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The Ultimate Pregnancy Appointment Guide: What to Expect Week by Week at Your Prenatal Visits

Central to ensuring the health and well-being of you and your growing baby is seeing your care team regularly for touchpoints and milestones that are part of your pregnancy appointment schedule. Diana Kaufman, MD , UnityPoint Health, shares the recommended timeline for prenatal visits, and the importance of each test and discussion that’ll prepare you for a safe pregnancy and delivery.

Confirming Your Pregnancy

Every woman’s body is unique, but it’s a good idea to visit a doctor to confirm a pregnancy when you’re experiencing early symptoms, such as a missed period or you’ve received a positive home pregnancy test. Typically, this visit happens at 6-8 weeks of pregnancy.

Your doctor may confirm your pregnancy through urine tests, blood tests or ultrasounds.

Initial Prenatal Appointment: 5-12 Weeks

Your first prenatal visit consists of important screenings and discussions, so your healthcare team can create a care plan that ensures you and baby stay healthy throughout your pregnancy. Prepare a few things for this visit, including:

• Complete medical history: It’s important for your doctor to know your past and present health conditions or concerns, medications and any history of disease, substance abuse or known genetic conditions in your family.
• Insurance information: This includes consents for care, your insurance carrier and other paperwork

Here’s what to expect at your first pregnancy appointment

• A physical, which will likely include a breast and pelvic exam.
• A urine sample is collected to check for certain infections and conditions that can occur during pregnancy. Urine tests may be taken at your following prenatal visits as well. Urine drug screening tests are also recommended for women, or their partners, with a history of substance use — including smoking.
• Routine testing that includes blood draws to check your blood type and complete blood count (CBC) and look for specific diseases including hepatitis, HIV, syphilis and checking for immunity against rubella. Other testing that may occur includes genetic screening and testing for diabetes.

Your care team will review prenatal educational materials with you and remedies for any unpleasant pregnancy symptoms, such as nausea or vomiting . Your team also will provide an estimated due date for baby.

It’s also important to take good care of your teeth and gums during pregnancy. Changing hormone levels make your gums more sensitive to disease, which increases your risk for a low-birth weight or premature baby. Consider making an appointment to see your dentist during your first trimester.

Prenatal Appointment: Second Trimester (13 – 26 Weeks)

During weeks 13-26, you’ll see your doctor every four weeks. It’s a good idea to write down questions or concerns before your appointments to ensure they’re addressed.

At each appointment throughout the rest of your pregnancy, your care team will check the following:

• Blood pressure
• Position of baby
• Baby’s heartbeat

Here are some additional things to expect.

• Prenatal genetic testing: There are many different options for prenatal genetic testing. Your care team will review these with you.
• Pregnancy blood tests: These are tailored to your specific needs. Most patients are tested for anemia and diabetes of pregnancy between weeks 24-28. Other recommended tests will be reviewed with you.
• Ultrasound: It’s common to have an ultrasound in the first trimester to confirm the estimated due date. Ultrasound is also common at 20 weeks to check on baby's growth and development. Further ultrasounds could be needed if changes in your pregnancy make it necessary, such as concerns about baby’s growth or to see if baby is head down.
• Discuss preterm labor signs: Preterm labor refers to labor that begins before the 37th week of pregnancy and requires medical attention. Knowing what to look for — such as contractions, changes in vaginal discharge  — is important for preventing potential complications.
• Childbirth classes: It’s a good idea to register for a class  to help you prepare for baby’s arrival.

When to Call Your Doctor

Pregnancy creates new and unfamiliar symptoms in many women. However, some symptoms need attention. Here’s when to call your doctor in the second trimester:

• Vaginal bleeding, even a small amount
• Leg pain with numbness or leg weakness
• Pain or tenderness in one of both calves that doesn’t go away
• Thoughts of hurting yourself or others
• Severe headaches that don’t go away with Tylenol
• Persistent changes in vision such as blurriness or floaters
• More than five contractions in an hour

Now, your visits to your care team become more frequent — happening every two weeks until you’re 36 weeks pregnant. Your care team continues to monitor you and baby. Here’s what else to expect:

Prenatal Appointments: Third Trimester (27 Weeks – Baby’s Arrival)

• Check fetal movement: It’s important to be aware of your baby's movements. If you notice a sudden change or absence of fetal movement, let you care team know.
• Rhogam injections: If an Rh-negative blood type was found during your initial prenatal visit, you’ll receive an injection to prevent immune system complications for future pregnancies. This usually happens at 28 weeks.
• Additional prenatal testing: Around 35-37 weeks, you’re checked to see if you carry group B streptococcus bacteria . This is one of many bacteria that can live on our skin and typically does not cause problems. However, it can infect a newborn when you deliver. Antibiotics are given during delivery to prevent infection in a newborn if you test positive.

Prenatal Appointments: 36 Weeks – End of Pregnancy

Once you’ve reached 36 weeks, you’ll see your doctor every week until you deliver. These visits are essential for ensuring the well-being of both you and your little one, as well as preparing for a safe and smooth delivery. In addition to routine physical examinations and checking baby’s heartbeat and movement, here’s what else you can expect:

• Cervical exams: If you’re having frequent contractions or preparing to be induced, your doctor will likely need to perform this exam.
• Discuss labor signs: You’ll likely discuss signs of labor with your doctor and when to go to the hospital.
• Discuss birth preferences: It’s not necessary to have a birth plan. Your care team has that covered. Our goal is to keep you and your baby healthy throughout the entire pregnancy and delivery process. However, if you have strong desires or needs for delivery, please discuss those during a prenatal appointment. It’s also helpful to write these things down and bring them to the hospital, since you may not be able to fully express your wishes during labor.

Postpartum Visits

After delivering baby, but before you leave the hospital, call your doctor to make your postpartum appointment, if it hasn’t been scheduled yet. This visit typically occurs around 6 weeks after you deliver. Other visits are scheduled based on your individual needs.

These visits are a time for your doctor to check on your healing , discuss normal or abnormal postpartum bleeding, talk about your well-being and any signs of postpartum depression or anxiety , discuss when it’s safe to start exercising again and address other questions or concerns you may have .

Our UnityPoint Health care team is here to care for you and baby throughout the entirety of your pregnancy and beyond. Call us  to schedule your first appointment or if you have questions about any future appointments.

More Maternity Content

Group B Strep in Pregnancy: Understanding Risks, Testing and Treatment

Second Time Mom Gets Wish of Vaginal Birth After C-Section

An OBGYN Answers 17 Questions to Help You Prepare for Postpartum

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Prenatal visits: What to expect and how to prepare

Regular prenatal visits are an important part of your pregnancy care. Find out how often you'll see a healthcare provider, what to expect at each appointment, and smart ways to prepare.

