Comprehensive Guide to Prenatal Care Schedule: What to Expect When You’re Expecting

prenatal check
Although the schedule of prenatal care varies from one provider to another, there is a general schedule that a majority of them follows.

Each schedule may include screening tests or other activities expectant mothers should expect.

It is important that medical checks up and screening tests are done according to schedule to ensure a healthy pregnancy and a healthy baby.

The more consistent the prenatal care is the healthier the mother and baby and the easier to spot the problems if and when they occur.

Sticking to the schedule religiously will help prevent problems during delivery.

Schedule of Prenatal Care

8 to 12 weeks

This refers to the initial prenatal visit where you will get a plan for your prenatal care. The provider you have chosen will explain what your prenatal care includes and what you can expect during the course of it.

Some of the procedures that will get done during the initial prenatal visit are to have your health history recorded, a physical exam that will include a pelvic exam, and a complete lab work, including screening for sexually transmitted infection, blood type and hemoglobin, urine tests, and a PAP test when needed.

An ultrasound may also be carried out if you are unsure as to when you had your last period in order to determine how far along you are. You may be able to hear your baby’s heartbeat during the initial prenatal visit.

Within this period, you may also be offered a genetic screening especially for women over the age of 35 and those with a history of genetic problems. A genetic counseling visit may include genetic screening or diagnostic tests, such as amniocentesis and chorionic villus sampling.

The former is done to check for certain birth defects, such as spina bifida, cystic fibrosis, and Down syndrome, while the latter is done to check for chromosomal disorders and genetic disorders.

Chorionic villus sampling also provides DNA when paternity testing is required.

First two trimesters

During the first two trimesters, you need to go on a prenatal visit every 4 to 6 weeks. This must be done until you are 28 weeks along. At every appointment, your weight and blood pressure will be taken.

The growth of your baby and your uterus will also be measured. And at each appointment, you get to listen to your baby’s heart. Depending on your prenatal provider, your urine, protein, and sugar will be checked as well.

15 to 20 weeks

At any time within this period, your appointment may include a Quad Screen test, which is done to check for any genetic and spinal cord abnormalities.

The maternal blood screening test will look for specific substances that may cause birth defects. These are AFP, hCG, Estriol, and Inhibin-A.

  • AFP or alpha-fetoprotein is a type of protein that a fetus produces. High levels may suggest a neural tube defect, such as anencephaly or spina bifida.
  • hCG or human chorionic gonadotropin is a hormone that is produced in the placenta. Abnormal levels suggest a baby developing in the womb may have Down syndrome (Trisomy 21) or Edwards Syndrome (Trisomy 18).
  • Estriol is an estrogen that is produced by both the placenta and the fetus. Abnormal levels of which indicate the same problems as with abnormal levels of hCG.
  • Inhibin-A is a protein produced by the ovaries and the placenta, which indicates Down Syndrome.

If there is a presence of any of these substances, further testing will be recommended because a quad screen test is not a diagnostic test.

Between 18 and 20 weeks

You may be offered an ultrasound to view your baby’s organs, their body systems, gender, and to confirm their age. It is also done to determine how well your baby and the placenta has grown.

27 or 28 weeks

Within this period, you may be encouraged to take a glucose challenge test, which is done to screen for your risk of gestational diabetes. The procedure starts with you consuming a special sugary drink from your doctor. An hour later, a blood sample will be taken to look for high blood sugar levels.

Depending on the test results, a glucose tolerance test may be recommended. The procedure involves the following:

  • A few days before the test, you must eat only what the doctor tells you to eat.
  • 14 hours before the test, you can’t eat or drink anything. But you can take sips of water.
  • A blood sample will be taken to test your fasting blood glucose level.
  • You will be given a sugary drink to consume. Every hour for the next 3 hours, your blood will be tested to determine how well your body processes sugar.

Apart from a glucose challenge test, your hemoglobin may be checked as well.

A pelvic exam will also be carried out to review warning signs of late pregnancy, which would indicate high blood pressure or preterm labor.

During this period, you may be encouraged to sign up for prenatal classes with a nurse-practitioner or a doctor that provides well-child care for your baby. You will also be provided information about making plans for labor.

28 to 36 weeks

After the 28-week period, your prenatal visits are reduced from every 4 to 6 weeks to just every 2 to 3 weeks until you reach 36 weeks of your pregnancy.

At each appointment, your doctor or midwife will listen to the baby’s heartbeat, record their growth, and check their position.

36 weeks

During this visit, several tests will be performed – a pelvic exam, a repeat of the STI screening tests, and a check on the size and position of the baby. If the baby is not head down, you may need to do certain exercises or go through a physical manipulation called external version.

The risks and benefits involved in this procedure that a midwife or doctor should explain carefully.

You may also be encouraged to take a Group B Strep tests during the 36-week appointment, which is done to look for bacteria that can cause serious infection or pneumonia in newborn babies.

The procedure involves taking cells to be tested from your vagina and rectum using a swab.

36 to 40 weeks

At every appointment, the usual monitoring of your blood pressure and weight, your baby’s heart rate, size, and position is carried out. Your prenatal care provider may also check your cervix for any signs of dilation.

40 weeks and more

You may be offered “post-dates” testing after your due date, which includes an ultrasound, non-stress tests, and biophysical profiles, which is carried out to monitor the baby’s overall health and to determine if they should be delivered earlier.

Depending on your prenatal provider, such tests may be offered at the 40-week mark or 10 days past your due date.

Without the medical check-ups and screening tests during your pregnancy, none of the problems that you and your baby may experience will be discovered.

This puts you and your child at risk for a lot of health conditions. This is why a prenatal care plan is essential, and you should follow the schedule religiously.

Take advantage of what every appointment has to offer, especially the education and counseling on how you can handle different aspects of your pregnancy.

Any health concerns discovered during your prenatal care schedule will also prove beneficial to you and your baby.
So make sure to have a plan for prenatal care once you know you are expecting.

Photo: Bigstock

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