Health and Preparation
What you'll find here: explanations of what to expect at healthcare visits, and normal feelings, during the 9 months of pregnancy. Optimally, you should have prenatal care that consists of monthly visits to your healthcare provider for the first 6 months, visits every two weeks for months 7-8, and weekly visits during month 9.
Sections:
Month 1 (1 visit with the healthcare provider)
What to expect at the visit:
Your provider will perform a complete history and physical examination.
Your pregnancy will be confirmed by testing your blood. He or she will
ask about pregnancy signs like vomiting or nausea and the date of your
last menstrual period. She or he will do a pelvic examination to check
your cervix and uterus. Your healthcare provider will also ask about
your usual food intake, discuss the necessity of stopping alcohol, drug,
and nicotine intake, and recommend that you begin prenatal vitamins.
Please read the sections "Healthy Weight Gain" and "Healthy Nutrition"
below. Please read the section "Signs of a Miscarriage" if you have
vaginal bleeding or blood clots, or heavy cramps during the first three
months.
Routine tests:
- Blood pressure, temperature, pulse, and weight.
- Blood test to determine blood type, check for anemia (low number of
red blood cells which is normal in early pregnancy), determine immunity
to such diseases as rubella, and test for herpes, sexually transmitted
diseases, and HIV/AIDS.
- Urine test to screen for sugar, protein, white blood cells, blood
and bacteria.
- A pap smear to test for cervical cancer
These are normal feelings during the first month:
-Tiredness or fatigue
-Absence of menstruation
-Nausea, with or without vomiting
-Frequent urination
-Food aversions or cravings
-Breast tenderness
-Mood swings
Signs of a Miscarriage
What is a miscarriage? About 15% of normal pregnancies end for no good
reason, all by themselves, within the first 3 months of pregnancy. Be
sure to tell your provider if you are having:
- Vaginal bleeding with usually heavy cramps
- Pain in the center of your lower abdomen
- Pain which is severe and occurs for more than one day
-You pass blood clots or a grayish or pink material from your vagina
Month 2 (1 visit with the healthcare provider)
What to expect at the visit:
Your healthcare provider will ask you the pregnancy signs you are experiencing
and ask how things are going with your food intake.
Routine tests:
- Blood pressure, temperature, pulse, and weight (target weight gain:
___ pounds)
-Urine test to check for sugar and protein in the urine.
These are new, normal feelings during the second month:
- General tiredness and fatigue
- Constipation or difficulty having bowel movements
- Nausea, with or without vomiting
- Breast fullness, tenderness, and darkening of the colored area around
the nipple
- Occasional headaches
- Occasional faintness or dizziness
- Clothes may be tighter around the waist
Month 3 (one visit to your healthcare provider)
What to expect at the visit:
Your healthcare provider will ask you the pregnancy signs you are experiencing
ask how things are going with your food intake, and ask about any vaginal
bleeding you might be having. Remember, a miscarriage (unexplainable
natural termination of a normal pregnancy) is most common during the
first three months of pregnancy. Your provider will also do a pelvic
exam to check your cervix and uterus.
Routine tests:
-Weight (target for weight gain: ____________ lbs. by this month)
-Blood pressure
-Baby's heartbeat
-Urine, for sugar and protein
-Size of uterus and height of fundus (dome-shaped top of the uterus)
These are normal feelings which are new during the third month:
-Veins may be visible in breasts or legs
-Abdomen may appear larger
-Nausea
Month 4 (one visit)
What to expect at the visit:
Your healthcare provider will ask you the pregnancy signs you are experiencing,
ask how things are going with your food intake, and ask about any vaginal
bleeding you might be having. Your provider will also do a pelvic exam
to check your cervix and uterus.
Routine tests:
-Weight (target weight gain: ____ more pounds for a total gain of _______
by this month)
-Blood pressure
-Baby's heartbeat
-Size and height of uterus
-Checking for swelling in your legs and feet (edema)
These are new, normal feelings during the fourth month:
-Enlarged veins around your rectum and anus which may hurt or bleed
(hemorrhoids)
-Increase in appetite
-Pink toothbrush from bleeding gums
-Slight whitish vaginal discharge
Month 5 (one visit)
What to expect at the visit:
Your healthcare provider will ask you the pregnancy signs you are experiencing,
ask how things are going with your food intake, and ask about any vaginal
bleeding you might be having. Your provider will also do a pelvic exam
to check your cervix and uterus.
