Most people go to the doctor’s office once a year, twice if they get sick. That’s usually all. But as soon as you are pregnant, your number of doctor visits skyrockets. You will likely go a few times in your first trimester, monthly in your second and much of your third trimesters, and weekly after 36 weeks until birth. That’s a lot of visits to pack into one year. This is meant to provide you with a snippet of information and what to expect.
The First Trimester
In the very beginning of your pregnancy, you actually won’t go to the doctor a ton. You may go in to confirm you are pregnant (which can also be done via an ultrasound). They will likely take time to answer a few questions and get you on track. They will want to make sure you are taking prenatal vitamins by now, and also to discuss things like nutrition and pregnancy sickness. In your first trimester, you may only see your provider once or twice though.
Your first trimester will usually contain a First Trimester Screening. It isn’t anything super fancy. Mostly it is blood tests, but sometimes includes ultrasounds if that seems necessary. These tests are usually not required. They are done to check for genetic defects such as down syndrome.
One of the tests they are running in the First Trimester Screening should be testing your Rh factor. You want to be sure that you and your baby are both Rh compatible or it may cause problems for your baby and for you. Treatment is available to prevent these problems though. The Rh factor is genetic, and most fetuses are Rh positive. Some individuals are born Rh negative though, and when you are Rh negative and your fetus is Rh positive, it is called Rh incompatibility. It isn’t a scary process overall, but it is one to be aware of as you make decision about participating in the First Trimester Screening.
Now is the time to start thinking about the type of birth you want as well. You want to be sure that your care provider, be it a midwife or a doctor, is on the same page with you around your birthing preferences. You don’t have to make every single decision right this moment, but start thinking about things like C-sections, epidurals, and home birth.
The Second Trimester
Come the second trimester, the frequency and how closely you are being monitored is going to increase. They want to make sure your baby is growing, moving correctly, and is strong and healthy. Around this trimester you will start seeing your doctor about once every month.
There will be more blood tests during this trimester, these ones are called the Multiple Marker Screening. Again, it’s a blood draw and looks for genetic conditions or birth defects. Abnormal results from this test may require additional testing. Again, these tests may be optional and you may want to ask your doctor exactly what they are for.
You also have an optional second ultrasound around 20 weeks. This ultrasound can screen for additional abnormalities, but also can just be for fun. It can give you a chance to see your baby again, as well as watch their little heartbeat go. You can also confirm how many fetuses you are carrying. And, if you absolutely must, you can discover the sex of your baby (although I highly encourage you to check out my blog about gendering our children).
Finally, really start mapping out your birthing plan at this point. You want to give birth in a location, be it hospital, home, or birthing center, that supports your birthing goals, which means you should start looking now. Take the time to journal and brainstorm ideal situations, hopes, fears, and wants. Your final plan should only be about a page in length, but it may take some time to come up with a plan you like. Don’t hesitate to be loud and demanding and to aim for everything out of birth you could possibly desire. It’s your birth, and as long as you are open to last minute changes if things go wrong, there is nothing wrong with planning an experience that will be reassuring and enjoyable for you.
The Third Trimester
By now you are seeing the doctor every month for sure. They will be measuring your belly and tracking your progress. Many doctors and midwives have a Doppler, a special device that lets them listen to the fetal heartbeat. I loved this point in my pregnancy because I could hear baby’s heartbeat loud and clear when they did this. The average heartbeat around this time is between 120 to 160 beats per minute. However, exertion and other factors may affect this. I know my midwives always had to chase my babies around to get a good reading.
Between 24 and 28 weeks you may be screened for gestational diabetes. This is The Drink that everyone always talks about it. The syrupy, sugary, try not to puke it up, drink. You chug it and then wait an hour and have your blood drawn and tested for glucose. I actually opted out of this test, so I’ve never experienced it firsthand (my pregnancy sickness was always so bad I really didn’t feel I needed one more reason to puke). I feel like every woman has heard of it and how gross it is though. Perhaps it has gotten better over the last few years? Regardless, if you are worried about gestational diabetes, I would suck it up and get the test done.
Finally, you should be swabbed for Group B Strep in this semester. Women who have Group B Strep and test positive for it can take medication which can minimize their ability to pass it on to their child. Not to alarm you, but Group B Strep can be very dangerous for your newborn, so you want to go into birth knowing you either don’t have it or that you do and you are taking appropriate precautions.
The Last 4 Weeks
Expect to increase your visits from monthly to weekly in the very last month of your pregnancy. Your care provider wants to be sure that the baby is head down, and monitor when it starts dropping low into your pelvis, preparing for birth. Plus, regular measuring to ensure your baby is continuing to grow and thrive. A lot of doctors will tell you how much your baby weighs at this point, especially if they use an ultrasound. However, be warned that these estimates are notoriously wrong and no reason to start panicking about how ‘big’ your baby might be. Do not let anyone convince you that your baby is too big for you to deliver vaginally if that is the route you want to go.
In these last 4 weeks you want to be sure your care provider has your birthing plan and is familiar and comfortable with the type of birth you would like to have (barring complications). Go over it one more time with them and start finishing your preparations for birth!
At Each Visit
At every visit, you will likely have your vitals checked, so taking your pulse and blood pressure. With my midwife, I always had to pee in a cup and dip a strip to check for protein and iron and such. It’s pretty straight forward in my experience, and doesn’t tend to be anything to be nervous or stressed about.
Then there are often lots of tests offered. I believe in doing your own research and making your own decisions around what tests you want run. I am very pro testing for the Rh factor and Group B strep, but I am actually against testing for genetic conditions (for me personally, you do you). For me, I thought I was going to want all of those genetic tests, but by the time I finally got pregnant, I realized that I didn’t care if there were any genetic anomalies, I was going to keep my baby. And, again, for me, knowing anything in advance wasn’t going to be helpful. So I skipped most of the genetic testing. Educate yourself and do what is right for you.
One of my favorite parts of every doctor visit is the questions and education section. This is the time to ask all your best (and worst) pregnancy questions. You get resources, education, and reassurance. If your provider rushes you through this section, or gives halfhearted or short answers, or worse, skips it all together, find a new provider. They should never be too busy to talk about your care. Write your questions down in advance too, that way you don’t forget your questions in the moment. I used to just keep a running list and bring things up as I felt they were necessary. Know that you are entitled to all the information you want or need to make the right decisions for you and your baby.
Doctor Vs. Midwife
Please note that this process with a midwife vs with a doctor are bound to look and feel a little different, but the overall care provided is relatively standardized. The big selling point with a midwife for me was being given a lot of education and the freedom to make my own choices based on my health and how well I know my body (which means I never had to do the nasty glucose test drink!). But overall, much of the care you receive should be pretty standard. The same tests should be offered, the same reassurance, and whichever care provider you go with, they should take time to answer every single question you have.
Medical Disclaimer
All of the information on this site assumes that the individual is in good physical and mental health, and that their pregnancy was without risk factors or complications. Web site content is for informational purposes only and is not intended to offer medical advice, or replace the recommendations of your doctor, midwife, or physical therapist. Always consult your doctor before beginning any exercise program.
