What to expect at your first prenatal appointment
Finding out you’re pregnant can bring a mix of excitement, joy, anxiety and a lot of questions. One of the first big milestones is your first prenatal appointment—a visit designed to make sure both you and your baby are healthy and off to a strong start.
If you’re wondering what will happen, what you should bring or whether it’s normal to feel anxious, you’re not alone. Here’s a step-by-step guide to help you feel prepared and confident before you walk through the door.
“The first prenatal visit is really about helping you feel informed and supported,” says Tufts Medicine physician assistant, Ellen Wheeler, MPAS, PA-C. “There’s a lot of information to cover early in pregnancy, so we guide patients through it one step at a time.”
When does the first prenatal visit happen?
The first prenatal visit is often broken up into two appointments so it feels less overwhelming with information. Many patients will first meet with nurses and advanced practice providers (APPs), who play an important role in prenatal care and help guide patients through the early stages of pregnancy.
A virtual prenatal visit usually takes place around 6 to 10 weeks of pregnancy, though timing can vary depending on your health history and your clinician’s recommendations. If you have certain medical conditions, previous pregnancy complications or are experiencing symptoms like pain or bleeding, your doctor may want to see you sooner.
An in-person exam and review of documents usually happens between 9 to 14 weeks, often close to your ultrasound appointment following your size and dates.
What happens at the first prenatal appointment?
Your first prenatal visits are usually some of the longest appointments during pregnancy because there’s a lot to cover. Think of them as the foundation for the months ahead.
A conversation about your health history
Your clinician will ask questions about:
- Your medical history
- Previous pregnancies, if applicable
- Medications and supplements
- Family health history
- Lifestyle habits like nutrition, exercise and sleep
- Your last menstrual period to estimate your due date
This is also your opportunity to ask questions—nothing is too small or silly.
“Patients often come into that first visit with a lot of questions and emotions,” says Tufts Medicine’s Ciara Wilson, RN. “Our goal is to make sure they feel heard, supported and prepared for what comes next.”
A physical exam
This portion happens during the in-person visit.
Depending on your clinician and your stage of pregnancy, the visit may include:
- Checking your weight and blood pressure
- A general physical exam including breast and pelvic exam as indicated
- A Pap test, if you’re due for one
These exams help establish a baseline for your health during pregnancy.
Lab work and testing
Most patients will have blood and urine tests during the first visit. These tests can help:
- Confirm the pregnancy
- Check blood type
- Screen for anemia
- Test immunity to certain infections
- Identify any conditions that may need monitoring during pregnancy
Your clinician may also discuss optional chromosomal and genetic screening tests.
All patients are offered carrier screening and genetic testing during pregnancy. Carrier screening includes testing for conditions such as cystic fibrosis, Fragile X syndrome, spinal muscular atrophy (SMA) and hemoglobinopathies including sickle cell disease and thalassemias.
The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant individuals, regardless of age or risk factors, be offered prenatal genetic screening, either through serum screening or cell-free DNA testing, also known as noninvasive prenatal testing (NIPT). At this time, NIPT is offered to all patients.
Most insurance plans provide coverage for carrier screening and prenatal genetic testing, though patients may still be responsible for costs applied toward their deductible. Self-pay options may also be available. Tufts Medicine patients who would like to learn more about potential testing costs can visit LabCorp to learn more.
“Genetic screening is optional and personal,” says Amna Khan, MD, FACOG, obstetrician and gynecologist, Tufts Medicine and Clinical Professor Tufts University School of Medicine. “Our role is to explain the options, answer questions and help you decide what feels right for you.”
Your first ultrasound
Some patients will have an ultrasound at the first appointment, while others may schedule it for a later visit. The ultrasound can help:
- Confirm how far along you are
- Check the baby’s heartbeat
- Determine whether you’re carrying more than one baby
Seeing the baby for the first time is often an emotional and exciting moment.
What should you bring?
A little preparation can make the appointment feel smoother. Consider bringing:
- A list of medications and supplements
- Your medical history
- Any prior genetic testing or documents from prior pregnancy
- Insurance information
- Questions you want to ask
- Your partner, support person or family member
It’s very common to forget questions once the appointment starts, so writing them down ahead of time can help.
Prenatal care timeline
Weeks 6–10
Confirmation of pregnancy
Virtual prenatal visit
Patients typically meet with a nurse during this visit to review health history, answer questions and discuss next steps in care.
- Dating ultrasound for due date estimates
- Health history
- Possible lab work
Weeks 9–14
In-person prenatal visit
Patients often meet with an advanced practice provider (APP), such as a physician assistant or nurse practitioner, for this visit.
- Routine prenatal lab work
- Health-specific lab work
- Optional genetic screening including carrier screening and NIPT
- Routine checkup including physical exam as indicated
- Monitoring symptoms
- Ultrasound for baby growth and risk for chromosomal abnormalities
Weeks 18–22
Anatomy ultrasound
- Lab test for baby neurodevelopment
- Detailed look at baby’s development
Weeks 24–28
- Glucose screening for gestational diabetes
- Routine labs
Weeks 28–36
- Visits usually become more frequent
- Monitoring blood pressure, baby’s movement and growth
- Vaccines as indicated
- Given information on prenatal classes, breastfeeding, postpartum depression and labor
Weeks 36–40
- Weekly visits
- Preparing for labor and delivery
Questions to ask at your first prenatal visit
If you’re unsure where to start, these questions can help guide the conversation:
- What symptoms are normal?
- Which prenatal vitamins should I take?
- Are there foods or activities I should avoid?
- When should I call the office?
- What can I do to manage nausea or fatigue?
- How often will I have appointments?
- What hospital will I deliver at?
Frequently asked questions
What week should I schedule my first prenatal appointment?
Most patients have their first prenatal visit between 6 and 10 weeks of pregnancy, although your clinician may recommend an earlier appointment based on your medical history or symptoms.
Is it normal to feel nervous before the first prenatal appointment?
Absolutely. Many people feel anxious, excited or overwhelmed before their first visit. Your care team is there to support you and answer your questions every step of the way.
Do I need an ultrasound at my first prenatal appointment?
Many patients have a dating ultrasound during the first trimester to confirm the due date, check for a heartbeat and assess early pregnancy development.
Will I hear the baby’s heartbeat?
We expect to see a heartbeat at your first and follow-up ultrasound appointment. We will then listen for the heartbeat at your follow-up visits.
What tests are done at the first prenatal visit?
Common tests include blood work, urine testing, blood type screening, anemia screening and discussions about carrier screening and noninvasive prenatal testing (NIPT).
How long does the first prenatal appointment take?
First visits are usually longer than future appointments and can last anywhere from 45 minutes to over an hour.
Who will I see at my first in-person prenatal visit?
Many patients meet with an advanced practice clinician (APC), such as a physician assistant or nurse practitioner, for their first in-person prenatal visit. Nurses, APCs and physicians all work together as part of your prenatal care team to help support you throughout your pregnancy.
Should my partner or support person come?
If you’d like them there, yes. Many people find it comforting to bring someone for support, especially for the first visit.
What if I don’t know exactly how far along I am?
That’s very common. Your clinician can help estimate your due date based on your last menstrual period and ultrasound findings.
The bottom line
You don’t need to have everything figured out before your first prenatal appointment. Your care team is there to guide you through it. Come with your questions and concerns. This first visit is about more than medical care, it’s the beginning of a partnership focused on keeping you and your baby healthy throughout your pregnancy journey.
Schedule prenatal care with the maternity specialists at Tufts Medicine and receive personalized support from your first appointment through delivery and beyond.
