Obstetric Appointment Guide
Once your pregnancy has been confirmed, the prenatal period officially begins. Prenatal care involves a series of regular examinations and tests by a healthcare provider.
In an uncomplicated pregnancy, most women will see their practitioner once a month until the 28th week of pregnancy. At this point, you will be seen every two weeks.
As you anticipate your baby’s arrival during your last month of pregnancy, you will have an appointment with a healthcare provider every week.
What to Expect
The initial prenatal visit is often the longest and is facilitated by our OB/GYN nurse. During the first appointment, a detailed family history and lab work will be performed.
The nurse will calculate your baby’s due date, which will serve as a reference point in future visits as the baby’s growth is assessed. See below for a list of common blood tests performed during this initial visit.
During your first prenatal visit with a healthcare provider, you will have a physical examination of your overall health. Your physician will then perform an obstetrical exam that includes looking at your abdomen, a measurement of the height of your uterus and a Pap smear.
All prenatal visits include a measurement of your weight and urine and blood pressure testing. Urine testing is performed to check for the presence of sugar and protein. Sugar in the urine could indicate gestational diabetes and the presence of protein could indicate toxemia.
If you have any questions regarding your appointments, please feel free to call us at (406) 883-5680.
Prenatal Lab Work Guide
Labs drawn at your first nurse visit
Blood typing –This test determines your blood type, Rhesus (Rh) type and antibody factor. If your blood type is Rh negative, special monitoring of your blood may be necessary to check for Rh incompatibility. Your pregnancy needs special care if you are Rh negative and your baby's father is Rh positive.
- Antibody screen – Detects unusual antibodies that may have arisen in a prior pregnancy or from a blood transfusion.
- CBC (Complete Blood Count) – Checks your blood to determine if you are anemic (do not have enough iron in your blood). Women usually become slightly anemic as the pregnancy progresses, but very low iron levels will need to be treated. Platelet levels in your blood are also measured.
- Rubella test (German measles) – Determines if you are protected from rubella. In adults, sometimes the vaccine has worn off, and this disease can cause major complications to the fetus.
- Syphilis screening (RPR/VDRL) – Checks for exposure to syphilis. If present, medical treatment can be initiated so the fetus is not harmed.
- Hepatitis B (HBSAG) – Checks for infection with the Hepatitis B virus, which can be passed to an unborn child.
- One-hour Glucose – Tests your blood glucose level. Your care provider may order this based on your obstetric history.
- Hepatitis C – Tests for infection with Hepatitis C, a viral infection of the liver.
- HIV – Checks for the AIDS virus. If you have HIV infection, you can be treated during pregnancy, which will reduce the chances of passing the virus to your unborn child.
- Cystic Fibrosis Carrier screening – Determines if you are a carrier of Cystic Fibrosis. Consult with your care provider if you think you or your partner may be a carrier.
- HGB Electrophoresis – Tests for Sickle Cell Anemia and other genetic causes of chronic anemia.
Screenings at your first doctor visit
- Pap smear – Checks for abnormal cervical cells.
- DNA probe – A cervical culture to check for diseases that can infect your baby during birth.
- Hearing and Dizziness – Help for hearing and dizziness difficulties.
Additional tests throughout pregnancy
- 10-13 weeks – Sequential Part I. A voluntary screening test for Down Syndrome and Trisomy 18. This test may be followed by Part II during 15-21 weeks gestation.
- 15-20 weeks – Quad Test is optional. This test measures the levels of AFP, HCG, estriol and inhibin A in your blood. These levels are then used to calculate the risk of chromosomal or neural tube abnormalities in your baby. If this test indicates a high probability, your care provider may recommend an amniocentesis.
- 15-21 weeks – Sequential Part II. The second screening tests for open neural tube defects, Down Syndrome and Trisomy 18.
- 16 weeks – Amniocentesis for genetic screening. This test is voluntary and may be recommended for certain high risk patients.
- 28 weeks – Required glucose screening. Following a sugary drink, your blood sugar level is measured to check for a condition of pregnancy called gestational diabetes. If gestational diabetes is present, special efforts will be necessary to keep your blood sugar at a normal level. This can often be done with dietary restrictions but may require you to take insulin. In the vast majority of cases, gestational diabetes goes away following delivery, although women who develop diabetes during pregnancy should be monitored later in life for the development of diabetes.
- 28 weeks – Rhesus Type Antibody screen. If you are Rh negative, a follow-up antibody screen will be performed. Along with this screening, you will have an injection of Rhogam to prevent antibody formation.
- 28 weeks – CBC follow up. This test checks for evidence of anemia in your blood.
- 36 weeks – GBS Screening. This is a vaginal/rectal culture that tests for the presence of Group B strep. If present, you will be treated during labor with antibiotics to prevent infection of the baby during birth.