Prenatal care is healthcare you get when you're pregnant. At Carilion, you can get prenatal care from a doctor, nurse practitioner, or a midwife. Regular prenatal checkups and testing give you the best chance of having a healthy, full-term baby and avoiding complications.

We count pregnancy in weeks from your last period. So, seven days after your last period started you were 1 week pregnant. You'll have regular, scheduled visits with your care team based on how far along you are.

Office visits

If your pregnancy is going smoothly, you'll see your care team once a month through week 28. From weeks 28 through 36, you'll have visits every 2 weeks, then every week from weeks 36 to birth.

These visits are usually quick. At each visit, you will:

• Discuss how you're feeling
• Urine test for sugar and protein levels
• Check your blood pressure
• Take your weight
• Listen to the baby's heart
• Measure your bump (fundal height)

If testing reveals a complication or you have an existing health issue, your pregnancy may be high risk. You may need to see more doctors and have more visits and tests.

Tests

You'll have several tests during your pregnancy. Some happen at every checkup while others happen just once.

Tests most people get during pregnancy include:

• Blood tests: These test for infections, immunity, and low iron levels
• Rh testing: Rh is a protein found on the red blood cells, and if your baby has it but you don’t, you'll be prescribed special medicine to help keep you and your baby healthy
• Non-invasive prenatal testing (after week 10): Test that looks for signs of genetic conditions using fetal DNA in the pregnant person's blood
• Quad screen (16-18 weeks): Tests up to 4 factors in the blood to help check for the baby’s risk for certain birth defects like Down syndrome or spina bifida
• Glucose challenge (24 weeks): Checks for gestational diabetes
• Group B strep test (at 36 weeks): A swab of the vagina and anus to check for bacteria that could be passed to the baby during birth 

There are also some prenatal tests that your doctor will only order if a screening test shows a higher risk of a health issue with the baby.

Tests for or because of complications include:

• Chorionic villus sampling (10 to 13 weeks): A doctor uses a wire or needle to take a piece of the placenta to test for genetic or chromosomal condition
• Amniocentesis (after 15 weeks): A doctor uses a needle to take a sample of the amniotic fluid to test for genetic or chromosomal issue
• Non-stress tests: These tests monitor the baby's heartbeat and activity level while you're resting.
• Blood glucose testing: If you have gestational diabetes, you must check your blood sugar levels multiple times a day

For other health issues, you may need more blood or urine tests. These may test for liver function, infections, or other various issues.

Ultrasounds

Ultrasounds use high-frequency sound waves to see inside the belly. It's common to get 2 or more during your pregnancy. They may include:

• An early ultrasound at around 8 weeks can give you an accurate due date and check that the embryo is in the uterus.
• Your care team may suggest a nuchal translucency ultrasound between 11 and 14 weeks to screen for certain complications.
• You'll have a more detailed scan, called an anatomy scan, at 20 weeks to check the baby's development.
• If your belly is measuring too big or too small, or you have complications like diabetes, you may need growth ultrasounds to monitor the baby's size. They may also do an amniotic fluid index ultrasound to check the amount of fluid.
• Doppler ultrasound checks blood flow, for example, within the heart or from the placenta to the baby. They may use this during an anatomy scan or other times to check for complications.

Prenatal and childbirth education

Carilion offers programs to help prepare you for labor and delivery. They include our virtual Understand Birth series. We also offer and virtual tours of our labor and delivery facilities at Carilion Roanoke Memorial and Carilion New River Valley Medical Center, called The Birthplace.

Whether you get prenatal care from a doctor or midwife, your first visit will be a little longer than later visits. 

Your care team will:

• Ask about your health history and your family's health history
• Check your weight, height, and blood pressure
• Do a physical exam, including a pelvic exam and Pap test
• Get additional blood and urine samples for a variety of tests
• Ask the date of your last period to calculate your due date

With subsequent visits, here's what you can expect:

Before your prenatal visit

Make a list of any questions or new concerns you have. It's important to tell your care team about any troubling symptoms, aches, or pains, however minor they may seem. It may help to note down your questions between visits.

During your prenatal visit

Your care team will take your weight and blood pressure and measure your belly to see how your baby grows. They'll listen to your baby's heartbeat through your belly. You'll need to give a urine sample so they can check for sugar and protein in your urine.

Your care team will ask if you have any questions about your pregnancy and discuss those with you. They can help you deal with new symptoms. They may order tests like ultrasounds or bloodwork.

After your prenatal visit

You'll usually schedule your visits well in advance. After your visit, schedule any extra testing, like ultrasounds or glucose tests. After the tests, you may see your results in MyChart or hear from your care team if there are any to follow up on.