Schedule of Prenatal Care
Specific schedules of prenatal care vary from provider to provider, but a general schedule follows below, as well as some of the screening tests or activities you might expect at various visits. More information about the tests mentioned below, including their benefits and drawbacks, can be found in the Antepartum Testing table in the module How Has Childbirth Changed in this Century?
8-12 weeks: Initial prenatal visit. The plan for your prenatal care at the practice you have chosen will be explained. A health history is taken, and a physical exam, including a pelvic exam is done. Lab work is completed, including your blood type and hemoglobin, sexually transmitted infection screening, a urine test, and a PAP test if you are due for one. You may be able to hear the baby's heart beat at this visit. If you cannot say with accuracy when you had your last period, an ultrasound might be scheduled to help determine how far along you are.
Optional genetic counseling visit: Early in your pregnancy, you may be offered genetic screening. This is commonly offered to women over the age of 35, or women who have a family history of genetic problems, but it is increasingly being offered to every woman. If you choose this screening, your care provider and/or genetic counselor may suggest additional genetic screening or diagnostic tests, including blood tests, chorionic villus sampling, ultrasound, and/or amniocentesis. These tests are done at specific times during pregnancy.
First two trimesters: Prenatal visits continue every 4-6 weeks through the first two trimesters, or until you are 28 weeks along. At each appointment, your care provider will weigh you and take your blood pressure, listen to the baby's heartbeat, and measure the growth of your uterus and baby. Some providers check your urine for protein and sugar at each visit.
15 to 20 weeks: At one of your appointments within this period, you will be offered the Quad Screen test, which screens for genetic and spinal cord abnormalities. You may also be offered an ultrasound between 18 and 20 weeks to view the baby's organs, and measure the growth of the baby and the placenta.
27 or 28 weeks: At an appointment within this period, you will be encouraged to take a glucose challenge test to screen for gestational diabetes. Your hemoglobin may be rechecked. Some providers do a pelvic exam. Expect to review warning signs of late pregnancy that would alert you to preterm labor or high blood pressure. You may be encouraged to sign up for prenatal classes, find a doctor or nurse-practitioner who will provide well-child care for your baby, and information may be provided about making plans for labor.
28 to 36 weeks: After 28 weeks, prenatal visits continue every 2-3 weeks until 36 weeks. Your doctor or midwife will continue to record the growth of the baby, listen to the baby's heartbeat, and will check the position of the baby.
36 weeks: At this visit, your midwife or doctor will do a pelvic exam, and encourage you to have a Group B Strep test. Screening tests for sexually transmitted infections may be repeated at this visit. The position and size of the baby are estimated. If your baby is not head down, your provider may suggest exercises to encourage the baby to turn, or suggest a physical manipulation called external version. The risks and benefits of this procedure should be carefully explained.
36 to 40 weeks: The usual monitoring of your weight and blood pressure, and the baby's size, position, and heart rate are done. Your care provider may offer to check your cervix for dilation.
40+ weeks: After your due date, your care provider may offer what is called "post-dates" testing, including nonstress tests, ultrasound, and biophysical profiles. Some providers start at 40 weeks, others not until 10 days past your due date.
