether the embryo might be at risk for health problems.
Some of the topics we'll discuss include:
- Alcohol, tobacco and caffeine use
- Chronic conditions, such as diabetes and high blood pressure
- Exposure to potentially toxic substances
- Genetic disorders
- Medications, including supplements and over-the-counter drugs
- Past surgeries
- Pregnancy complications
- Travel to countries where infectious diseases—such as Zika virus or malaria—are common
At your first visit, we'll also discuss social concerns, such as whether you feel safe at home and at work. Your employer is required to give you accommodations if your job is unsafe for pregnancy. If you don’t feel safe, we can discuss options to manage that situation.
Lab Tests
You’ll also get a battery of tests to examine the health of you and your baby. These can include blood and urine tests to look for:
- Anemia
- Blood type and Rh status to determine if you are Rh negative, which can affect the pregnancy
- Glucose levels
- Immunity to measles and chickenpox
- Infections such as rubella, hepatitis B and C, syphilis and HIV
- Urinary tract infections, gonorrhea and chlamydia
Depending on your age and health history, your may also be offered an optional blood test called noninvasive prenatal testing (NIPT). This screening can be done as early as nine weeks and can determine whether the embryo may be at risk for genetic conditions such as:
- Down syndrome (trisomy 21)
- Edward’s syndrome (trisomy 18)
- Patau syndrome (trisomy 13)
Physical Exam
We’ll check your vitals such as blood pressure and calculate your body mass index to determine how much weight you should gain during pregnancy. We’ll also do a head-to-toe physical exam that may include a breast exam, pelvic exam and screenings of your heart, lungs and thyroid. If you’re due for a Pap smear to check for cervical cancer, we can also do that test at the first visit. We may also try to find out how big your uterus is and if this corresponds to how many weeks pregnant you think you are. We can usually hear fetal heart tones with a doppler after 10 weeks.
Ultrasound
Getting an ultrasound at your first prenatal appointment is not required. But we do them more often than not. The ultrasound helps narrow down your due date and confirms that the pregnancy is in the uterus. We also may be able to hear the heartbeat at this time and see if you’re having than one baby.
However, if you’re hoping to learn whether you’re having a boy or girl, you'll have to wait a bit longer! The baby won't be that apparent on ultrasound until approximately 20 weeks.
Education and Resources
Education is a big part of prenatal care. All patients who deliver at UNM Hospital get access to:
- Managing pregnancy symptoms: Some early pregnancy body changes are weird, but normal. These include tender, swollen breasts, fatigue or nausea and vomiting. We can discuss how to manage these symptoms and when to see your doctor.
- Prenatal vitamins: It’s important to take prenatal vitamins with folic acid to prevent neural tube defects and walk you through some foods to avoid—such as alcohol, unpasteurized cheeses, deli meats, and raw fish. We also can suggest exercises that are safe to do during pregnancy.
- Drug and alcohol support: During pregnancy, it's important to quit drinking, smoking and using drugs. If you need help to quit, we can recommend pregnancy-safe medications and options. For example, our Milagro Clinic is designed specifically to give pregnant patients safe, respectful addiction care.
- Prenatal classes: From new parent classes to childbirth classes, we offer a range of in-person and Zoom classes to help you prepare for parenting.
- Financial assistance: There are financial programs at UNM Hospital and in the community to help families with no or limited health insurance.
- Home visits: We can connect you to programs for first time moms that offer home visits at no charge to families with new babies. At these visits, we'll answer your questions and help troubleshoot feeding concerns.
Your first prenatal appointment might seem a bit overwhelming. But we are here for you. We will give you all the information you need to have a healthy pregnancy. And we’ll be by your side, all the way.