Whether you've planned your pregnancy for years, or you're surprised
that you're expecting, pregnancy is an exciting time and a memorable
journey in a woman's life. You may be still absorbing the news, sitting
in disbelief, or you may be just waiting to shout the news from the rooftops:
You're pregnant! A baby is on the way! Wherever you fall on the continuum,
we're here for you... every step of the way.
First Trimester (Weeks 0-13)
You saw the + on the home pregnancy test. Now what? Scheduling and attending
regular prenatal visits will help ensure the best possible health for
your baby. Even if you've been pregnant before and have a good idea
of what to expect, it's important to see your provider in the first
- In the first trimester, your provider will give you an estimate of the
expected delivery date, also known as a "due date." Your personal
health history and family history will be documented. At your first prenatal
visit, and every visit after, your weight, blood pressure, and the size
of your uterus will be monitored. These measurements can reassure you
that your pregnancy is on track and going well.
- Early detection of any problem usually means that the issue can be treated
more easily. And some visits, you will be offered screenings for specific
concerns. Prenatal screening tests are optional for all patients; they
assess the risk of having a baby with a specific birth defect or genetic
disorder. When a screening is positive, it means that you are in a higher
risk category for a certain condition. It does NOT mean your baby has
that condition. A normal or negative screen result suggests that you are
in a lower risk category. It does not completely rule out the possibility
of the concern. Your provider is happy to talk with you about the benefits
and limits of prenatal screens. It is always your choice whether or not
to have a screening test.
- Your provider will recommend that you stop smoking if you smoke and that
you avoid alcohol during your pregnancy. He or she will likely recommend
a prenatal vitamin to ensure that you're getting the recommended daily
requirements of key vitamins and minerals for you and your baby. A visit
with our registered dietitian is also advised so that you can better understand
the key nutrients that will serve as the building blocks for your baby's
development. For example, Omega 3s are important for the baby's brain
development, and you can easily add more to your diet by including more
fish or taking a fish oil supplement.
- Warning signs that you should be seen by your doctor include abdominal
pain or severe lower back pain, vaginal bleeding, or excessive nausea
or vomiting that prevents you from going about your day,
You'll also be given a CBHA Pregnancy Passport with key steps along
the way to the healthy delivery of your baby. Completing these steps as
you progress on your journey to delivery will give you peace of mind –
and your choice of a car seat, high chair, or baby activity center!
Questions to ask your health care provider about a prenatal screen:
- What do you hope to learn from this screen?
- Are there risks to the screen?
- If the screen is positive, how likely is it my baby has a condition?
- If the screen is positive, what happens next?
- If the screen is normal, how likely is it that my baby could have the condition?
- What alternatives are there to having this screen?
Second Trimester (Weeks 14-28)
Many women find this trimester to be their favorite. The constant nausea
and fear of miscarriage in the first trimester has subsided. Their energy
surges. They can begin to feel the baby move. The heartbeat can be heard
with a stethoscope. And they get their first glimpse of the baby at the
18-20 week ultrasound. We won't say it's smooth sailing from here
because there's still the tiring and often uncomfortable third trimester
around the corner, as well as labor and delivery, but overall, there's
less to worry about in weeks 14-28.
- Prenatal visits occur monthly during the second trimester. Your provider
will measure your abdomen to track the baby's growth.
- Your overall health is monitored closely, to check for edema (swelling,
and a sign of preeclampsia), high blood pressure, varicose veins, and
other common pregnancy issues.
- Typically, an ultrasound will be done at 18-20 weeks. You will hear the
baby's heartbeat and may be able to determine the gender if you want to know.
- You may be tested for RH antibodies if you are Rh negative, and given an
injection of Rhogam to keep antibodies from forming.
- Your blood glucose levels will be checked at some point during the second
trimester. This test will identify whether you are at risk for gestational diabetes.
- This is a good time to schedule a routine dental exam. Gum disease, like
gingivitis, is common during pregnancy, but regular cleanings can help.
Oral health is connected to overall health, so extra attention to your
teeth is in order.
- Depending on your age, tests like the triple screen for Down syndrome may
Third Trimester (Weeks 29-40)
You're in the home stretch now! It won't be long until you meet
your little one. Prenatal visits this trimester are focused on your baby's
position and you being ready for delivery.
- This is a good time to sign up and attend childbirth classes if you haven't
already done so.
- Prenatal appointments will occur every other week now, and every week between
36 and 40 weeks.
- Your provider will regularly check the position of the baby by palpating
your abdomen. If the baby is breech, gentle compressions will attempt
to change his/her position.
- Common tests and screenings during this trimester include: Group B Strep
screen, blood tests to check iron levels, urine tests to check for protein
levels that might indicate preeclampsia, ultrasound if you have low lying
placenta or other developments indicated in second trimester ultrasound,
and a non-stress test to more closely examine baby's heartbeat, especially
if you are still pregnant past 40 weeks.
- A pelvic exam during this trimester will determine if your cervix is thinning
or dilating, which are signs that delivery is imminent.
- If this is your first child, it's is a good time to interview pediatricians,
so you know who your baby will be seeing those first important months of life.
Packing a bag for the hospital for your delivery is a good plan during
these last several weeks. Here are some items others have found useful
during their delivery stay:
- Photo ID, insurance information, hospital forms, and your birthing plan
if you have one
- Toiletries and personal items: shampoo, conditioner, lotion, toothbrush,
toothpaste, deodorant, face wash, hair brush
- Lightweight clothing for optimal comfort
- 2-3 maternity bras
- Snacks and money for vending machines
- Cell phone and charger
- Hair accessories – ponytail holder, clips, headband etc…
- Sweater or robe to keep you warm
- Nonskid socks
- Eyeglasses or contacts with contact solution (if you use these)
It might feel like the birth is over and you have your healthy baby, so
your time in the OB office is finished. But the postpartum appointment
is important so your provider can make sure your body is healing from
the delivery as it should. Nearly every bodily function is affected by
pregnancy; you'll have peace of mind knowing yours are returning to
business as usual. Postpartum appointments generally take place about
6 weeks after delivery.
- A pelvic exam will allow your provider to ensure that your incision is
healing if you've had an episiotomy or tear. By 6 weeks, your uterus
should also have returned to its normal size (about that of a grapefruit).
- If you're breastfeeding, a breast exam may be performed to check for
mastitis, an infection of a milk duct.
- Pregnancy takes a toll on the bladder and intestines as well as the rest
of your body, so your doctor will likely want to ensure that they're
back to their pre-pregnancy state as well.
- Up to one-third of women experience postpartum depression in the first
year after giving birth, so a routine screen for PPD is just as important
as checking your overall physical health.
- If you're having any breastfeeding challenges, this is an excellent
time to mention those concerns. CBHA's lactation specialist can help
you address those concerns and optimize your ability to breastfeed your new baby.
- While resuming your sex life may be the last thing on your mind, your provider
will likely talk to you about family planning and birth control so that
you can fully recover from pregnancy and enjoy your baby before another
is on the way.
- Any other concerns you may have about your overall health can also be addressed
at this postpartum visit.