What to expect at your first appointment

When the day of your first appointment arrives, allow plenty of time in your schedule, up to two or three hours so that you won't feel rushed. You'll probably be meeting several different people, including nurses and office staff who work with your health care provider.

After discussing your medical history with you, your health care provider will perform a physical exam and calculate your due date. During or just after your first prenatal visit, you can also expect to have several lab tests.

Assessing your medical history

At your first appointment, your health care provider will review your past and current health, including any chronic medical conditions you have and problems you've had during past pregnancies, if any. Gathering as much

First-appointment checklist

Discussion of your medical history at your first appointment with your health care provider will likely cover the following topics:

□ Details of any previous pregnancies

□ The typical length of time between your periods

□ The first day of your last period

□ Your use of contraceptives

□ Prescription or over-the-counter medications you're taking

Allergies you have

□ Medical conditions or diseases you have had or now have

□ Your work environment

□ Your lifestyle behaviors, such as exercise, diet, smoking or exposure to secondhand smoke, and the use of alcoholic beverages or recreational drugs

□ Risk factors for sexually transmitted diseases — such as you or your partner having more than one sexual partner

□ Past or present medical problems, such as diabetes, high blood pressure (hypertension), lupus or depression, in your or your partner's immediate family — father, mother, siblings

□ Family histories, on both sides, of babies with congenital abnormalities or genetic diseases

□ Details on your home environment, such as whether you feel safe and supported at home information as possible about your past and present health is one of your health care provider's biggest goals at your first visit. The answers you give will have an impact on the care you receive.

Come to your appointment prepared to answer questions about these topics, your pregnancy to date and your insurance coverage.

While you're discussing your medical history with your health care provider, you'll also have a chance to ask the many questions you may have about your pregnancy. If you've been keeping a running list of questions, bring it to your first appointment so that you won't forget anything.

The physical exam

During the physical exam on your first prenatal visit, your health care provider will probably check your weight, height and blood pressure and assess your general health. The pelvic exam is an important part of this evaluation.

During the exam, your health care provider may look in your vagina using a device called a speculum. This device allows for a clear view of your cervix, the opening to your uterus. Changes in your cervix and in the size of your uterus help your health care provider tell how far along you are.

While the speculum is still in place, your health care provider may gently collect some cells and mucus from your cervix for a Pap test and to screen for infections. The Pap test helps detect abnormalities that indicate precancer or cancer of the cervix. Infections of the cervix such as the sexually transmitted diseases gonorrhea and chlamydia can affect your pregnancy and the health of your baby.

After removing the speculum, your health care provider may insert two gloved fingers into your vagina to check your cervix and, with the other hand on top of your abdomen, check the size of your uterus and ovaries. Many health care providers evaluate the size of your birth canal during this exam. These measurements may help predict whether you might have problems during labor and delivery, though it's difficult to make an accurate prediction about it this early in the pregnancy. But if your pelvis seems too narrow for a baby's head to easily pass through the birth canal, your health care provider may make a note of this in your file as something to reevaluate later.

You may be apprehensive about having a pelvic exam. Many women are. During the exam, try to relax as much as you can. Breathe slowly and deeply. If you tense up, your muscles can tighten, which can make the exam more uncomfortable. Remember, a typical pelvic exam takes only a couple of minutes.

You may have some vaginal bleeding after your pelvic exam and Pap test, especially within 24 hours of your visit. The bleeding may be just some light spotting, or it may be a little heavier. It usually goes away within a day. This occurs often because the softened cervix of pregnancy bleeds a bit after a

Pap test. The bleeding is from the outside of your cervix and isn't a risk to your baby. If you're concerned about it, call your health care provider.

Calculating your due date

Your health care provider is just as interested in your due date as you are. Why is that? Establishing the due date early in pregnancy allows your health care provider to monitor your baby's growth as accurately and precisely as possible. It's more difficult to provide an accurate due date if your health care provider doesn't see you early in your pregnancy. A firm idea about when your baby is due helps your health care provider interpret lab results. Certain lab test results change over the course of your pregnancy. As a result, a test result might be mistakenly interpreted as abnormal if the estimate of your baby's age is off. Knowing the due date also significantly affects how your health care provider might manage preterm labor, if it occurs.

