Part III: The Timeline of Routine Pregnancy Care

In the third and final part of our three part series on pregnancy care, today we are providing you with an overview of what routine pregnancy care looks like, after the first prenatal visit we discussed last week! After the initial visit where we do a deep dive into your and your family’s medical history and a long survey of health related questions, we'll ask you to come back in about two to three weeks later for a complete physical exam. 

In today’s post, we’ll do an overview of what you can expect at your first physical, but subscribers to our Pregnancy to Parenthood Podcast Series get a much more in-depth look at what conditions we look for and tests we do, and what certain prognoses can mean for you. For the low, one-time cost of $47, get full access to over 40 informative episodes supporting you week by week, focused on the trimester and stage of pregnancy you are in. Tune in every week, or binge listen all at once and come back to the episodes you found most helpful as you move through pregnancy to parenthood!

The Timeline of Routine Pregnancy Care

First Trimester

• At your first physical exam, typically around the 8-10th week of pregnancy, your provider will get a baseline picture of your general health, including taking your blood pressure, heart rate, and a routine breast exam which can help address any potential issues with breastfeeding
• If you're not up-to-date on your cervical cancer screening, this an important and safe time to get your cervical screening done
• If you are around the 10-12th week of pregnancy, your provider can also listen to the fetal heartbeat for the first time
• For the remainder of the 1st and 2nd trimesters, you’ll routinely see your care provider at a minimum of every four weeks, where any physical or mental health issues or worrisome symptoms can be addressed, as well as a routine blood pressure and fetal heart rate checks

Second Trimester

• At the 18 to 20 week mark, in addition to regular visits, you'll be offered your routine anatomy scan. This important ultrasound takes a detailed look at your pregnancy, assessing your baby’s growth from head to toe including; it’s brain, facial bones, heart, kidney, stomach, bowels, bladder, etc. It measures the baby’s size and ensures your baby is generally on track for where we expect most babies to be around 20 weeks. 
• The ultrasound also looks at a few other things such as your uterus and your cervix, your placenta and its location, as well as other organs around your uterus. 
• Late in the 2nd trimester, around the 28 week mark, there is one more set of routine blood work that includes your gestational diabetes screen, rechecks your hemoglobin or your red blood cell levels and iron stores, as well as testing your blood type. 
• Listen to our podcast on Understanding your Blood Type in Pregnancy for more information on how your blood type can affect your pregnancy! As well as podcasts on Anemia and Low Iron in Pregnancy and Gestational Diabetes in Pregnancy. 

Third Trimester 

• After 28 weeks, your visits increase in frequency to every two weeks to keep a closer eye on your wellbeing and the baby’s growth.
• In addition to the usual physical and mental health check-ins for you and baby, we also start to check your symphysial fundal height (SFM). This is the measurement from your pubic symphysis (just below your bikini line) to the top of the uterus (also known as the fundus). We do this to approximately assess the size of your baby!
• Two week visits continue until the 36 week of pregnancy at which point, we’d like to see you every week until baby arrives.
• Between the 35th and 36 week mark is also when we do the Group B Strep Swab. This swab is done along the perineum, just inside the vagina and along the rectum, looking for a bacteria called Group B Streptococcus - about 30% of the population at any one time will be a carrier. While this is not a worrisome diagnosis for the pregnant person, babies born to people that are group B strep positive are at higher risk of getting infections in their lungs, brain, and blood so we recommend screening. If you're positive we recommend antibiotics in labor to help prevent this infection. We've also got a great podcast on Group B Strep in Pregnancy you can check out here!

It’s not a bad idea to make appointments in advance because regardless of when you give birth, appointments continue on for a few weeks into postpartum. And what are reasonable expectations around having contact with your care provider outside of those times? Overnight and on weekends? We discuss this and so much more in today’s episode, as well as the Pregnancy to Parenthood Podcast Series!