Each pregnancy is unique and requires its own special individual attention and some pregnancies are significantly higher risk than others. Having said that, the following is a general outline of what one might expect at various gestational ages throughout their pregnancy.
First visit/ Amenorrhea (missed period or cycle) visit:
I encourage my patients to schedule their first visit with me as soon as they learn they are pregnant. This is often as early as 4 to 5 weeks gestation in my patient population. This is an important appointment during which we discuss any questions or concerns my patient and her partner may have, the do’s and don’ts of pregnancy and obtain the initial blood-work of the pregnancy. This blood-work includes a quantitative beta-hcg and a progesterone level which are both hormones that play a vital role in pregnancy and pregnancy management. This visit also affords me the opportunity to discuss proper prenatal vitamins, diet and exercise during pregnancy, and first trimester testing.
Second or initial ultrasound visit:
This visit is generally scheduled around the 7th gestational week. This visit is equally important as I am able to confirm that the gestational dating for the pregnancy based on last menstrual period is correct. This is vitally important information moving forward during the pregnancy as the gestational age of the pregnancy has a significant impact on decisions one must sometimes make, especially in pregnancies complicated by high-risk findings such as preeclampsia or preterm labor. There are also many prenatal tests available during one’s prenatal care that are available only at certain gestational ages and it is, therefore crucial that dating of the pregnancy is correct.
Third visit:
This visit is scheduled at 10 weeks gestation. This is because it is at this gestational age that one is normally able to hear the fetal heart beat using Doppler technology. This visit also usually includes a complete physical examination, Pap smear, cultures and more blood-work.
Ten to 28 weeks:
Visits from 10 to 28 weeks are usually scheduled at 4 week intervals with specific additional sonograms and prenatal testing offered/ performed at specific gestational ages during the first and second trimesters. Assessment of fetal growth and heart rate is performed at each visit.
Twenty-eight to 36 weeks:
Visits from 28 to 36 weeks are usually scheduled at 2 week intervals with continued assessment of fetal growth and heart rate as well as third trimester testing at specific gestational ages. Delivery planning is also discussed at this time.
Thirty-six weeks to delivery:
Visits after 36 weeks are scheduled at intervals of one week or less depending on issues specific to each individual pregnancy. Delivery generally occurs anywhere from 37 to 41 weeks gestation. Patients are given options of spontaneous labor, induction, elective or repeat cesarean section.
Immediate post-partum care:
Patients undergoing vaginal delivery usually stay in the hospital until post-partum day 1 or 2. Patients delivered by cesarean section generally stay in the hospital until post-partum day 2, 3 or 4 depending upon their wishes.
Post-partum care:
Patients who deliver vaginally usually have a single post-partum visit 4 weeks post-partum. Those delivered via cesarean section generally have a post-operative visit 2 weeks post-partum and then follow-up again 6 weeks post-partum.
Again, this list presents a very general outline. The specifics of prenatal care in any given gestation are affected by numerous variables including maternal, fetal and environmental variables among many others.
