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Great Expectations: Your All-in-One Resource for Pregnancy and Childbirth

What to Expect When You're Expecting

Your Pregnancy Week by Week

Belly Laughs: The Naked Truth about Pregnancy and Childbirth

The Belly Book: A Nine-Month Journal for You and Your Growing Belly

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Prenatal Care

Prenatal care is the medical care you and your developing baby receive during pregnancy. Its main purpose is to prevent complications or detect them as quickly as possible. The sooner you begin prenatal care, the more likely you will have a safe pregnancy and give birth to a healthy baby.

Get prenatal care as soon as you think you’re pregnant.
Never skip prenatal care appointments, even if you feel well or if getting to the appointment is a hassle.

Ideally, you should see the same healthcare provider or group of providers throughout your pregnancy. If you‘re not satisfied with the care you receive, however, switch to a different provider who makes you feel more comfortable.

Finding a Prenatal Care Provider

Prenatal care is typically provided by an OB/GYN, a family physician, or a certified nurse midwife.

OB/GYN: A doctor who specializes in obstetrics (pregnancy care) as well as gynecology. Oversees healthy pregnancies and can diagnose and treat pregnancy complications.
Family physician: A doctor trained to provide standard care for healthy pregnancies. Will refer you to a specialist if complications arise. Also can provide general medical care for babies after birth.
Certified nurse midwife (CNM): A nurse trained to provide care for healthy pregnancies. Will refer you to a specialist if complications arise. Not all midwives are certified, so be sure only to see one who is.

Selecting an Obstetrician or Midwife

If you have health insurance, you can select a obstetrician or midwife in a few different ways:

Continue with your current doctor: If you already have an OB/GYN or family physician who you like, feel free to continue seeing that doctor.
Contact your insurance provider: Ask your insurance company for a list of appropriate healthcare providers in your area.
Ask for recommendations: Get references from your general healthcare provider or from friends or colleagues.

If You Don’t Have Health Insurance

Assistance is available even if you have no health insurance. State and local health departments, community clinics, and other private organizations offer free or low-cost healthcare for women during and after pregnancy. To find out more, consult:

Your state or local health department
A social worker at your local hospital
A local social service agency, such as Planned Parenthood
The internet or phone book

A Typical Prenatal Care Schedule

Be sure to schedule prenatal care appointments as often as your healthcare provider recommends. For a woman with a normal pregnancy and no health problems, a prenatal care schedule should be as follows:

Weeks 4–28: One visit per month
Weeks 28–36: Two visits per month
Weeks 36–birth: One visit per week

If you have certain risk factors (such as a history of pre-term labor), a chronic health problem, or if you experience complications, your healthcare provider may suggest more frequent appointments.

Your First Prenatal Care Visit

During your first prenatal care visit, your healthcare provider will ask questions and perform tests to assess your medical history and current health status. Your healthcare provider will:

Ask about your health, the health of the baby’s father, and the health of your immediate family members (it’s not a problem if you don’t know all the answers)
Identify any existing medical problems
Ask about any medications you take regularly
Conduct a physical exam, including checking your weight and blood pressure
Conduct a pelvic (internal) exam
Take blood and urine samples to test for infections and diseases, including sexually transmitted diseases such as HIV/AIDS
Perform a Pap smear to screen for cervical cancer
Provide information about pregnancy and how to take care of yourself and your baby

Everything you tell your healthcare provider is considered confidential. Though it can be difficult to discuss sensitive topics with healthcare providers, it’s crucial that you not withhold any information. Being open about your past and present health status could mean the difference between a safe pregnancy and one with complications that could pose health risks to you or your baby.

Estimating a Due Date

Your healthcare provider will estimate your baby’s due date by doing one of the following:

Asking for the date of your last period: Pregnancy lasts, on average, 40 weeks from the first day of your most recent menstrual period.
Conducting an ultrasound: If you don’t know the last day of your period, your provider may perform an ultrasound, a procedure in which sound waves are used to create an image of the fetus (the term for an unborn baby from the eighth week after fertilization until birth).

The due date is only an estimate: most women give birth anytime from two weeks before to two weeks after their due date. But knowing your due date is still helpful. It will:

Give you an approximate timeframe for delivery
Help assess the growth of the fetus
Determine if you’re carrying more than one baby
Identify if you are going into labor preterm (before 37 weeks of pregnancy) or postterm (after 42 weeks). The care you and your baby receive depends on how early or late you are in relation to your due date.

Subsequent Prenatal Care Visits

During later prenatal visits, your healthcare provider may:

Check your weight, blood pressure, and urine
Monitor preexisting or developing medical conditions
Measure you to get a sense of the baby’s growth
Feel your abdomen to assess the baby’s position
Listen to the baby’s heartbeat
Explain physical and emotional changes you feel
Conduct tests to ensure your (and your baby’s) health

Prenatal Tests

Your healthcare provider will perform several routine tests throughout your pregnancy to monitor your health and the health of your growing baby. These tests typically just require you to provide blood and urine samples. Based on your family history, age, lifestyle, or other risk factors, your healthcare provider may recommend that you have additional tests, called selective tests or screening tests. These tests may include:

Blood tests: Blood is screened to identify possible complications (see Pregnancy Complications).
Amniocentesis: A long, thin needle is inserted into the abdomen to remove amniotic fluid from the uterus for testing.
Ultrasound: Sound waves are used to produce an image of the fetus and identify possible birth defects.
Vaginal fluid: The vaginal fluid is tested, as it can signal possible complications in the pregnancy.
Non-stress test: The fetus’s heart rate is monitored as it moves naturally in the womb.
Contraction-stress test: Contractions are induced to test the baby’s heart rate under stress. This test is only performed during the last week of pregnancy if there are indications that the baby may not be getting enough oxygen.

Prenatal Education

Most hospitals and medical centers offer classes to educate first-time expectant mothers about:

Pregnancy
Delivery
Infant care

Ask your healthcare provider for more information about the classes available in your area. (For information on caring for your baby after you give birth, see the Quamut guide to Infant Care, available in Barnes & Noble bookstores and online at www.quamut.com.)

Acknowledgments & Disclaimer