Expert: Catherine Beier MS CBE - 2/23/2008

Question
I am about nine weeks along in my pregnancy and i have my first appointment on monday, i am so nervous and so excited to find out what they will tell me.  Would you be able to help me out and tell me what to expect during my first appointment, like about what questions they will ask, and if they will do an ultra sound, or be able to hear my baby's heart beat?  thank you so much!!!

Answer
Autumn,

First of all, congratulations!  First appointments can vary depending on whether you've chosen an obstetrician, midwife or general practitioner and what is standard practice for that office.  However, there are several things you can expect to happen.


Your care provider will ask for your medical history, which includes:

Any medical conditions, including past pregnancies, miscarriages or abortions
Blood pressure
Height
Weight
Breast exam
Cervical exam
The date of your last period
The regularity of your cycles
Birth control choices
Allergies, including to medications
Family medical history
Current medications you're taking
Past hospitalizations or surgeries


Your care provider will also perform a physical exam which may include a pap smear or cervical cultures, and possibly a transvaginal  ultrasound if you are unsure of your last period date, have long or irregular cycles, have cramping and/or bleeding, a past history of miscarriage or other potential problems.


At nine weeks, you probably won't be able to hear your baby's heart beat with a doppler, but if a transvaginal ultrasound is performed, you should see it on the screen.  If the equipment has sound, then you may be able to hear it this way as well.


Some care providers now routinely perform an early transvaginal ultrasound even if no risk factors are present to check fetal size and development and to confirm a due date.  Some insurance companies only pay for one ultrasound, so you may need to call your insurance and care provider to see if an ultrasound will be performed and to make sure it will be covered.  


Blood will be drawn and several tests will also be done, and may include:

Red blood count
Blood sugar levels
Your Rh factor   
Screen for Measles immunity
Screen for Chicken pox immunity
Screen for Cystic Fibrosis
Screen for Hepatitis B
Screen for Tay Sach's
Screen for Sickle Cell anemia
HIV test


Then your care provider will probably want to discuss the "dos" and "do nots" of pregnancy including:

Proper nutrition
Dental care
Travel guidelines
Environmental hazards
Risk factors
Medications including prenatal vitamins
Exercise
Weight gain
Prenatal visit schedule
Office rotation
Routine procedures


You might also want to prepare a list of questions to ask your care provider.  Pregnancy and birth are very personal times.  It's critical to choose a care provider whose philosophy of birth matches your own.


For example, if you are planning a natural birth and find that your doctor has a 60% cesarean section rate, it isn't likely that particular provider will be supportive of your wishes.


For more information on what questions to ask a potential care provider, see this article:  http://www.givingbirthnaturally.com/caregiver.html


I hope this helps and good luck!  Being a mom is the best!

Best,
Catherine