When to schedule a prenatal visit

Prenatal visitation schedule, how should i prepare for a prenatal visit, what happens during prenatal visits, how can i make the most of my pregnancy appointments.

Make an appointment for your first prenatal visit once you're aware you are pregnant – when you receive a positive home pregnancy test, for example. Booking it around week 8 of pregnancy is typical.

You'll come back regularly in the weeks and months following that initial appointment. Most people have between 8 and 14 prenatal visits throughout the course of their pregnancy.

During this time, you'll see a lot of your healthcare practitioner. That's why it's so important to choose someone you like and trust. If you're not comfortable or satisfied with your provider after your first visit or visits, don't be afraid to find someone with whom you have a better connection.

Typically, a pregnant woman will visit their doctor, midwife , or nurse practitioner every four weeks during the first and second trimesters. In the third trimester, you'll be seen more often – usually every other week until 36 weeks, and then every week until the baby is born.

For more information on what happens at these visits, see:

Your first prenatal visit

Second trimester prenatal visits (14 weeks to 27 weeks)

Third trimester prenatal visits (28 weeks through the end of pregnancy)

The specific number of scheduled appointments you'll have depends on if your pregnancy is considered to be high-risk. This is determined by your medical history and whether you have any complications or conditions that warrant more frequent checkups, such as gestational diabetes , high blood pressure , or a history of preterm labor . If you've had any medical problems in the past or develop any new problems during this pregnancy, you may need more prenatal visits than the average pregnant woman.

In the weeks before each visit, jot down any questions or concerns in a notebook or a notes app on your smartphone. This way, you'll remember to ask your practitioner about them at your next appointment. You may be surprised by how many questions you have, so don't miss the opportunity to get some answers in person.

For example, before you drink an herbal tea or take a supplement or an over-the-counter medication , ask your provider about it. You can even bring the item itself – or a picture of the label – with you to your next appointment. Then, your doctor, midwife, or nurse practitioner can read the label and let you know whether it's okay to ingest.

Of course, if you have any pressing questions or worries, or develop any new, unusual, or severe symptoms , don't wait for your appointment – call your practitioner right away.

In addition to your list, you may want to bring a partner, friend, family member, or labor coach with you to some or all of your prenatal visits. They can comfort you, take notes, ask questions, and help you remember important information.

The goal of prenatal visits is to see how your pregnancy is proceeding and to provide you with information to help keep you and your baby healthy. It's important that you go to all of your prenatal appointments, even if you're feeling just fine and believe that everything is progressing perfectly.

Your practitioner will start by asking how you're feeling physically and emotionally, whether you have any complaints or worries, and what questions you may have. They'll also ask you about your baby's movements once you begin to feel them, typically during the second trimester. Your practitioner will have other questions as well, which will vary depending on how far along you are and whether there are specific concerns.

Your midwife, doctor, or nurse practitioner will also:

• Check your weight , blood pressure , and urine
• Check for swelling
• Measure your abdomen
• Check the position of your baby
• Listen to your baby's heartbeat
• Perform other exams and order tests, as appropriate
• Give you the appropriate vaccinations
• Closely monitor any complications you have or that you develop, and intervene if necessary

Near the end of your pregnancy, your provider may also do a pelvic exam to check for cervical changes. You will also discuss your delivery plan in more depth.

At the end of each visit, your practitioner will review their findings with you. They'll also explain the normal changes to expect before your next visit, warning signs to watch for, and the pros and cons of optional tests you may want to consider. Lifestyle issues will likely be a topic of discussion, as well. Expect to talk about the importance of good nutrition , sleep, oral health, stress management, wearing seatbelts, and avoiding tobacco , alcohol , and illicit drugs.

Many people look forward to their prenatal appointments but are disappointed to find that, with the exception of the first visit, they're in and out of the office in 10 minutes. A quick visit is typical and is usually a sign that everything is progressing normally. Still, you want to make sure your concerns are addressed – and that you and your baby are being well cared for.

Here are some things you can do to ensure that your prenatal visits are satisfying:

• Speak up. Your practitioner isn't a mind reader and won't be able to tell what you're thinking just by performing a physical exam. So, if anything is bothering you, say your piece. Are you having trouble controlling your heartburn ? Managing your constipation ? Suffering from headaches ? This is the time to ask for advice. Consult the notebook of questions you've been compiling. In addition to physical complaints, let your practitioner know if you have emotional concerns or fitness or nutrition questions.
• Ask the staff about the administrative stuff. Save your questions about things like insurance and directions to the hospital for the office staff so your practitioner has more time to answer your health-related questions. Go to the admin staff with any inquiries about payments, scheduling, office policies, and your contact information.
• Be open-minded. When talking with your doctor, midwife, or nurse practitioner, you should feel comfortable speaking freely. But remember to listen, too. Take notes if you find it helpful.

Keep in mind, too, that some days are busier than others. This is especially true during the COVID-19 pandemic. That doesn't mean your practitioner doesn't have to answer your questions, but sometimes a discussion can be continued at the next visit if it's a really busy day or if your practitioner needs to head to the hospital to deliver a baby.

At the same time, don't tolerate a healthcare practitioner who won't give you thorough answers, doesn't show reasonable compassion, or barely looks up from your chart. You and your baby deserve more than that.

Now that you know what to expect during all those prenatal visits, you might like a sneak peek at what else is in store. Here's an overview of the next nine months .

Learn more:

• The ultimate pregnancy to-do list: First trimester
• 12 steps to a healthy pregnancy
• When will my pregnancy start to show?
• Fetal development timeline

Was this article helpful?

What happens at second trimester prenatal appointments

Advanced maternal age: What pregnancy after 35 is like

What to expect at your first prenatal appointment

What happens when you stop taking birth control

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

MedlinePlus. (2021). Prenatal care in your first trimester. https://medlineplus.gov/ency/patientinstructions/000544.htm Opens a new window [Accessed September 21, 2021.]

March of Dimes. (2017). Prenatal Care Checkups. https://www.marchofdimes.org/pregnancy/prenatal-care-checkups.aspx Opens a new window [Accessed September 21, 2021.]

Office on Women’s Health. (2019). Prenatal Care and Tests. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests Opens a new window [Accessed September 21, 2021.]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2017). What happens during prenatal visits? https://www.nichd.nih.gov/health/topics/preconceptioncare/conditioninfo/prenatal-visits Opens a new window [Accessed September 21, 2021.]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2017). What is a high-risk pregnancy? https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/high-risk Opens a new window [Accessed September 21, 2021.]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2018). What are some factors that make a pregnancy high-risk? https://www.nichd.nih.gov/health/topics/high-risk/conditioninfo/factors Opens a new window [Accessed September 21, 2021.]

