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Prenatal Care — Your Trimester Breakdown

Having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular prenatal care, with the goal of promoting your own maternal health and monitoring your growing baby, improves the chances of a healthy and full-term pregnancy. Read on for a breakdown of what to expect during your first, second and third trimesters.

prenatal care

The First Visit

Obstetrician Dr. Perry Osborn advises to schedule your first prenatal appointment around week eight — sometimes sooner if you have had a previous pregnancy with a complication.

During your first two appointments, your obstetrician will get an in-depth overview of your medical history and complete an exam and other necessary testing. You can expect to address the following:

  • Physical examination — Your obstetrician will perform a physical exam and ultrasound.
  • Medical history — Including lifestyle, medications, personal and family medical history, and past pregnancies.
  • Blood tests — Screening for blood type, proper immunizations, and infections.
  • Prenatal vitamin and medication education
  • Determine due date — Your obstetrician will determine your due date using your last menstrual cycle and earliest ultrasound.

Other First Trimester Visits

Your next prenatal visits — scheduled every four weeks until 32 weeks of pregnancy. Prenatal appointments are a great opportunity for you to address any questions or general concerns with your obstetrician.

Depending on your age, health, and medical history, you may require more frequent checkups.

In recent years, high-risk pregnancies have increased. In higher-risk pregnancies, prenatal care is managed by your obstetrician and a consulting perinatologist, who can provide additional testing and recommendations. Certain factors may increase the number of visits you make throughout your pregnancy, including:

  • Maternal age >35 years
  • Multiple gestation
  • High-blood pressure
  • Diabetes
  • Obesity
  • IVF

There are now many indications for patients to start a low-dose aspirin by 12 weeks and have an early glucose challenge test. Your obstetrician will identify if you need these during your appointment.

Second Trimester Visits

During your second trimester, you and your baby will be the center of attention during prenatal appointments! Visits might entail any of the following:

  • Track baby’s growth — Your obstetrician will start doing this at around 20 weeks of pregnancy.
  • Listen to baby’s heartbeat — You may hear baby’s heartbeat using a Doppler instrument.
  • Assess fetal movement — You may feel baby move around 20 weeks of pregnancy.
  • Perform fetal ultrasound — A detailed fetal ultrasound can give your obstetrician more insight to evaluate fetal anatomy. You may also be able to find out baby’s gender.
  • Perform blood tests — Blood tests will be run to check blood count and iron levels, as well as screen for gestational diabetes. All pregnancies are screened for Group B Strep.
  • Check your weight and blood pressure.

Around 32 weeks, your obstetrician will increase your appointment frequency to one prenatal visit every two weeks. If you are pregnant with twins, you will likely have more frequent prenatal visits. It is important to attend every one of your prenatal appointments — even if you feel like nothing has changed — to keep you on track for a healthy pregnancy.

The Last Trimester

During your last trimester of pregnancy, your visits will shift to preparing you for delivery. Your appointments will increase to every two weeks, and starting at 36 weeks, you will come for weekly checkups until you deliver.

During your third trimester checkups, your obstetrician will:

  • Check your current health — Signs of contractions or fluid, blood pressure and weight gain, and baby’s heartbeat and movements. Your obstetrician will advise you to count kicks.
  • Test for group B strep — Prenatal infection is more common than you think. All mothers are tested for group B strep, which, if contracted by baby during vaginal delivery, can become very ill.
  • Administer the Pertussis booster — This has recently been shown to provide effective protection for your newborn.
  • Check baby’s position — Your obstetrician will check for optimal baby position as you approach your due date. In general, your baby should be head down by 36 weeks.
  • Plan for delivery — Your obstetrician will help you choose a hospital and pediatrician, and check into breast pump benefits.

By working with your obstetrician throughout your pregnancy and following quality recommendations, both you and baby will have a healthy outcome! Visit our website or call 515.875.9290 to learn more about The Iowa Clinic’s OB/GYN providers and services.

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