Your first prenatal appointment will probably be your longest appointment. Here you will provide your doctor your complete health and pregnancy history. This information is important because it will give your practitioner a good idea of how healthy you are and what type of problems you are most likely to experience during your pregnancy. It is at this visit that we make a plan for you and your pregnancy. Below is a general outline of things that may be done at this visit:

  • Basic prenatal blood work and any other labs your doctor deems important for your care
  • Pregnancy Test
  • Check your blood pressure
  • Record your weight
  • Collect urine sample to screen for protein and sugar
  • We will contact your insurance and discuss with you the details of your maternity benefits

Most women will be seen for their first appointment between 5 and 10 weeks gestation.

Your second prenatal appointment is usually done about a month after your first appointment and is dependent on how far along you were at the time of your initial visit, unless you are having problems. This is what will most likely happen during this prenatal care visit:

  • Check your blood pressure
  • Record your weight
  • Dating ultrasound or 1st trimester ultrasound
  • Additional testing, such as blood testing and screening for genetic disorders

Your baby's first heart beat will usually be heard with a Doppler after 10 weeks gestation. If we have trouble hearing the baby’s heartbeat we will probably check your baby on ultrasound.

During this time, you will be scheduled a prenatal visit with the genetic counselor who will help coordinate your genetic testing choices.

  • Nuchal Translucency Test (Screening for Down Syndrome and Trisomy 18)
  • Chorionic Villous Sampling (CVS) (Diagnostic test for many genetic diseases.)
  • Early Amniocentesis (Diagnostic test for many genetic diseases.)
  • First Trimester Anatomy Ultrasound
  • Cell Free DNA (Screening for Down Syndrome, Trisomy 18, Turner Syndrome, Sex Linked Disorders and the Sex of your baby if you wish). These tests are optional but may be requested by you or recommend by your doctor. Be sure to discuss all of your options regarding these tests, including the risks and benefits, how the test results are given and whether the test is a screening test or a diagnostic test.)
  • Maternal and possibly Paternal Genetic Carrier Screening (Carrier testing for Cystic Fibroisis, Fragile X and Muscular Dystrophy and others if you elect to)

Towards the third prenatal visit you are mostly likely around 15-17 weeks pregnant. You usually are feeling better. At this point it is a good time to discuss your exciting news with your friends and family, since you are past the most likely time in your pregnancy to miscarry. Here is what to expect during your visit.

  • Check your blood pressure
  • Record your weight
  • Collect urine sample to screen for protein and sugar
  • Listen for baby’s heart beat on doppler
  • Full physical exam
  • Measure your fundal height to check baby's growth

You may also have the following prenatal testing done if you request it:

  • Neural Tube Defect (NTD)/Down Syndrome Screening by way of maternal blood work (Several tests can be used including Alphafetoprotein (AFP), Quad Screen, or part II of your sequential screen if you decided to have it drawn at the time of your 1st trimester ultrasound. These test results will be completed and available for you by the time of your anatomy ultrasound visit.
  • Amniocentesis (Diagnostic test for many genetic diseases, such as Down Syndrome.)
  • Cell Free DNA (Screening test that detects 99+% of baby’s effected with Down Syndrome and also screens for other genetic disorders.)

You are most likely between 18-20 weeks at your 4 or 5th visit, and it's been about a month since your last appointment. Many times you feel like you've made a huge amount of growth since your last appointment and you may now be wearing maternity clothes and possibly even feeling your baby move. This is what your visit will be like.

  • Check your blood pressure
  • Record your weight
  • Collect urine sample to screen for protein and sugar
  • Listen for baby´s heart beat
  • Measure your fundal height to check baby's growth

This is when you will have the Anatomy ultrasound, which is when we will evaluate your baby's organs in detail, and at this time, may reveal baby's gender.

Between 22-24 weeks you may be having your fifth prenatal care visit. Here is what will be done during this visit.

  • Check your blood pressure
  • Record your weight
  • Collect urine sample to screen for protein and sugar
  • Listen for baby´s heart beat on Doppler
  • Measure your fundal height to check baby's growth

Very important things to be monitoring for at this point on are.

