What Will My First Pregnancy Doctor's Appointment Be Like?

By Beth M. Iovinelli, RN, BSN, IBCLC

Q: I'm feeling a little nervous about my first doctor's appointment. What can I expect? Will there be tests?

A: The first office visit usually begins with a check of your height, weight, and blood pressure.
You and your healthcare provider will also discuss the following:

Review of medical history
Date of last menstrual period or LMP (this will help to calculate your due date)
Contraceptive history
Family history of major disease or genetic issues
General health
Allergy history (drug or food)
Use of medications and/or herbs
Any history of previous pregnancies or miscarriages

Tests at your first visit include:

Blood work (includes checking: hCG levels—pregnancy test, hemoglobin (to test for anemia), blood type and RH factor, Hepatitis B screening, HIV testing, Rubella titer, syphilis screening)
Pap smear (to check for abnormal cervical cells)
Gonorrhea and Chlamydia cultures
Urinalysis
Heart, lung, and thyroid assessment by your doctor

There will be an internal (pelvic) exam to check your cervix and uterus. They will also do a measurement of your pelvis to see how roomy it is to accommodate delivering your baby. (Generally there won't be more internal exams until much later in your pregnancy.)
After this initial visit, you will see your doctor once a month until the 32nd week of pregnancy, after which you'll go every two weeks, and finally once a week from week 37 until you deliver.
These monthly check-ups will include:

Urine check
Weight check
Blood pressure
Check hands, feet, and face for excessive swelling
Hemoglobin check (to make sure you are not anemic)
Measurement of your abdomen to assess fetal growth (fundal height)
Check baby's position (determined by your doctor feeling your belly)
Fetal heart rate check (listening for your baby's heart beat; this can be done between week nine and week 12)

Other tests:

Blood glucose screening (glucose tolerance test) to check for pregnancy-related diabetes. This is done between 24 weeks and 28 weeks.

Ultrasound at around 20 weeks. However, this can be done sooner if your doctor feels it is necessary.

Group B Streptococcus culture, done between 32 weeks and 36 weeks (if you are positive you will be treated with antibiotics in labor to prevent spread to your baby).

Exam of your breasts and discussion of preparing to breastfeed.

AFP or MSAFP (maternal serum alpha fetal protein) test to screen for Down syndrome and neural tube defects—this test, recommended by the ACOG (American College of Obstetricians and Gynecologists) will only tell you if you are at risk, but it is not a positive confirmation. If the test is positive your doctor will recommend further testing and screening.

Beth M. Iovinelli, RN, BSN, IBCLC

Beth M. Iovinelli, RN, BSN, IBCLC, has worked as a maternal child health nurse in both labor and delivery and post partum since 1994. She has written for various newsletters and websites, taught thousands of parents, and trained nurses, doctors, and nutritionists. In 2004, she contributed to the Don't Panic Pregnancy book (Lyons Press) written by Emmy Award-winning producer Judy Morris. Iovinelli works as a maternal child health educator and lactation consultant at Norwalk Hospital in Norwalk, Connecticut, and is currently being featured in the Newborn Channel's latest breastfeeding program, Breast is Best, which is broadcast in more than 1,000 hospitals nationwide.

All articles by Beth M. Iovinelli, RN, BSN, IBCLC