Antenatal care

Prenatal care is crucial for a healthy pregnancy
First trimester, what to expect?

The first few appointments

You and your doctor should focus and involve discussing your medical history, risk factors for pregnancy problems, and lifestyle information. The due date is the estimated date of delivery, which helps monitor the baby’s growth and pregnancy progress.

Physical exams are conducted to determine the necessary weight gain for a healthy pregnancy, including a breast and pelvic exam, Pap test, and exams of the heart, lungs, and thyroid. Blood tests may be done to check blood type, hemoglobin, immunity to certain infections, and detect exposure to other infections.

In summary, prenatal care is essential for a healthy pregnancy, and the first few appointments should focus on the first few visits, including the first visit, physical exam, lab tests, and exposure to other infections.

What to expect in your first visit

When you find out you’re pregnant, make your first prenatal appointment. Set aside time for the first visit to go over your medical history and talk about any risk factors for pregnancy problems that you may have, your doctor will get your weight and blood pressure recorded.
Documenting your first ultrasound either transvaginal or transabdominal is critically important first to check the site of the pregnancy sac, second to hear the baby pulse and count your due date.

Life style

Your lifestyle, including your use of tobacco, alcohol, caffeine and recreational drugs
Travel to areas where malaria, tuberculosis, Zika virus, mpox — also called monkeypox — or other infectious diseases are common
Share information about sensitive issues, such as domestic abuse or past drug use, too. This will help your health care provider take the best care of you — and your baby.

Lab tests
At your first prenatal visit, your doctor may ask for the following blood test:

Check your blood type.
Check your complete blood picture
Complete urine analysis
Liver function
Kidney function

Second trimester, what to expect?

The first few appointments

The second trimester of pregnancy is often the most enjoyable.

During the second trimester of pregnancy, you might experience physical changes, including:

1- Growing belly and breasts: As your uterus expands to make room for the baby, your belly grows. Your breasts will also gradually continue to increase in size. A supportive bra with wide straps or a sports bra is a must.

2- Braxton Hicks contractions: You might feel these mild, irregular contractions as a slight tightness in your abdomen. They’re more likely to occur in the afternoon or evening, after physical activity or after sex.

3- Skin pigmentation: Hormonal changes during pregnancy stimulate an increase in pigment-bearing cells (melanin) in your skin. As a result, you might notice brown patches on your face (melasma), when you’re outdoors, use sunscreen. You might also notice reddish-brown, black, silver or purple lines along your abdomen, breasts, buttocks or thighs (stretch marks).

4- Nasal problems: During pregnancy, your hormone levels increase and your body makes more blood. This can cause your mucous membranes to swell and bleed easily, resulting in stuffiness and nosebleeds.

5- Dental issues: Pregnancy can cause your gums to become more sensitive to flossing and brushing, resulting in minor bleeding. Rinsing with salt water and switching to a softer toothbrush can decrease irritation.

6- Dizziness: Pregnancy causes changes in circulation that might leave you dizzy. If you’re having trouble with dizziness, drink plenty of fluids, avoid standing for long periods.

7- Leg cramps: Leg cramps are common as pregnancy progresses, often striking at night. To prevent them, stretch your calf muscles before bed, stay physically active, and drink plenty of fluids. Choose shoes with comfort, support and utility in mind. If a leg cramp strikes, stretch the calf muscle on the affected side.

8- Vaginal discharge: You might notice a sticky, clear or white vaginal discharge. This is normal. Contact your health care provider if the discharge becomes strong smelling, unusual in color, or if it’s accompanied by pain, soreness or itching in your vaginal area. This could indicate a vaginal infection.

9- Urinary tract infections: These infections are common during pregnancy. Contact your health care provider if you have a strong urge to urinate that can’t be delayed, sharp pain when you urinate, urine that is cloudy or has a strong smell or you have a fever or backache.

During the second trimester, prenatal care includes routine lab tests and measurements of your baby's growth.

Your doctor checks your blood pressure and weight at each visit. These visits focus on:

Your baby’s growth. Your baby’s growth is tracked by measuring from your pubic bone to the top of your uterus. This is called the fundal height. After 20 weeks of pregnancy.
Your baby’s heartbeat and umbilical artery doppler At second trimester visits, you might hear your baby’s heartbeat using a Doppler device.
Your baby’s movement. You might start to feel flutters or kicks around 18 to 22 weeks of pregnancy. Tell your healthcare professional when they start.

Your third trimester pregnancy: What to expect?

As your pregnancy progresses, your baby’s movements will become more obvious. These exciting sensations are often accompanied by increasing discomfort and other signs and symptoms, including:

Braxton Hicks contractions. You might feel these mild, irregular contractions as a slight tightness in your abdomen. These contractions also tend to occur more often and become stronger as you approach your due date.
Backaches. Pregnancy hormones relax the connective tissue that holds your bones in place, especially in the pelvic area. These changes can be tough on your back, and often result in discomfort during the third trimester of pregnancy.
Shortness of breath. You might get winded easily. Practice good posture to give your lungs more room to expand.
Heartburn. Pregnancy hormones relax the valve between your stomach and esophagus. This can allow stomach acid to reflux into your esophagus and cause heartburn. To prevent heartburn, eat small, frequent meals. Also, avoid fried foods, citrus fruits, chocolate, and spicy or fried foods.
Spider veins, varicose veins and hemorrhoids. Increased blood circulation might cause tiny red-purplish veins (spider veins) to appear on your face, neck and arms. Redness typically fades after delivery. You might also notice swollen veins (varicose veins) on your legs. To ease swelling, exercise and elevate your legs frequently, include plenty of fiber in your diet and drink lots of fluids.
Frequent urination. As your baby moves deeper into your pelvis, you’ll feel more pressure on your bladder. You might find yourself urinating more often. This extra pressure might also cause you to leak urine — especially when you laugh, cough, sneeze, bend or lift.

You will also need screening tests for various conditions, including:

Gestational diabetes. This is a type of diabetes that sometimes develops during pregnancy. Prompt treatment and healthy lifestyle choices can help you manage your blood sugar level and deliver a healthy baby.
Iron deficiency anemia. Iron deficiency anemia occurs when you don’t have enough healthy red blood cells to carry adequate oxygen to your body’s tissues. Anemia might cause you to feel very tired. To treat anemia, you might need to take iron supplements.

Keep asking questions

You likely have lots of questions as you near your due date. Is it OK to have sex? How will I know when I’m in labor? What’s the best way to manage any pain? Should I make a birth plan?

Talk to your care team about all the questions you have. Knowing the answers can help calm you before delivery.

Be sure to ask members of your healthcare team about when you should call them, such as if you have vaginal bleeding or fluid leaking from the vagina. Also ask how to contact the team once labor begins.