March of Dimes. (2020). Over-the-Counter Medicine, Supplements, and Herbal Products During Pregnancy. https://www.marchofdimes.org/pregnancy/over-the-counter-medicine-supplements-and-herbal-products.aspx Opens a new window [Accessed September 21, 2021.]

Associates in Women’s Healthcare (2021). Preparing for Your First Prenatal Visit. https://www.associatesinwomenshealthcare.net/blog/preparing-for-your-first-prenatal-visit/ Opens a new window [Accessed September 21, 2021.]

National Health Service (UK). (2018). Your baby’s movements. https://www.nhs.uk/pregnancy/keeping-well/your-babys-movements/ Opens a new window [Accessed September 21, 2021.]

MedlinePlus. (2021). Prenatal care in your third trimester. https://medlineplus.gov/ency/patientinstructions/000558.htm Opens a new window [Accessed September 21, 2021.]

UCLA Health. (2021). Schedule of prenatal care. https://www.uclahealth.org/obgyn/workfiles/Pregnancy/Schedule_of_Prenatal_Care.pdf Opens a new window [Accessed September 21, 2021.]

UCR Health. (2021). Healthy Pregnancy: The Importance of Prenatal Care.   https://www.ucrhealth.org/2018/07/healthy-pregnancy-the-importance-of-prenatal-care/ Opens a new window [Accessed September 21, 2021.]

Mayo Clinic. (2020). Prenatal care: 1 st trimesters visits. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044882 Opens a new window [Accessed September 21, 2021.]

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Prenatal care: First trimester visits

Pregnancy and prenatal care go hand in hand. During the first trimester, prenatal care includes blood tests, a physical exam, conversations about lifestyle and more.

Prenatal care is an important part of a healthy pregnancy. Whether you choose a family physician, obstetrician, midwife or group prenatal care, here's what to expect during the first few prenatal appointments.

The 1st visit

When you find out you're pregnant, make your first prenatal appointment. Set aside time for the first visit to go over your medical history and talk about any risk factors for pregnancy problems that you may have.

Medical history

Your health care provider might ask about:

• Your menstrual cycle, gynecological history and any past pregnancies
• Your personal and family medical history
• Exposure to anything that could be toxic
• Medications you take, including prescription and over-the-counter medications, vitamins or supplements
• Your lifestyle, including your use of tobacco, alcohol, caffeine and recreational drugs
• Travel to areas where malaria, tuberculosis, Zika virus, mpox — also called monkeypox — or other infectious diseases are common

Share information about sensitive issues, such as domestic abuse or past drug use, too. This will help your health care provider take the best care of you — and your baby.

Your due date is not a prediction of when you will have your baby. It's simply the date that you will be 40 weeks pregnant. Few people give birth on their due dates. Still, establishing your due date — or estimated date of delivery — is important. It allows your health care provider to monitor your baby's growth and the progress of your pregnancy. Your due date also helps with scheduling tests and procedures, so they are done at the right time.

To estimate your due date, your health care provider will use the date your last period started, add seven days and count back three months. The due date will be about 40 weeks from the first day of your last period. Your health care provider can use a fetal ultrasound to help confirm the date. Typically, if the due date calculated with your last period and the due date calculated with an early ultrasound differ by more than seven days, the ultrasound is used to set the due date.

Physical exam

To find out how much weight you need to gain for a healthy pregnancy, your health care provider will measure your weight and height and calculate your body mass index.

Your health care provider might do a physical exam, including a breast exam and a pelvic exam. You might need a Pap test, depending on how long it's been since your last Pap test. Depending on your situation, you may need exams of your heart, lungs and thyroid.

At your first prenatal visit, blood tests might be done to:

• Check your blood type. This includes your Rh status. Rh factor is an inherited trait that refers to a protein found on the surface of red blood cells. Your pregnancy might need special care if you're Rh negative and your baby's father is Rh positive.
• Measure your hemoglobin. Hemoglobin is an iron-rich protein found in red blood cells that allows the cells to carry oxygen from your lungs to other parts of your body. Hemoglobin also carries carbon dioxide from other parts of your body to your lungs so that it can be exhaled. Low hemoglobin or a low level of red blood cells is a sign of anemia. Anemia can make you feel very tired, and it may affect your pregnancy.
• Check immunity to certain infections. This typically includes rubella and chickenpox (varicella) — unless proof of vaccination or natural immunity is documented in your medical history.
• Detect exposure to other infections. Your health care provider will suggest blood tests to detect infections such as hepatitis B, syphilis, gonorrhea, chlamydia and HIV , the virus that causes AIDS . A urine sample might also be tested for signs of a bladder or urinary tract infection.

Tests for fetal concerns

Prenatal tests can provide valuable information about your baby's health. Your health care provider will typically offer a variety of prenatal genetic screening tests. They may include ultrasound or blood tests to check for certain fetal genetic problems, such as Down syndrome.

Lifestyle issues

Your health care provider might discuss the importance of nutrition and prenatal vitamins. Ask about exercise, sex, dental care, vaccinations and travel during pregnancy, as well as other lifestyle issues. You might also talk about your work environment and the use of medications during pregnancy. If you smoke, ask your health care provider for suggestions to help you quit.

Discomforts of pregnancy

You might notice changes in your body early in your pregnancy. Your breasts might be tender and swollen. Nausea with or without vomiting (morning sickness) is also common. Talk to your health care provider if your morning sickness is severe.

Other 1st trimester visits

Your next prenatal visits — often scheduled about every four weeks during the first trimester — might be shorter than the first. Near the end of the first trimester — by about 12 to 14 weeks of pregnancy — you might be able to hear your baby's heartbeat with a small device, called a Doppler, that bounces sound waves off your baby's heart. Your health care provider may offer a first trimester ultrasound, too.

Your prenatal appointments are an ideal time to discuss questions you have. During your first visit, find out how to reach your health care team between appointments in case concerns come up. Knowing help is available can offer peace of mind.

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• Lockwood CJ, et al. Prenatal care: Initial assessment. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• Prenatal care and tests. Office on Women's Health. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests. Accessed July 9, 2018.
• Cunningham FG, et al., eds. Prenatal care. In: Williams Obstetrics. 25th ed. New York, N.Y.: McGraw-Hill Education; 2018. https://www.accessmedicine.mhmedical.com. Accessed July 9, 2018.
• Lockwood CJ, et al. Prenatal care: Second and third trimesters. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization. http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/. Accessed July 9, 2018.
• Bastian LA, et al. Clinical manifestations and early diagnosis of pregnancy. https://www.uptodate.com/contents/search. Accessed July 9, 2018.

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Prenatal Visit Schedule: What To Expect During Each Appointment

Prenatal care is an important part of a healthy pregnancy and allows your doctor to regularly monitor you and your baby . But what should you expect when it comes to your prenatal visit schedule?

