Your first prenatal OB visit

Congratulations!  You are pregnant.  This is going to be a very special and cherished time of your life.  Pregnancy can be a very natural process, but there are the possibilities of complications.  Prenatal care is critical in preventing, detecting and managing complications related to pregnancy.

Your first OB visit can be a little different depending on the medical practice that you choose.  However, there are some basic things that should be similar.

First, you should have a thorough history taken that includes your medical history as well as the medical history of the family of the father of your baby.  Additionally, there will be a discussion regarding the first day of your last menstrual cycle and your certainty of this date.  There also may be discussion of the number of days that are typically between each period.  This will help your doctor determine your date of delivery, also known as your “due date”.  If you do not know the first day of your last period, I recommend an ultrasound to determine your due date.

Next, you will also have a detailed physical exam that is very similar to the type of exam that you would have during your annual exam.  If your first visit is at about 12 weeks gestation, your doctor will include an assessment of the fetal heart rate.  Sometimes the fetal heart rate can be heard with the Doppler at about 10 weeks gestation in experienced hands.  During this exam, the size of your uterus will be assessed as a component of the pelvic exam.  If the size of your uterus is not consistent with the dates determined by the first day of your last period, you will need an ultrasound to confirm your due date. 

Additionally, you will have labs drawn on this day.  Labs include blood type, screening for infectious diseases such as Hepatitis B, Syphilis, HIV, complete blood count, possibly a urine culture and a pap smear.  You will also be tested to confirm your immunity to Rubella.  If you have a chronic medical condition, such as hypothyroidism or diabetes, there will be additional labs ordered.

Lastly, your doctor or midwife will begin prenatal counseling.  You will learn about the style of the practice.  You will learn about options that you may have between providers and how it is determined who will actually deliver your baby.  You will be encouraged to stop smoking if you are a smoker.  There will likely be a discussion about cats and refraining from changing the litter box.  You will be encouraged to take a prenatal vitamin that includes folic acid and DHA (an omega 3 fatty acid that has been shown to have a positive effect on the vision and neurologic development of your baby).  You will probably be instructed to limit medications to a pre-printed list that many offices will provide for you.  There will be a discussion about nutrition and things to avoid such as high mercury fish. 

This visit is exciting!  Feel free to bring a list of your own questions as well.  The first visit should set the precedent for a 40+ week relationship with the doctor or midwife of your choice.