What to Expect at Your First Prenatal Appointment

Note: This post is not intended to diagnose or treat.

The wait was finally over! I found out I was pregnant fairly early on, and my doctor would not see me in the office until I was 8 to 12 weeks pregnant. This felt like an eternity, and all the while I sat around wondering, “Am I really pregnant? Is there really a little baby growing inside me?” I was even a bit relieved when the morning sickness kicked in, just so I had evidence that my baby was actually in there. 

After that long wait, I really had no idea what to expect for my first appointment. I figured I would see the doctor, have an ultrasound, and then go home with cute pictures of my little baby. Since I had no idea what to expect, I figured that many other new mamas may have no idea what to expect either. Although your appointment may look slightly different, I decided to provide a rundown of what a basic first appointment looks like.

Meeting the Doctor

Like me, this may be your first time meeting your doctor or midwife, and it is the perfect time to determine if you think their personality will mesh with yours. You definitely do not want to keep seeing a doctor that you have a bad feeling about- mother’s instinct. During this meeting, my doctor asked several questions about my health history, my husband’s health history, and our families’ health histories. It will be  important that you have a basic idea of these things. She asked about which medications or supplements I was taking and if I was having any symptoms (See my previous post “Sick and Tired: First Trimester Symptoms”). 

Testing and Labs

After this initial interview with my doctor, she wanted to perform some tests to check my health and the health of my growing baby. Just know that at any point you are not comfortable with a test, you always have the right to refuse it- always! We chose to opt out of a few of them. This is a personal decision that should be discussed with you and your doctor or midwife based on your current situation. Every pregnancy is different!

Last Menstrual Period, Vitals, and Weight

Just like any doctor’s appointment, my doctor wanted to get a baseline set of vitals, including blood pressure, heart rate, temperature, and respiratory rate. She also took my weight. This is important to determine how much weight is healthy for you to gain during your pregnancy. Another important thing to know is the first day of your last menstrual period. This date will help the doctor determine how far along you are and when your baby is due.

Transvaginal Ultrasound

Another test my doctor performed was a transvaginal ultrasound. This test is exactly what it sounds like, an ultrasound probe that is inserted into your vagina. I was expecting the typical abdominal ultrasound (you know the one we see on TV), but I learned that at this early stage of pregnancy, the baby is often too small to see with the “regular” ultrasound. The doctor may give you the option to insert the probe yourself. In my experience, it was not painful but somewhat uncomfortable. This will be the first time you get to see your baby! The doctor will use this probe to take your baby’s first pictures, take measurements of your baby’s size to determine age, and listen to your baby’s heartbeat. Usually, they will print out pictures of your baby for you to take home!

Pap Smear

Another test that your doctor may perform is a pap smear, especially if you have never had one, it has been a while since your last one, or you have had abnormal results in the past. For this test, the doctor will insert a tool called a speculum into your vagina to open it and will then use a small brush-like tool to take a sample of the cells on your cervix to test for any abnormal cells. Again, in my experience, this test was not painful but was a bit uncomfortable. 

Genetic Testing

Your doctor may also want to perform genetic testing. This test is also called the non-invasive prenatal screening/testing or NIPT. This is a screening test done by drawing the mother’s blood and looking for abnormalities in the DNA of the baby’s cells. This is just a screen and cannot diagnose so if any abnormalities are found then you will need to complete further, often invasive testing. This test can also fairly accurately determine the gender of your baby any time after 10 weeks. 

Another genetic test that your doctor may want to perform is the genetic carrier screening. This test will screen you for 14 different genetic conditions that you may not have symptoms for, but could carry in your genes. If your husband also carries this gene, then there is a chance that it could be passed to your baby. If you are positive for any of the conditions, then your husband may also want to get screened. Just like any test, you do not have to do this test, but you may want to consider getting tested if you have a family history of any of the conditions they look for, so that you can better plan for your baby’s care in the future. (If you would like more information about these tests, I can send you the handout that was provided to me by my doctor.) 

