Your first pregnancy visit involves being asked many questions and having several blood tests as well as a few simple examination procedures. Some procedures and tests offered are considered routine, meaning they are usually recommended for all pregnant women. However, others are optional depending on your preferences, after discussing them with your caregiver. If you have a medical condition such as diabetes, high blood pressure, epilepsy, thyroid or metabolic disorders, you may require additional tests. Women with multiple pregnancies or babies with suspected health issues may also require more testing than normal.
Standard tests and procedures you may be offered at your first pregnancy visit can include:
Blood tests
The first pregnancy visit is when most required blood tests are performed. Your caregiver will either take the blood during the consultation, or order the tests to be taken at the hospital or a private pathologist. They can include:
Urine tests
You may be asked to provide a sterile urine specimen for testing, or perhaps be asked to bring a urine specimen with you in a clean jar to the appointment. A sterile urine specimen is sent to the pathologist to test for a possible bladder infection, which can sometimes occur without any obvious physical signs, called asymptomatic bacteriuria. For urine in a jar, your caregiver may just perform a rapid dipstick test to look for substances such as protein and perhaps glucose or ketones in the urine.
Physical examinations
A physical examination at the first pregnancy visit involves a few routine procedures. Your caregiver will take your blood pressure and may ask you to weigh yourself. An initial weight measurement at the beginning of the pregnancy is aimed at recording a baseline weight, in case you need to be prescribed drug dosages that are calculated on your average weight at a later stage of pregnancy or during labour. Weighing at subsequent pregnancy visits is not really necessary.
Feeling and measuring your belly
Once you are past 12 weeks of pregnancy your caregiver will be able to feel the top of your uterus, called the fundus. As your pregnancy progresses, they may also use a measuring tape to estimate your fundal height.
Listening to your baby
As your pregnancy progresses, your caregiver will start listening to your unborn baby’s heartbeat. Depending on what equipment is available, they may be able to detect your baby’s heart beat as early as 12 to 14 weeks with a Doppler machine. However, this is not always possible and you may not be able to hear your baby until about 16 to 18 weeks of pregnancy with this device. Alternatively, your caregiver may use a Pinard’s stethoscope from about 20 to 24 weeks of pregnancy, when the baby is large enough to hear their heartbeat clearly in this way. You can read more in listening to your baby.
If you have never heard the heartbeat of an unborn baby it can sound a little like a horse galloping.
Vaginal examination
If you need a Pap test, this entails a vaginal examination. Otherwise you should not need a vaginal examination at your first pregnancy visit.
Ultrasounds
Ultrasounds may be recommended at various times during pregnancy for different reasons. During the first 12 weeks, the most common reason to perform an ultrasound is to check the well-being of the baby if experiencing unexplained vaginal bleeding.
Sometimes the caregiver orders an ultrasound to date the pregnancy if you are unsure when your last period was, or didn’t have a last period because you recently stopped contraception, were breastfeeding or experienced a recent miscarriage. Ultrasound is now also commonly used to perform a genetic screening test known as a nuchal translucency scan. You can read more in ultrasounds.
Genetic testing
Your caregiver may offer you genetic testing (or you may request it) at your first pregnancy visit to screen for inherited abnormalities in your baby. There are many options to consider and often these tests are organised after genetic counselling. This is covered in more detail in genetic testing and early ultrasounds.