Topic Overview

Your first prenatal visit is likely to be more extensive than later prenatal checks. Your doctor will take your medical history and do a complete physical exam.

Medical history

Your medical history helps your doctor plan the best possible care for your pregnancy and childbirth. It includes:

• Your menstrual history, including your age when menstruation started, whether your cycles are regular, and the date of your last menstrual period.
• Your reproductive history. This includes:
  • Any previous pregnancies, abortions, miscarriages, or stillbirths.
  • Problems with previous pregnancies.
  • Any problems with reproductive organs.
• Family health conditions, such as heart disease or genetic defects.
• All vaccinations, surgeries, and serious illnesses you have had.

Physical exam

Your complete physical exam will include:

• Weight and blood pressure measurement.
• A pelvic examination to confirm the pregnancy.
• A Pap smear (if not done recently).

Urine tests

A urine test can check for:

• Sugar, a sign of gestational diabetes.
• Protein, a sign of preeclampsia.
• Bacteria, a sign of urinary tract infection (UTI), which can be present without symptoms. UTI is common during pregnancy and, if untreated, may lead to kidney infection.

Blood tests

Blood testing may include:

• Blood typing (A, B, or O, and Rh factor). If you are Rh-negative and the father is Rh-positive, your fetus may have Rh-positive blood, which can lead to problems with Rh sensitization. For more information, see the topic Rh Sensitization During Pregnancy.
• Complete blood count (CBC), which checks hemoglobin and hematocrit to make sure you don't have iron deficiency anemia.
• Checking for immunity to German measles (rubella).
• Checking for the sexually transmitted disease syphilis. This blood test is called a venereal disease research laboratory (VDRL) test. The U.S. Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommend that all pregnant women be screened for syphilis early in pregnancy.^{1, 2}
• Testing for the human immunodeficiency virus (HIV). This is done only with your consent or request. Early detection and treatment lowers the chance that the baby will get HIV from the mother. The U.S. Preventive Services Task Force and U.S. Centers for Disease Control and Prevention recommend that all pregnant women be screened for HIV infection to help prevent fetal infection.³

You may also be screened for:

• Hepatitis B. If you have a hepatitis B infection, your baby will receive the hepatitis vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth.
• Diseases that are passed down through your family (genetic disorders). You may want to have a screening test if you or your partner has a family history of genetic disorders or if certain genetic disorders are more common among people of your racial or ethnic background. Screening tests for genetic disorders include those for:⁴
  • Sickle cell disease, which is most common in people of African descent.
  • Tay-Sachs disease, which is most common in people with an Ashkenazi Jewish, Cajun, or French Canadian background.
  • Cystic fibrosis, which is most common in people with a Caucasian, European, or Ashkenazi Jewish background.
• Sexually transmitted infections (STIs). STIs during pregnancy have been linked to miscarriage, premature birth, low birth weight, and stillbirth. Many doctors routinely test for the sexually transmitted infections gonorrhea and chlamydia. If test results show that you have an STI, your doctor will discuss treatment with you.
• Thyroid disease. Many women have thyroid tests done if they have a personal or family history of thyroid problems.