Basically, you’ll visit your doctor once a month at the beginning of your pregnancy and then once a week at the end of your pregnancy. That said, it’s important to schedule your first prenatal visit as soon as you see a positive pregnancy test!

In this article, the experts at Mustela discuss how your prenatal visit schedule will most likely look and what to expect during each appointment.

Prenatal Visit Schedule: First Trimester

This is such an exciting time in your life! When you saw the positive pregnancy test , you were probably four to six weeks pregnant, so go ahead and call your doctor to schedule your first appointment.

During the first trimester , you will have your initial prenatal visit, and then your doctor will schedule your visits every four weeks or once a month.

Check with the doctor or staff for a printout of your prenatal visit schedule.

What To Expect At Your First Appointment

Your first prenatal visit will be around six to nine weeks and will most likely be the lengthiest of all your appointments, so block out a good bit of time on your calendar.

Your doctor will ask a good bit of detailed questions and perform a pretty thorough check. Let’s take a look at what they’ll do during this appointment.

Medical History

Your doctor will ask questions about your:

• Last menstrual cycle so they can give you a due date
• Gynecological history
• Obstetrical history (any past pregnancies)
• Personal and family medical history
• Supplements or medicines you’re taking (if any)
• Lifestyle (use of tobacco products, alcohol, and caffeine; eating and exercising habits)
• Recent travel adventures
• Feelings of depression or anxiety (if any)

Your doctor will order various lab work to check your blood for:

• Blood type and Rh status
• Hemoglobin levels
• Infections such as hepatitis B, syphilis, gonorrhea, chlamydia, and HIV
• Thyroid levels
• Any other important screenings

Physical Exam

To give you and your baby the best care, your doctor will need to do a thorough physical exam, which most likely will also include a Pap smear to detect any abnormal cervical cells.

Your doctor’s observation also includes:

• Checking your blood pressure
• Measuring your height and weight to determine your recommended weight gain for a healthy pregnancy
• A breast exam
• A pelvic exam
• Screening your heart, lungs, and thyroid

Discuss any pregnancy discomforts , such as nausea and fatigue, with your doctor. Be honest with your doctor so they can take care of you and your baby to the best of their knowledge.

Some doctors also do an ultrasound during the first trimester to confirm or date your pregnancy. (Your first prenatal visit will vary based on the specific policies of your doctor’s office.)

What To Expect At Your 12-Week Appointment

You're nearing the end of your first trimester! During this appointment, you can expect your doctor to check the following:

• Weight and blood pressure
• Urine for sugar and protein levels
• Your baby’s heartbeat (This will be the first time you’ll hear it!)
• Size of your uterus
• Hands and feet for any swelling

Prenatal Visit Schedule: Second Trimester

Assuming you have a healthy pregnancy and no further examinations are necessary, this is what your prenatal visit schedule will look like during your second trimester :

• Four-month appointment (around 16 weeks)
• Five-month appointment (around 20 weeks)
• Six-month appointment (around 24 weeks)

What To Expect During Routine Appointments

Many of your appointments from here on out will look similar regarding what your doctor will check for. During these visits, you can expect your doctor to look at:

• Your baby’s heartbeat
• Your fundal height (The size of your uterus is used to assess fetal growth and development. Your doctor will get this measurement by measuring the length from the top of your uterus to the top of your pubic bone. This measurement should match how many weeks you are. Example: If you’re 20 weeks pregnant, your fundal height should equal 20 centimeters.)
• Hands and feet for swelling
• Any symptoms you’ve been experiencing

At this point in your pregnancy, you may notice your skin becoming dry and starting to stretch a bit. Don’t worry; it’s completely normal!

To tackle dry skin, try Mustela’s Stretch Marks Cream . This velvety, hard-working cream delivers immediate moisture and comfort to your skin!

And our Stretch Marks Oil treats recently formed stretch marks. It’s a fast-absorbing oil that hydrates your skin throughout your pregnancy!

What To Expect During Your 20-Week Sonogram:

Sometime around your 20-week appointment, your doctor will schedule an ultrasound to determine the gender of your baby! During this sonogram, your sonographer will take a look at:

• Baby’s size and all their major organs
• Amniotic fluid
• Location of placenta

Your sonographer passes this information to your doctor to give them a clear picture (literally!) of the overall health of your baby and your pregnancy.

Prenatal Visit Schedule: Third Trimester

During your third trimester , your prenatal visits will be every two weeks until the last month of your pregnancy, when you’ll have them every week. So that means your prenatal visit schedule will look like this:

What To Expect At Your Seventh- and Eighth-Month Visits

During your seventh and eighth months of pregnancy, expect your doctor to check the following:

• Urine for sugar and protein
• Your fundal height (top of your uterus)
• Size and position of your baby
• Feet and hands for swelling
• Varicose veins in your legs
• Glucose screen test (read below for more information)
• Group B strep test (read below for more information)
• Blood test for anemia
• Any symptoms you’ve been having

Glucose Screen Test

This test is used to determine if you have gestational diabetes. Once you arrive at your doctor’s office, be prepared to have your blood drawn first.

Next, you’ll drink a very sugary drink that tastes like flat orange soda. Some women enjoy the taste, while others feel a little queasy afterward!

After you consume the entire drink, you’ll wait one hour before having your blood drawn again. If your blood work comes back with elevated numbers, your doctor will order the next level of tests, which is used to officially diagnose gestational diabetes.

Should you need to take the second test (no studying required!), you’ll have to fast before the appointment. Just like with the initial round of tests, your doctor will draw your blood first and then have you consume the drink.

The only difference is this time, your blood will be drawn every hour for three hours. Be prepared to stay in your doctor’s office for three to four hours.

If the results from this test also come back elevated, your doctor will discuss management techniques for gestational diabetes.

But don’t let this information worry you. Most women who monitor their blood sugar levels and work closely with their doctor have perfectly normal pregnancies and healthy babies!

Group B Strep Test

Group B Strep (GBS) is bacteria that can be found in the vaginas of healthy women. (It’s not related to strep, the throat infection.)

If you are a carrier of GBS, your baby can catch the infection during delivery when they pass through the birth canal. While this bacteria isn’t harmful to you, it can be dangerous for your baby.

To check for GBS, your doctor will perform a test just like they would a Pap smear. If the test shows that you’re a carrier, you’ll receive antibiotics through an IV once you’re in labor. This way, you won’t pass the infection to your baby!

You’re routinely tested for GBS around the seventh or eighth month of pregnancy so your doctors can be prepared to give you the antibiotics at the onset of labor.

What To Expect During Your Ninth Month

Similar to months seven and eight, your doctor will closely monitor you and your baby during this time. Since you’re getting closer to your due date, expect a few additional observations from your doctor.

