Your First Obstetical Visit

We have a lot of information to review with you in this first appointment. We will discuss your pregnancy and address your specific questions.  It helps to write your questions down ahead of time.  Your due date will be calculated.  You will also have a physical exam where we will perform a pap smear and we will test for infections.  You will be given information about how to access our website for important information regarding your pregnancy.

+ Blood Work/Tests

At your first appointment, you will have your initial prenatal labs drawn.  For your convenience, these labs can be drawn at the laboratory located within our office immediately after your visit.  These labs include a complete blood count (CBC), tests for infections (Rubella, Hepatitis B, HIV, Syphilis), sickle cell screen, blood type and screen, urinalysis, and a urine drug screen.

  • Between 10-18 weeks of pregnancy an Integrated Screening Test is done to screen for possible abnormalities such as open neural tube defects (i.e. spina bifida) and Down’s Syndrome. This is a two part blood test. Part one is drawn between 10-14 weeks and part 2 between 14-18 weeks of pregnancy.
  • Between 24-28 weeks, we will be performing a diabetes screen and a blood test screening for anemia. Pregnancy can cause a diabetic condition called Gestational Diabetes.  We will screen you for this condition between the 24th and 26th week of your pregnancy, unless otherwise instructed by your physician.  You DO NOT need to fast for this test, however please refrain from a meal with high sugar content.  We will give you a special glucose (sugar) solution to drink and one hour afterwards, a blood sample will be drawn to monitor your blood sugar level.  If your blood sugar level is too high, we will do further tests on another day.
  • At 36 weeks we obtain a vaginal culture for Group B Beta Strep to determine if you are a carrier of this infection.  Although many women are carriers of this infection, it only becomes a factor during pregnancy.  If you test positive for Group B Strep, you will be treated with an antibiotic while in labor and the baby will be closely monitored by your pediatrician following delivery to minimize complications.

+ The Rh Factor

Approximately 10% of people have Rh negative blood type and may be at risk for Rh Disease.  Rh Disease is a pregnancy complication in which your immune system attacks your baby’s blood cells and can result in a life-threatening situation for the baby. This can be prevented with a shot called RHOGAM which is given to mom at 28 weeks or anytime during the pregnancy when vaginal bleeding occurs.

If you are Rh negative you will be given a Rhogam shot at your 28 week visit or at anytime during your pregnancy if you develop bleeding or if you experience any trauma to your belly.

+ Other Genetics Testing Offered

  • Cystic Fibrosis Screening can be performed at your initial visit to determine if you are a gene carrier.  If the test is positive then further testing is required to find out if your baby is at risk for the disease.
  • Early Screen/Nuchal Translucency is an ultrasound and blood test performed at the high risk OB office between 11-13 weeks.  The test determines if the baby is at high or low risk for genetic disorders including Down’s Syndrome, Trisomy 13 and Trisomy 18.  If the test reveals your baby is at high risk, we offer additional testing.
  • Amniocentesis – This can be performed anytime after 16 weeks.  It can determine if the baby has abnormal genes such as Down’s Syndrome.  A needle is inserted through mom’s abdomen and into the baby’s sac of fluid.  A small amount of the fluid around the baby is then removed and sent for genetic testing.  This procedure carries a small risk of miscarriage and is performed by the high risk OB doctors.
  • CVS (Chorionic Villus Sampling) – This test can be performed at 10-12 weeks and is also used to determine genetic abnormalities including Down’s Syndrome.  A needle is inserted through mom’s abdomen or cervix and placental tissue is obtained for genetic testing.  This procedure has a small risk of miscarriage.

+ Frequency Of Pregnancy Visits

We would like to schedule your visits about every 4 weeks for the beginning of your pregnancy.  Around 30 weeks, we will increase the visits to every 2 weeks and then every week after 36 weeks.  If you are high risk or having problems, then we may see you more frequently.

+ Ultrasounds

Ultrasounds are performed in our office by ultrasound technicians. We will perform an ultrasound at your first visit to confirm your pregnancy, detect the baby’s heartbeat and assign your due date. We will then perform another ultrasound around 18-20 weeks to examine the baby’s development, growth and anatomy.  Additional ultrasounds may be performed throughout the pregnancy based on the medical need.

We also offer 3D/4D ultrasounds for “entertainment purposes only” with the option for early gender scan at 16 weeks for a fee.  Please ask the front desk about our exciting 3D/4D packages.  They make great gifts for grandparents! See our Ultrasounds page for examples.

+ Fetal Movement

You may start feeling the baby move around 16-22 weeks.  Initially, movements will be small and infrequent.  As your baby grows, you will feel him or her more often.  After 28 weeks, we recommend counting your baby’s movements once daily until you get 10 movements within 2 hours.  You should do this once a day and call your doctor if you notice any decreases in movements.  If you have difficulty feeling your baby, try lying on your left side, pressing your hands on your belly and eating a snack.  Many babies are more active in the evening, when tired moms are resting and have eaten dinner, making this an ideal time to check on your baby. Click here for a Fetal Tracker pdf.