Routine tests:
-Weight (target weight gain: ____ more pounds for a total gain of _______
by this month)
-Blood pressure
-Baby's heartbeat
-Size and height of uterus
-Edema (swelling) check
-Ultrasound examination of the baby for growth and development
These are normal feelings which are new during the fifth month:
-Feeling the baby's movement
-Increasing whitish discharge from the vagina
-Lower abdominal soreness from stretching of the ligaments supporting
the uterus
-Leg cramps
-Hearty appetite
-Increased pulse
-Easier or more difficult sexual orgasm
-Skin color changes on abdomen and or face - may be either lighter or
darker
Month 6 (two visits per month beginning this month)
What to expect at each visit:
Your healthcare provider will ask you the pregnancy signs you are experiencing,
ask how things are going with your food intake, ask about any vaginal
bleeding you might be having, and ask about the baby's movement. Your
provider will also do a pelvic exam to check your cervix and uterus.
During this month, you should schedule childbirth education classes
to prepare you for the experiences of labor and birth.
Routine tests:
-Weight (target weight gain: ____ more pounds for a total gain of _______
by this month)
-Blood pressure
-Baby's heartbeat
-Size and height of uterus
-Edema (swelling) check
These are new, normal feelings during the sixth month:
-Baby's movements are stronger and more noticeable
-Nasal congestion and occasional nosebleeds; ear stuffiness
-Itchy skin on your abdomen
-Backache
-Enlarged breasts
Month 7 (two visits)
What to expect at each visit:
Your healthcare provider will ask you the pregnancy signs you are experiencing,
ask how things are going with your food intake, ask about any vaginal
bleeding you might be having, and ask about the baby's movement. Your
provider will also do a pelvic exam to check your cervix and uterus.
You will begin classes on birthing options.
Routine tests:
-Weight (target weight gain: ____ pounds this month for a total gain
of _____ pounds)
-Blood pressure
-Baby's heartbeat
-Size and height of uterus
-Edema (swelling) check
-Size and position of baby
These are new, normal feelings during the seventh month:
-Baby's movements are stronger and more frequent
-Increasingly heavy whitish vaginal discharge
-Difficulty sleeping
-Scattered "false labor" ("Braxton Hicks") contractions: irregular,
painless or slightly painful contractions that can occur throughout
the pregnancy but are more common after the seventh month
-Clumsiness and waddling movement from relaxation of the pelvic ligaments
-Difficulty reaching your feet
-Creamy white/yellowish pre-milk fluid ("colostrum") leaking from nipples
Month 8 (two or four visits)
What to expect at each visit:
Your healthcare provider will ask you the pregnancy signs you are experiencing,
ask how things are going with your food intake, ask about any vaginal
bleeding you might be having, and ask about your baby's movement. Your
provider will also do a pelvic exam to check your cervix and uterus.
Routine tests:
-Weight (target weight gain: _____ pounds this month for a total gain
of ____ so far)
-Blood pressure
-Baby's heartbeat
-Size and height of uterus
-Edema (swelling) check
-Size and position of baby
These are normal feelings which are new during the eighth month:
-Baby's movements are regular, strong, and predictable
-Increased constipation and indigestion
Month 9 (four visits, one each week until birthing)
What to expect at each visit:
Your healthcare provider will ask you the pregnancy signs you are experiencing,
ask how things are going with your food intake, ask about any vaginal
bleeding or clear fluid leakage you might be having, and ask about the
baby's movement. Your provider will also do a pelvic exam to check your
cervix and uterus, and ask about the frequency and duration of Braxton
Hicks (false labor) contractions. Your provider will discuss with and
recommend to you possible methods of birthing and pain relief, and caring
for your infant. You will receive instructions about who and when to
call if you think you are in labor (see the description below, "How
to know you are in true labor versus false labor").
Routine tests:
-Weight (target weight gain: ____ pounds this month for a total gain
of 25-30 pounds total for the pregnancy – see the "Breakdown of
weight gain" below)
-Blood Pressure
-Baby's heartbeat
-Size and height of uterus
-Edema (swelling) check
-Size and position of baby
-Cervix check
These are new, normal feelings during the ninth month:
-Changes in baby's activity
-"Dropping" of the outward abdominal bulge as the baby moves down in
the pelvis
-Aching in your bottom and back from pressure of the uterus
-Protruding belly-button
-Enlarged or varicose veins in your legs
-Relief that you are almost there but nervousness about what to expect
with labor
-Possibly a rush of warm fluid from your vagina (it feels like you have
urinated unexpectedly) if your "water" breaks
Breakdown of Healthy Weight Gain (Target total weight gain: 25-30 pounds)
-Baby: about 7 ½ pounds
-Placenta (sac that surrounds the baby, transferring oxygen and nutrients):
1 ½ pounds
-Amniotic fluid (fluid that surrounds the baby): 2 pounds
-Uterus enlargement: 2 pounds
-Breast enlargement: 2 pounds
-Retained "water" in mother's tissues: 4 pounds
-Increased fat stores: 7 pounds