During your last month of pregnancy, they will take a look at:

• Your cervix by an internal examination to check for effacement (thinning) and dilation (opening)
• Baby’s heartbeat
• Baby’s size (At this point in your pregnancy, your doctor may give you an estimation of your baby’s weight. They can tell your baby’s presentation: head or bottom first, and their position: front- or rear-facing.)
• Any questions or concerns you may have about delivery

A Beautiful Pregnancy And Beautiful Skin

Throughout these nine months , your prenatal visits are special moments of checking on your sweet little baby. It’s exciting to see your belly grow with each visit! But that also means possible stretch marks.

The good news is that Mustela offers a line of prenatal products, including our Stretch Marks Cream and Bust Firming Serum , to soothe and hydrate your skin while you manage the busyness of your prenatal visit schedule.

Let Mustela help you start your beautiful pregnancy with beautiful skin!

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Normal Pregnancy Visit Schedule

This schedule depicts the typical pregnancy calendar and what will be done at each prenatal visit.

Week 8-10 (approximately)

• Pregnancy confirmation visit includes: Ultrasound* – particularly for patients who are unsure of  last menstrual period date or who have had a history of miscarriage
• Doctor/Nurse Practitioner/Midwife visit to discuss ultrasound findings

Week 11-13  (approximately)

• Doctor/Midwife visit: pap smear, physical exam
• NT (FIRST TRIMESTER SCREEN) must make ultrasound appointment in conjunction with the OB work up visit.
• Doctor/Midwife visit
• AFP4* (16-18 weeks)
• Amniocentesis* (16-18 weeks) Must be scheduled along with genetic counseling
• Rhogam following Amnio (if Rh negative)
• U/S* (18-21 weeks) (Must be scheduled in addition to office visit)
• 1 hr Glucose Tolerance Test* (24-28 weeks)
• Hemoglobin, Antibody scrn (if Rh negative)
• RhoGAM (if Rh negative)
• Group Beta Strep Culture* (36 weeks)
• Doctor/Midwife visit with Cervical Exam
• Non-Stress Test
• Discuss induction with provider

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Prenatal Appointment – Weeks 28 to 31 | My Doctor Online

My Doctor Online

Prenatal appointment – weeks 28 to 31.

During your prenatal appointment, we:

• Check your blood pressure and weight. 
• Take a urine sample, if you have certain conditions. 
• Listen to your baby’s heartbeat. 
• Measure your abdomen to check your baby's growth. 
• Give you a medication (Rhogam) if you have an Rh-negative blood type. 

We might also talk about: 

• Choosing a doctor for your baby. 
• Reviewing the results of any previous tests, such as for anemia, gestational diabetes, and Rh factor. 
• Healthy weight gain, nutrition, and exercise during pregnancy. 
• Coping with any discomforts you’re having.

We’ll also make sure you’re signed up for appropriate education classes, such as: 

• Childbirth Preparation
• Newborn Care
• Breastfeeding

Signs of preterm labor

Because we don’t want your baby to be born too early, we teach you how to recognize the signs of preterm (premature) labor, such as: 

• Contractions 
• Vaginal discharge 

Knowing these signs can help you to take immediate action to prevent or stop preterm labor. 

What to expect

As you move into the third trimester of pregnancy, your care includes:

• Getting a Tdap booster vaccine to protect you and your baby from whooping cough.
• Selecting the hospital you want to deliver your new baby.
• Reviewing how healthy lifestyle choices such as nutrition, exercise, and work affect your baby.
• Talking about the signs of depression (“baby blues”) that can occur before or after childbirth, and when to call us.

Additional References

• Join a Pregnancy Class

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only. 

• 770.720.7733

What to Expect at Your 10-12 Week Prenatal Appointment

Congratulations, you’re pregnant! If you’re already a parent, you know what to expect, but if this is your first child, navigating through pregnancy can be a mysterious process. Once you reach 10-12 weeks, genetic testing, screening ultrasounds, and gender identification are offered at your appointment. Even if you have been through this appointment in the past with previous pregnancies, genetic testing and screenings can be overwhelming and scary. Don’t let the tests scare you! They are available to ensure both your health and that of your baby.

Screening Ultrasound

A screening ultrasound , called a Nuchal translucency scan, is performed to evaluate for certain fetal problems. Screening tests do not diagnose a birth defect, they determine the risk. This scan measures the baby’s nuchal translucency, the fluid-filled space at the back of your baby’s neck. The results of the scan show your baby’s risk of a chromosomal abnormality like Down Syndrome, heart defects, or other complications. The Nuchal translucency scan is not the only factor in calculating the risk of a chromosomal abnormality. Other factors are the mother’s age, the gestational age of the baby, blood tests, and the Nuchal translucency measurement of the baby.

Genetic Testing

Believe it or not, pieces of your baby’s DNA circulate in your bloodstream! This is why NIPT (non-invasive prenatal test) is performed. NIPT is a prenatal screening, which looks at DNA from your baby’s placenta in a sample of your blood to identify whether you’re at increased risk of giving birth to a child with a genetic disorder. The results of a NIPT test can help the doctor and you decide if further testing is needed or not. The test is safe for you and the baby since it only needs a quick blood draw to be completed.

Finding out the Sex

If you have NIPT done, the sex of the baby can also be determined since the test examines chromosomes. Make sure to discuss with your doctor if you want to find out during this test, you can also find out the sex during your later ultrasound that is usually done between 12-18 weeks.

We’re Here for You

Pregnancy is a beautiful and busy time of your life! Several tests are available in your first and second trimesters to provide information on the genetic health of your developing baby. But all this testing can be confusing and can cause anxiety. The key thing to remember is that testing itself does not make the pregnancy healthy or unhealthy. We gather information from every pregnant patient to look for issues that may cause problems. Our OBs at Cherokee Women’s Health Specialists are help you navigate through your pregnancy journey. Call us at 770.720.7733 or schedule an appointment online.

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Week 17 of Your Pregnancy

It's week 17 of your pregnancy, and you may notice your symptoms are changing. Here’s everything you need to know about this week of pregnancy.

Design By Alice Morgan / Illustration by Tara Anand

Week 17 of pregnancy is an exciting time because you may start feeling movement from your unborn baby. That was the case for me. I was in week 17 when I first felt my twins move. I paused mid-conversation and told my aunt (a mother of two) what I thought was happening. Seconds later, I felt it again, and I immediately became a bag of tears.

New experiences like this tend to make the second trimester exciting for many pregnant people. Here’s what else you’ll want to look for during this week and why you should begin thinking about how to advocate for your unborn baby’s birth.

Pregnancy Week 17 Quick Facts

• At 17 weeks, you're four months pregnant
• You have 23 weeks until your due date
• You're in your second trimester

Your Unborn Baby's Size At 17 Weeks

At this stage, your unborn baby is about 5.12 inches long and weighs 4.94 ounces . That's like the size of a pear.