Preterm labor: Are you at risk?

Your health care provider will want to assess your risk of preterm labor — that is, labor and delivery that occurs before the end of the 37th week of pregnancy. The exact causes of preterm birth aren't known. But some factors seem to increase a woman's risk of preterm labor, including:

• A previous preterm birth

• A pregnancy with twins, triplets or more

• Several previous miscarriages or abortions

• An infection of the amniotic fluid or the fetal membranes

• An excess of amniotic fluid (hydramnios)

• Abnormalities of the uterus

• Problems with the placenta

• A serious illness or disease in the mother

Cigarette smoking

• The use of illicit drugs

• Advanced maternal age

In the United States, black women are at higher risk of preterm labor than are American Indian, Hispanic, white, Asian or Pacific Island women.

To estimate a due date, most health care providers take the date when your last period began, add seven days and then subtract three months. For example, if your last period started on Nov. 20, adding seven days (Nov. 27) and subtracting three months gives you a due date of Aug. 27.

Laboratory tests

Routine lab tests during your first prenatal visit include blood tests to determine your blood type (A, B, AB or O) and rhesus factor (for example, Rh positive or Rh negative), and determine whether you've been exposed to syphilis, German measles (rubella) or hepatitis B. Most Americans were vaccinated against German measles as children and are still immune. But if you aren't, you must avoid contact with anyone who has German measles while you're pregnant. Exposure to German measles can have serious consequences for your growing baby.

Your blood is also screened for red blood cell antibodies — most commonly, Rh antibodies. These types of antibodies can increase your baby's risk of developing anemia and jaundice after birth. You'll also be offered a test for human immunodeficiency virus (HIV), the virus that causes AIDS. Tests for immunity to chickenpox, measles, mumps and toxoplasmosis may be done as well. Some women may be screened for thyroid problems. It typically takes just one needle stick and one blood sample to run all these tests.

You'll probably be asked to provide a urine sample. An analysis of your urine can determine whether you have a bladder or kidney infection, which would require treatment. The urine sample can also be tested for increased sugar, indicating diabetes, and protein, indicating possible kidney disease.

Getting the most from your first visit

Whether this is your first pregnancy or not, your first prenatal visit with your health care provider gives you a chance to review your health and lifestyle and talk honestly about being pregnant and giving birth. To get the most out of your first visit, keep the following tips in mind:

• Spend some time during the visit talking with your health care provider about your general lifestyle and how you might improve it to have the healthiest possible pregnancy. Possible topics to cover include nutrition, exercise, smoking, alcohol use and how you'll handle your pregnancy in your workplace.

• Raise any concerns or fears you may have about your pregnancy and childbirth. The sooner these fears and concerns are addressed, the sooner you can have peace of mind.

• Be assertive and persistent. If your health care provider doesn't answer your questions to your satisfaction or uses words you don't understand, ask again until you do understand.

• Be honest and accurate when talking with your health care provider. The quality of care you receive depends in large part on the quality of the information you provide.

Setting up your next visit

Your health determines how many follow-up visits your health care provider will recommend. Most women have visits every four to six weeks until their eighth month. Then the visits become more frequent: every two weeks until the start of the ninth month, then weekly until the baby arrives. If you have a chronic health problem, such as diabetes or high blood pressure (hypertension), you'll probably need to have more frequent visits with your health care provider. If you're in good health and have previously been pregnant and gone through labor, you may be able to schedule fewer visits. If any problems or concerns arise between visits, contact your health care provider.

Health And Fitness 101

Health And Fitness 101

Self-improvement is a thing which you must practice throughout your life because once you started to believe that you are perfect then, things will start to become complex. You need to know that no one is perfect and no one can be perfect.

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