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Prenatal care is the series of visits, tests and conversations that runs from a positive pregnancy test to the day you deliver. Its purpose is not reassurance for its own sake. It is to catch the small number of problems — high blood pressure, gestational diabetes, growth restriction, infection, blood group incompatibility — that are manageable when found early and dangerous when found late.

Dr. Adeeb Alshahrour, MD, FACOG, provides prenatal care at the Women's Health Center of Chicago, and personally attends his own patients' deliveries. If you are pregnant or think you might be, book the first visit now rather than waiting for symptoms.

Your first visit

Come in when you have a positive test. The first full prenatal visit usually happens between 8 and 10 weeks, though we will see you sooner if you have bleeding, pain, a previous ectopic pregnancy, or a medical condition that needs early attention.

That visit covers:

Dating. An early ultrasound establishes how far along you are more accurately than a remembered last period, and the due date set early is the one used for every decision afterwards.
History. Previous pregnancies and deliveries, medical conditions, surgeries, medications, and family history on both sides.
Baseline blood work. Blood type and Rh factor, antibody screen, complete blood count, immunity to rubella and varicella, hepatitis B, syphilis, HIV, and thyroid or diabetes testing where indicated.
A urine sample, and screening for chlamydia and gonorrhea — see STI testing.
Medication review. Some prescriptions need changing in pregnancy and some do not. Do not stop anything on your own before you have asked.
Prenatal vitamins, with folic acid begun as early as possible.

The visit schedule

For an uncomplicated pregnancy:

Up to 28 weeks: every four weeks
28 to 36 weeks: every two weeks
36 weeks to delivery: every week

Higher-risk pregnancies are seen more often. Every visit checks your blood pressure, weight, urine, the baby's heartbeat and, from the second trimester, the growth of the uterus.

What gets tested, and when

First trimester screening. Cell-free DNA screening for chromosomal conditions can be done from 10 weeks. Nuchal translucency ultrasound is performed between 11+0 and 13+6 weeks. Both are optional, and both are screening tests, not diagnoses — an abnormal result means further testing, not an answer.
Anatomy ultrasound at 18 to 22 weeks. A detailed structural survey of the baby, the placenta and the amniotic fluid. This is the main scan of the pregnancy. See how ultrasound works and what it can see.
Gestational diabetes screening at 24 to 28 weeks. A glucose drink and a blood draw. Screening is offered to everyone because most women who develop it have no symptoms and no obvious risk factors.
Rh immune globulin at about 28 weeks if your blood type is Rh negative, and again after delivery if the baby is Rh positive.
Group B strep swab between 36+0 and 37+6 weeks. This determines whether you receive antibiotics during labor.
Vaccines. Tdap between 27 and 36 weeks in every pregnancy, to pass whooping cough protection to the baby. Influenza vaccine in season, and COVID-19 vaccination per current recommendations. Both are recommended in pregnancy by ACOG and the CDC.

The symptoms that are normal

Nausea, fatigue, heartburn, constipation, back pain, round ligament pain, swollen ankles, and broken sleep are all ordinary. Bring them up anyway — several of them are treatable, and pregnancy nausea in particular does not have to be endured untreated. Ask about which foods matter; the fish question in particular is more nuanced than the internet suggests, and is covered in seafood during pregnancy.

Call the same day for these

Vaginal bleeding at any stage
Fluid leaking from the vagina
Severe or persistent headache, blurred vision or flashing lights
Pain under the ribs on the right side, or sudden swelling of the face and hands — with headache or vision change, this pattern suggests preeclampsia
Reduced fetal movement after 28 weeks
Regular contractions before 37 weeks
Fever over 100.4°F, painful urination, or persistent vomiting

None of these are things to sleep on. Calling and being told it is nothing is a good outcome.

Toward delivery

From around 36 weeks the conversation shifts to the birth itself: your preferences, pain relief, who will be with you, and what happens if a cesarean becomes necessary. See labor and delivery for where we deliver and what happens when labor starts, and postpartum care for what follow-up looks like afterwards.

Talk to us

Medical disclaimer

This page is general health information, not medical advice for any individual. Testing recommendations and schedules are adjusted to your history and your pregnancy. For vaginal bleeding, leaking fluid, severe headache with vision changes, upper abdominal pain, reduced fetal movement, or contractions before 37 weeks, contact us immediately or go to the nearest emergency department.