Pregnancy Symptoms Week 17

While some symptoms may have eased at this point in pregnancy, you might not be able to shake some others like these:

• Round ligament pain
• Energy dips
• Mild cramping

By 17 weeks, I was no longer dragging through my days from intense fatigue , and I loved it. But my energy would drop at some point in the day, and I needed a bed. I couldn't make it without a nap. If you have this feeling, give your body what it needs—rest. If you have the option, plan some downtime in the middle of your day for a quick power nap to recharge your wildly working body.

Design by Alice Morgan

It's also common to experience some mild cramping , but always check with your health care provider if you have any concerns. And muscle and/or ligament pain is not unusual. Some exercise can help that discomfort. "Yoga during pregnancy is very helpful to alleviate some of the muscle and ligament pains that come with the growing uterus," says Jill Purdie, M.D., a board-certified OB-GYN at Pediatrix.

Developmental Milestones

Your unborn baby's eyebrows and hair are forming this week, and they're also starting to grow nails, says Yamel Belen, a Tampa, Florida-based doula and owner of One Love Doula . Their arms and legs are growing and becoming proportional, and the fetus is gaining more weight. Sweat glands are also developing.

Prenatal Tests And Doctor's Appointments

Week 17 is typically an off week from scheduled visits, as there are no significant tests during this time. For other health-related appointments, like dental care or eye exams, be sure to make them aware of your pregnancy.

Common Questions at This Pregnancy Stage

When will I feel my unborn baby move?

If you've been anticipating feeling your baby move , don't be surprised if you do during week 17—especially if this isn't your first pregnancy. "The most common type of movement at 17 weeks is a fluttering feeling in the lower abdomen,” explains Dr. Purdie. “Many describe it as butterflies in their bellies, gas bubbles, or a small tapping sensation."

But it’s also normal if you don’t feel anything at all during week 17. That’s especially true if you’re in your first pregnancy, as most first-time pregnant people will feel fetal movement around 20 weeks.

How often should I feel my baby moving?

Experts say there's no need to clock your unborn baby's movements at this stage. Just enjoy them as they come. "If you do feel movement, it is unlikely to be regular,” says Dr. Purdie. “You may feel some movement one day and then not again for several days.” This is OK.

Things You Might Consider This Week

If you haven't shared the news that you're expecting, people around you may begin to notice as your belly is likely starting to grow at this point. When and how you reveal a pregnancy is a personal choice and there should be no rush. If you want to let relatives, friends, and/or co-workers know at this point, that’s great, and however you choose to do it is acceptable. But with that news can come a ton of questions and a desire for people to rub your belly. Get prepared for how you plan to dodge any unwanted contact or how you might answer questions like, “Do you know what you’re having?” and “Do you know what you’ll name your baby?”

Your growing body can stir up emotions, especially if you’ve ever struggled with an eating disorder . That’s not unusual, but it’s important to find ways to cope if you find yourself struggling or worrying you might begin to. Don’t hesitate to seek therapy if you feel it will benefit you. Your medical provider can be a great resource to help you find a therapist.

Also, consider treating yourself to a prenatal massage. You deserve it! Just make sure it’s a credible place. Your health care provider may be able to recommend a qualified massage therapist in your area.

Support You May Need This Week

Advocacy during birth is essential. But speaking up for yourself may be difficult, especially when you’re vulnerable and going through an intense labor experience. It can be beneficial to have a partner or family member familiar with advocating for your birth plan . Start having these conversations with them. 

If you haven’t already, use this week to also consider having a doula. They familiarize themselves with your needs and desires and can coach you through the rest of your pregnancy. A major part of their job is advocating in birth spaces to ensure your safety.

Head over to week 18 of pregnancy

Related Articles

Second Trimester Weeks—Your Pregnancy Journey Continues

Pregnancy Weeks 13-16: You're Starting to Get the Hang of Being Pregnant​

Good news! Many women find the second trimester of pregnancy to be the easiest and most enjoyable. Morning sickness typically begins to ease, you can feel the baby move, and your belly becomes noticeable. There’s a lot to love about the second trimester, and it’s a great time to focus on your own well-being.  

How Many Calories Should a Pregnant Woman Eat?

During the second trimester, your little one is growing rapidly. To fuel you and baby through this growth, you’ll need to add  about 340 calories per day. That’s only about the equivalent of a peanut butter and jelly sandwich. So be careful not to overeat as you add extra calories. Try incorporating some of these  healthy snack ideas   into your daily routine and check out The Art of Eating for more info about nutrition.

Preparing for Doctor Visits

You’ll begin regular prenatal care visits to your doctor during the second trimester. The frequency varies, but it’s common to have appointments every 4 weeks. Download the  doctor visit checklist to help you prepare for appointments. During these appointments, your doctor will take lots of measurements for both you and baby. If you’re experiencing issues, such as nasal discomfort or continued morning sickness, be sure to let your doctor know. 

Should You Share the News?

Many people wait until week 13 before telling friends and family that they are expecting. This is because statistics show the rate of miscarriage drops dramatically during the second trimester. The decision of when to tell people the news is very personal, and there are many individual factors to consider. Whatever you decide, remember that the right answer is the one you’re most comfortable with. 

Pregnancy Weeks 17-19: Pregnancy Doctor Visits—You, Your Baby, and Your Doctor

Second trimester weeks - pregnancy symptoms, pain & fetus growth.

Your little one is making major developments during this time—and some you can even feel. How exciting! As you continue to go to appointments, be sure to let your doctor know how you’re feeling and what you’re experiencing. 

There’s A Lot to Know About You & Baby

By this time, you may be able to determine a lot of information about you and your baby. An ultrasound or sonogram can reveal:

• The sex of your baby
• Whether you’re having more than 1 baby
• Your baby’s fetal age
• Location of your placenta
• Fetal position, movement, breathing, and heartbeat
• Amount of amniotic fluid
• Length of your cervix

Your doctor will take note of these factors and keep track of how things are developing. In future appointments, they will measure growth and change in many of these areas. 

Your Next Doctor Visit — When to See a Doctor When Pregnant?

Sometime around week 18 of pregnancy is a common period for a prenatal doctor appointment. Be sure to download the  doctor visit checklist to help you prepare. During this appointment, the doctor will measure things like baby’s size, movement, blood pressure, and heartbeat. You may even have the joy of hearing your baby’s heartbeat (if you haven’t already) through the use of a Doppler instrument.

Fat Intake During Pregnancy

Fat is important for your baby’s development, but not all fats are the same. According to the American Heart Association, the majority of the fats you consume should come from unsaturated fats. Polyunsaturated and monounsaturated fats are especially important during pregnancy. Be sure to check the nutrition labels of foods for these fats and try to avoid trans fats as much as possible. Read more about nutrition in  The Art of Eating .

