If you suspect or are sure that you are pregnant, it is best to immediately schedule an appointment, ideally with your partner.
First appointment – The first appointment will be quite detailed. The first thing your doctor would do is to make note of your medical history. Your doctor will ask several questions regarding your menstrual cycle and gynaecological history, past pregnancies, personal and family medical history, medications and lifestyle. It is very important to be open and honest so that it helps your doctor to best assess your prenatal care needs. Your doctor will discuss normal discomforts of pregnancy such as nausea, tenderness and swelling of body parts. Lifestyle habits suitable for first trimester of pregnancy such as nutrition, exercise, sex during pregnancy will also be recommended by your doctor.
Your doctor may conduct a physical exam to check for height, weight, blood pressure and heart rate. A first trimester screening is testing for diseases or conditions in a foetus before it is born. Screening tests tell you your chance of having a baby with Down syndrome, trisomy 18 or structural abnormality such as an open neural tube defect. Blood tests and an ultrasound, are done starting at 11 weeks of pregnancy.
Screening tests cannot tell you for sure whether or not your baby has one of these three conditions, only the chance of this. To find out for sure, you would have to decide whether to have a diagnostic test
In the first trimester you may also have to take a blood test to check for blood type, haemoglobin levels, thyroid levels and tests to determine exposure to certain infections.
Generally for your first pregnancy, you will be recommended 10 hospital visits, provided there are no complications. If you already have a child, you will need 7 visits.
Your Obstetrician may recommend more frequent visits if there is any variation in the way your pregnancy is progressing.
During the second trimester of pregnancy, your nausea tends to reduce, your belly becomes more noticeable and you begin to feel your baby moving. You may have three visits during second trimester preventive care. The second trimester screening focuses more on the development of the baby. Your doctor will measure the baby’s growth, listen to the baby’s heartbeat and assess the baby’s movements.
The second trimester is when you may have to take various tests and scans. Second trimester tests include blood tests to screen for blood count and iron levels, genetic or chromosomal conditions, gestational diabetes and other conditions as recommended by the doctor. Urine tests may also be conducted to test for infection. Your doctor may also conduct an ultrasound scan during the second trimester to evaluate foetal anatomy. If the results of blood test or ultrasound are a cause for concern, your doctor may recommend additional diagnostic tests.
During the third trimester, your prenatal visits will increase. The third trimester screening prenatal visit would be quite similar to the previous visits. Your blood pressure and weight will be checked and a urine test may be conducted. You will be asked to be aware of baby movements and immediately alert if the baby seems to be less active than before.
Additionally, during the third trimester of pregnancy, you would be screened for group B streptococcus (GBS). You may also be asked to take some third trimester tests for sexually transmitted infections (STIs). You may also have to take a non-stress test (NST) that measures your baby’s heart rate as they move around.
Towards the end of the third trimester, your doctor will estimate the baby’s weight and position in the uterus. You may also be asked to have an ultrasound scan in the third trimester to assess the baby’s position and level of amniotic fluid around the baby. As your due date approaches, your doctor may also perform a pelvic exam to detect cervical changes for dilation and efface.
Postnatal preventive care is as important as prenatal care. The postnatal period lasts for 6-8 weeks after the baby is born. During this period a new mother goes through several physical and emotional changes while learning to care for her newborn. The most important elements of postnatal care are enough rest, good nutrition and vaginal care. At about six weeks post-birth, you may have a postnatal screening where your doctor will check for general physical and mental well-being.