Other Labs

The labs your doctor recommends may vary from the ones that I had. The ones I will describe are the ones that my doctor recommended to me. First, she recommended testing for sexually transmitted diseases such as HIV, syphilis, hepatitis C, hepatitis B, chlamydia, and gonorrhea. These tests may be unnecessary if you have only had one trustworthy sexual partner in the past, but this is a decision that you should make with your doctor. If you plan to skip the newborn vaccination for hepatitis B or eye antibiotic ointment, you may find it helpful to get tested to show the doctor that your baby is at low risk of developing these conditions, since you would not be able to transmit them to your baby during birth. This again is just a personal opinion and should be discussed with your doctor and decided on your own.

My doctor also recommended we check my hemoglobin A1c. This blood test is done to check how well your blood sugar has been controlled over the last three months. Additional testing will be done throughout your pregnancy to test for the possibility of gestational diabetes as well. 

My doctor also checked for rubella antibodies, an antibody screen, and ABO/RH test. The rubella antibody test checks your immunity to rubella. If a pregnant mama is infected with rubella, it could cause problems such as congenital defects or miscarriage. It would be important to discuss with your doctor what your personal risk is for catching rubella. The antibody screen and ABO/RH test are to test your blood type (it is a bit more complicated than that but that is the basic explanation). Blood typing is super important in pregnancy because if your baby has an incompatible blood type from yours, it could cause serious complications later on and for future pregnancies.  However, there is a treatment that can be done to prevent these complications. 

Some other basic labs that my doctor requested were a complete blood count (CBC), a urine culture, and a drug screen. The CBC checks your different blood cells and can tell the doctor things like if you have anemia or an infection. A urine culture is done to test for a urinary infection, and the drug screen is just what it sounds like- it tests to make sure you have not taken any harmful drugs. 

I realize this may seem like a lot, but it is really just as simple as a poke and a urine sample. Just like anything else, it is important to educate yourself, ask questions about things you do not understand, and to consider your current health situation when making decisions. Like I said before, you always have the right to refuse any treatment or test that you are not comfortable with. Make sure you have a doctor who is willing to listen to your concerns and one that you feel comfortable talking to. 

Thank you for taking the time to read this post. If you have any questions, feel free to reach out! I am always willing to provide you with more resources and answer any questions to the best of my ability! Have fun meeting your baby for the first time!

References

"Fast Facts: Rubella and Congenital Rubella Syndrome (CRS)." CDC. September 30, 2024. https://www.cdc.gov/global-rubella-vaccination/data-research/facts-stats/index.html.

"HIV Screening Test." MedlinePlus. National Library of Medicine, August 22, 2022. https://medlineplus.gov/lab-tests/hiv-screening-test/.

Morales, Michelle , Tatiana Lanzieri, and Susan Reef. "Rubella." CDC. January 31, 2025. https://wwwnc.cdc.gov/travel/yellowbook/2024/infections-diseases/rubella.

Multum, Cerner. "RHo (D) Immune Globulin." Drugs.Com. July 31, 2023. https://www.drugs.com/mtm/rho-d-immune-globulin.html.

"Prenatal Panel." MedlinePlus. National Library of Medicine, September 23, 2024. https://medlineplus.gov/lab-tests/prenatal-panel/.

"Red Blood Cell Antibody Screen." MedlinePlus. National Library of Medicine, January 21, 2025. https://medlineplus.gov/lab-tests/red-blood-cell-antibody-screen/.

"Rh Incompatibility." MedlinePlus. National Library of Medicine, September 16, 2024. https://medlineplus.gov/rhincompatibility.html.

"Transvaginal Ultrasound." MedlinePlus. National Library of Medicine, April 16, 2024. https://medlineplus.gov/ency/imagepages/9987.htm.

"What Is Noninvasive Prenatal Testing (NIPT) and What Disorders Can It Screen for?" MedlinePlus. National Library of Medicine, July 28, 2021. https://medlineplus.gov/genetics/understanding/testing/nipt/.