Pregnancy Weeks 20-22: When Can You Feel the Baby Move?

Have you felt your little one moving yet? If you haven’t, you probably will very soon. Your baby is developing very rapidly and starting to gain senses and move around in the womb. You might even feel a little hiccup from your baby.

Baby Movement—Breathing, Hearing, and Kicking in Belly

By now, your baby’s limbs are well developed, and their brain is moving their limbs, both voluntarily and involuntarily—and you can feel it! They can also hear things both inside and outside your body. Your little one is hearing things like your heartbeat, your stomach gurgling, your voice, and the voices of others. So, go ahead and sing a song to your baby—they can hear you!

Iron and Anemia in Pregnancy

During pregnancy, your body produces more blood to help support the growth of your baby. Because of this, your body requires more iron and other nutrients to keep up with the increased blood production. If you do not have enough iron in your diet, you may develop anemia—a condition in which your blood doesn’t have enough red blood cells to deliver oxygen to you and your baby. If your doctor determines you have anemia, you may be required to add iron into your diet via a supplement or diet alteration.

Week 22: Pregnancy Checkup

You’re probably planning a visit to your doctor for another prenatal visit around the 22nd week of pregnancy. Here’s what you can expect: 

• Similar to previous prenatal checkups, your doctor checks both your health and your baby’s progress.
• Your doctor may discuss an upcoming glucose screening—a routine test that checks for gestational diabetes. You might take this test at your next appointment, sometime between the 24th and 28th week of pregnancy.

Swollen Gums & Gingivitis During Pregnancy

Of all the things to consider during pregnancy, oral health may not be the first thing on your list. But it’s common for pregnant women to experience swollen, tender, or even bleeding gums. This is because you have increased progesterone hormone levels, which can make you more susceptible to developing the bacterial plaque that impacts gum health. Be sure to practice good oral health, eat a healthy diet, and visit your dentist to help combat gingivitis during pregnancy. 

Pregnancy Weeks 23-25: Avoid Pregnancy Issues—Taking Care of Baby Means Taking Care of You

A healthy mom gives baby the best chance of being healthy. Take some time to make sure you’re on track with your weight, stress levels, and nutrition. You and your doctor should be tracking several health indicators to make sure you’re headed in the right direction.

Gestational Diabetes During Pregnancy

During a prenatal doctor visit, you may undergo a glucose screening to determine if you’re at risk for gestational diabetes. Gestational diabetes is a condition in which you have high blood sugar levels during pregnancy, despite having normal blood sugar levels before pregnancy. You can still have a healthy baby if you have gestational diabetes. If it’s determined that you have gestational diabetes, your doctor will work with you to manage your blood sugar levels during pregnancy. 

Urinary Health

Urinary tract infections (UTIs) are not uncommon during a pregnancy. This is because the uterus sits directly on top of the bladder. As your uterus grows during pregnancy, its increased weight can block drainage of the bladder and lead to infection. Symptoms of a UTI include:

• Pain or burning (discomfort) when urinating
• The need to urinate more often than usual
• A feeling of urgency when you urinate
• Blood or mucus in the urine
• Cramps or pain in the lower abdomen
• Pain during sexual intercourse
• Chills, fever, sweats, or leaking of urine (incontinence)
• Waking up from sleep to urinate
• Change in the amount of urine, either more or less
• Urine that looks cloudy or smells foul or unusually strong
• Pain, pressure, or tenderness in the area of the bladder
• When bacteria spreads to the kidneys, you may experience back pain, chills, fever, nausea, and vomiting.

If you experience some or all of these symptoms, contact your doctor immediately.

How to Choose a Pediatrician?

Many pregnant women will begin   their search for a pediatrician around this time. Having to interview and select a physician while you’re managing a newborn can be time consuming. So, choosing a pediatrician while you’re still pregnant may ease the stress of parenthood after the baby has been born. Because every parent is different, it’s important to know what matters most to you in choosing a doctor for your baby. In addition to  our pediatrician checklist(PDF, 75 KB) , you can also check out these  recommendations from Parents.com for helping you make the right choice. 

Joint & Hip Pain During Pregnancy—Be a Little Extra Careful

As you progress through pregnancy, it’s common to feel as if your joints and ligaments have loosened or weakened. This is because your body is releasing the hormone relaxin.  As you move closer to labor, this is your body’s way of opening up your pelvis to deliver your little one. Because your joints are a little looser, you’ll want to be extra careful as you go through your day-to-day activities—especially if you’re doing exercise like yoga, Pilates, or other fitness regimens. As always, consult your physician to discuss your exercise routine during pregnancy.  

What Is Normal Weight Gain During Pregnancy?

With all the information out there about diet, nutrition, and weight, it can be easy to become overwhelmed. Just remember that it’s never too late to start a healthy diet plan, no matter how much you weigh. For more on healthy eating during pregnancy, see  our prenatal nutrition guide . A certain amount of  weight gain is completely normal, and you shouldn’t necessarily be discouraged by what you see on the scale. As always, consult your doctor if you think your weight is unhealthy. 

Pregnancy Weeks 26-27: What You Need to Know at the End of Your Second Trimester​

Ok, pregnancy isn’t always pleasant. Heartburn, constipation, and Braxton Hicks contractions all become common concerns for women as they head into the third trimester of pregnancy. But, don’t worry, you got this. Read on to learn how you can manage some of these events.

Managing Heartburn and Constipation in Pregnancy

Your expanding uterus and hormonal changes may be causing you to experience some digestive issues. Your diet and nutrition during this period can help relieve or reduce the symptoms of pregnancy-induced heartburn and constipation. See  our guide for managing these conditions .

Preterm Labor vs Braxton Hicks Contractions During Second Trimester

According to the Mayo Clinic, preterm labor occurs when regular contractions result in the opening of your cervix after week 20 and before week 37 of pregnancy and can result in premature birth. If you think you’re experiencing preterm labor, call your healthcare professional or call 911. Even if you’re unsure, call your doctor just to be safe. In contrast to preterm labor signs, Braxton Hicks contractions are irregular, weak contractions that vary in length and intensity and typically stop when you rest, walk, or change positions.

Consult your physician for help determining the difference between preterm labor and Braxton Hicks contractions.  

You and Baby Are a Team. Take Care of the Both of You.

You and your little one are on this journey together. So while you’re taking care of baby, also make sure you’re taking care of yourself. Be aware of how you’re feeling physically, mentally, and emotionally. Drink plenty of water, follow nutrition guides, go for walks to relieve stress, and find support groups of other parents that understand what you’re going through. Sometimes it’s nice to hear that other people have had the same experiences you’re having—the good ones and the not-so-good ones. 

