Prenatal care schedule

Your first prenatal appointment should take place when you are about eight weeks pregnant (eight weeks from the first day of your last menstrual period). At this appointment, one of our team members will perform a transvaginal ultrasound to confirm pregnancy and check viability. Routine blood work will be drawn at your 12-week appointment.

During a typical pregnancy, you will see a doctor or an advanced practice clinician:

• Every four weeks until you are 28 weeks pregnant.

• Every two weeks from 28 weeks of pregnancy until 36 weeks of pregnancy.

• Every week from 36 weeks of pregnancy until delivery.

Until you are 36 weeks pregnant, these appointments will include checks of your weight and vital signs, and your belly will be measured for growth. Your baby's heart rate will also be examined. After 36 weeks, these appointments will include those checks and, if needed, cervical exams.

You will alternate between appointments with one of the doctors and with one of our advanced practice clinicians. During the last few weeks of pregnancy, we will try to schedule your appointments with a doctor. By the time you deliver, we hope you will know both doctors well.

Mandatory and optional prenatal testing

Tests and screenings during your pregnancy can identify potential problems with your health and your baby's health.

Early tests include:

• Standard early tests for anemia, blood type and blood antibodies, Rubella vaccination status and bladder infections.
• Mandatory testing for sexually transmitted infections including syphilis, hepatitis B, gonorrhea, chlamydia and HIV. These are required by the state.
• Pap tests. This will be performed during your pregnancy, if necessary.
• Cystic fibrosis screening. If you are found to carry this gene mutation, testing will be offered to the father of your child. Cystic fibrosis can only be present in a baby if both parents are carriers.
• Sickle cell screening. This is performed on all African-American or Hispanic patients to check for the sickle cell trait. Sickle cell can only be present in a baby if both parents are carriers.
• First trimester genetic screening. This involves a specialized vaginal ultrasound and blood tests, and it allows parents to find out if their baby is at risk for Down syndrome or Trisomy 18. This test gives results earlier than the traditional Quad Screen.
• Quad Screen (AFP). Done between 15 and 20 weeks gestation, this blood test can assess the risk of your baby having Down syndrome, spina bifida or other neural tube defects, abdominal wall defects and Trisomy 18. If positive, further testing, including amniocentesis, might be recommended.
• This test involves using a thin needle to extract amniotic fluid from the uterus. The fluid is analyzed to learn about the baby's genetic makeup and identify potential abnormalities. There is a 1 in 250 chance of miscarriage with this procedure. If your provider recommends this procedure, we will refer you to a nearby office to have it completed.
• Between 18 and 22 weeks, an ultrasound can identify adequate growth and can detect certain problems.
• Diabetes screening. You will drink a sugary beverage when you arrive at your appointment. Your blood sugar will be checked one hour after you have this drink. If your glucose level is too high, you will be required to take a three-hour version of this test.
• Anemia testing. Iron-deficiency anemia is common and easily treated.
• Rhogam. This is an injection given to you if you have an Rh-negative blood type. The injection prevents your blood antibodies from attacking your baby.

Testing between 35 and 37 weeks includes:

• Group B Strep Culture. A swab taken from the outside of your vagina and the space between your vagina and your rectum identifies the presence of Group B Strep bacteria. This bacteria typically causes no symptoms in women but can cause infection in your baby. If you test positive, you will receive antibiotics during labor.
• HIV, Syphilis, Gonorrhea and Chlamydia. These are state-mandated tests.