  • Signs of Preterm labor, regular cramping or abdominal pain, vaginal bleeding or leaking of fluid, vaginal discharge that has color.
  • Vaginal discharge that has color other that clear or white, and any unusual vaginal odor.
  • Fetal movement. Your baby should move throughout the day. If you have any concerns your baby is not moving, then lie on your left side after drinking a glass of cold water, and if your baby moves 5 or more times in that hour your baby is ok. If your baby does not move 5 times in that hour come in immediately to the hospital.

If you have ANY of the above symptoms call us immediately (509)628-8866 or present immediately to the Birth Center at the hospital. Things you can be working on at this time.

  • Found a childbirth class?
  • Registered for baby registry?

Between 25-28 weeks of pregnancy you will have blood tests for diabetes in pregnancy (Gestational Diabetes) and anemia. You are still being seen monthly. During this visit we will:

  • Check your blood pressure
  • Record your weight
  • Collect urine sample to screen for protein and sugar
  • Listen for baby's heart beat on Doppler
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements

During this visit we will screen for Gestational Diabetes if you do not have diabetes. If you are at low risk we will do a 1 hour glucose test in office (Glucose Challenge Test). You will need to fast 6 hours prior to the testing (you may drink water). Once you come in we will give you glucose to drink and an hour after to check your blood sugar. If this test is high, or if you are at high risk of gestational diabetes we will send you to the lab for a 3 hour glucose (Glucose Tolerance Test), which you must be fasting for 6 hours before. If this test is positive then you have Gestational Diabetes and we will schedule you for diabetes education and close monitoring of you and your baby. You may be given Rhogam (an injection) to prevent problems to your baby or future babies if your blood type is negative. You may also receive Rhogam before this point in your pregnancy if you have any bleeding, which you should notify us immediately.

Between 28-32 weeks of pregnancy is your next visit. During this visit we will:

  • Check your blood pressure
  • Record your weight
  • Collect urine sample to screen for protein and sugar
  • Listen for baby's heart beat on Doppler
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Palpate to check baby's position (vertex, breech, posterior, etc.)

At this time it is very important for you to obtain a Tdap(Whooping Cough) booster vaccination from your primary doctor or pharmacy. Below is listed who needs a Tdap booster.

    You will need a Tdap booster during each of your pregnancies, even if you received it just prior to your current pregnancy. This is important so your baby receives your antibodies inutero and breastfeeding to help protect him/her for the first 2 years of their life from whooping cough.
    Any primary caregiver (Dad, Grandparents and Caregivers),needs a Tdap booster if they haven’t had it in the past 5 years.

Between 32 and 36 weeks of your pregnancy you will be seen every 2 weeks. Below is how a typical visit will look like.

  • Check your blood pressure
  • Record your weight
  • Collect urine sample to screen for protein and sugar
  • Listen for baby's heart beat on Doppler
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements

At 36 weeks we will screen for Group B Strep (GBS) bacteria. Group B Strep (GBS) involves a rectal and vaginal swab. Group B is a normal skin flora and if present you will receive antibiotics in labor to prevent your baby from becoming infected.

Between 36-40 weeks of pregnancy you will have weekly prenatal visits. At these visits we will:

  • Check your blood pressure
  • Record your weight
  • Collect urine sample to screen for protein and sugar
  • Listen for baby's heart beat on Doppler
  • Measure your fundal height to check baby's growth
  • Questions about baby's movements
  • Check your cervix to evaluate your progress towards delivery

You will continue to be seen every week until 41 weeks. After 40 weeks you are past your due date and may have the below noted tests done to evaluate your baby’s well being, size and position.

  • Non-Stress Test (NST)
  • BioPhysical Profile (BPP)

We will estimate the size of your baby, but the accuracy is limited. If you are considering induction of labor, we are able to schedule your induction after 39 weeks at the earliest, unless there is a medical reason necessitating it. It is optimal to go into labor on your own, decreasing prolonged labor and induction. After 41 weeks it is important to plan means of assisting you into labor, such as membrane sweeping or induction, since risks of c-section and to your baby increase after that point. It is very important to continue monitoring for fetal movement and if you have any concerns to call us or present immediately to the hospital. Do not wait until the next day or your next appointment to address concerns.

Means of induction include those noted below.

  • Membrane sweeping (Stretching your cervix, Stripping your membranes)
  • Breaking your water
  • Prostaglandins (Cytotec or Cervidil)
  • Pitocin