References:

Pregnancy week by week. Mayo Clinic website. Accessed August 3, 2023.  https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044581

Best time to tell people about pregnancy. Healthline website. Accessed August 3, 2023.  https://www.healthline.com/health/pregnancy/when-to-announce-your-pregnancy#first-prenatal-visit

Pregnancy nutrition chart: 32 essential nutrients for pregnant women. What to Expect website. Accessed August 3, 2023.  https://www.whattoexpect.com/pregnancy/fat-in-diet/

Anemia in pregnancy. WebMd website. Accessed August 3, 2023.  https://www.webmd.com/baby/guide/anemia-in-pregnancy#1

Gingivitis during pregnancy. Healthline website. Accessed August 3, 2023.  https://www.healthline.com/health/pregnancy/gingivitis#treatment

Signs of labor. What To Expect website. Accessed August 3, 2023.  https://www.whattoexpect.com/pregnancy/labor-signs#joints

Glucose Screening. Mayo Clinic website. Accessed August 3, 2023.  https://www.mayoclinic.org/tests-procedures/glucose-tolerance-test/about/pac-20394296

Gestational diabetes. WebMD website. Accessed August 3, 2023.  https://www.webmd.com/diabetes/gestational-diabetes-guide/gestational-diabetes#1

Urinary tract infections during pregnancy. American Pregnancy website. Accessed August 3, 2023.  https://americanpregnancy.org/womens-health/urinary-tract-infection/

How to select a pediatrician. Parent Magazine website. Accessed August 3, 2023.  https://www.parents.com/baby/care/pediatricians-medicine/how-to-select-a-pediatrician/

Preterm labor. Mayo Clinic website. Accessed August 3, 2023.  https://www.mayoclinic.org/diseases-conditions/preterm-labor/symptoms-causes/syc-20376842

Braxton Hicks Contractions. What to Expect Website. Accessed August 3, 2023.  https://www.whattoexpect.com/pregnancy/symptoms-and-solutions/braxton-hicks-contractions.aspx

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Pregnant mom, 25, experienced blurry vision, headaches and doctors advised her to rest. Weeks later she died

Olivia “Liv” Harlow, 25, was 32 weeks pregnant with her second daughter when her vision blurred. Later, she visited a hospital where doctors gave her a “pregnancy safe scan” and then sent her home. But her health worsened, and she began experiencing intensely painful headaches. Then on June 16 at 37 weeks pregnant, Harlow of Brisbane, Australia, learned her baby, Adeline, had died. 

Still, her headaches and blurry vision persisted and days later, her partner, Ryan Stephenson, found her unconscious on the floor.

“The hospital conducted full CT scans and all relevant tests, and the results showed that Liv had multiple masses in her head/brain and on her lungs,” her sister-in-law Stefanie Harlow, 32, of North Queensland, Australia, tells TODAY.com via email. “She had a large mass to the back of her head … that caused her to stop breathing etc. Hence, her unresponsive state. This large (mass) had also ruptured.”

Doctors told the family that Liv Harlow was “brain dead” and they said goodbye to her.

“The doctors could not explain why in 26 days, she had nothing in the original scan and then by the second scan she had so many of these masses,” Stefanie Harlow says. “They said they’d never seen anything like it.” 

Headaches, blurry vision in late pregnancy

Liv Harlow grew up in a small rural town and enjoyed competing in equestrian events with her horse. In school, she earned good grades and dreamed of being a lawyer. After graduating, she worked as a governess at cattle stations in Western Queensland before moving closer to home and eventually meeting Stephenson. After giving birth to their first daughter, Evaliah, in April 2020, Liv Harlow became a stay-at-home mom. She loved sports and participated in any she could.  

“It didn’t matter what activity was on offer, she was always keen to be involved,” Stefanie Harlow says. “Liv has always been healthy, fit and active.”

After her blurry vision began, doctors told Liv Harlow that her pregnancy was “high risk” and worried that her sight troubles could be “an early sign of stroke.” By the time she was 34 weeks pregnant, she went to the emergency room where doctors performed a “pregnancy safe scan” of her head and brain.

“The result was perfectly clear, and nothing was abnormal,” Stefanie Harlow explains. “She was released and sent home to rest and take it easy.”

Then 18 days later, Liv Harlow experienced something troubling — baby Adeline stopped moving. Panicked, she visited the hospital where scans revealed that Adeline had died at 37 weeks. After delivering her baby “forever sleeping,” Liv Harlow underwent some following up postnatal exams and was released. But she did not feel well.

“She was still suffering these intense headaches and blurred vision,” Stefanie Harlow says.

Again, Liv Harlow visited the hospital and doctors re-examined the scan taken while she was pregnant. They looked clear and doctors sent her home again to rest without conducting new tests. Two days later, Stephenson found her “on the floor unresponsive.”

“(An ambulance) rushed her to the hospital where she was placed on life support,” Stefanie Harlow says.

After several tests, doctors found the masses in her head and lungs.

“The doctors were unable to determine what they actually were at the time and what caused them,” Stefanie Harlow says. “We were told (the masses) were inoperable and that Liv was already brain dead.”

Devastated, the family “prayed for a miracle,” but sadly Liv Harlow’s health did not improve. By June 24, the family said their goodbyes before they took the young mom off life support.

“We feel very sad that this was our family’s outcome,” Stefanie Harlow says. “We don’t understand why or how this happened so quickly.”

Finding answers and raising awareness

Stefanie Harlow is married to Liv Harlow’s older brother, Christopher, and the two were expecting their sixth child at the same time as Liv Harlow was expecting Adeline.

“That was really tough and super emotional for both our families,” Stefanie Harlow says. “Liv and I were due to have our baby girls a week apart with me due first.”

The family doesn’t know why Liv Harlow developed the masses and if they caused her death and the coroner kept her brain to conduct more testing. Results could take up to two years for the family to understand what happened to Liv Harlow.

“We have to wait for those answers as we don’t know what they were or what caused them,” Stefanie Harlow says. “Understandably, we are all struggling to come to terms with these tragic losses.”

As they grapple with “disbelief and shock,” the family wanted to share Liv Harlow’s story to encourage others who do not feel well to advocate for their health.

“We thought it would be a good opportunity to bring some light to the situation so should future women find themselves in a similar position they might have the courage to push harder for further testing to be done,” Stefanie Harlow says. “I just hope that everyone who presents to a hospital knowing their own bodies and sensing something isn’t right have the courage to speak up and they want more done for themselves.”

Meghan Holohan is a digital health reporter for TODAY.com and covers patient-centered stories, women’s health, disability and rare diseases.

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Fentanyl misuse during pregnancy can cause severe birth defects

The number of babies born with severe birth defects affecting their growth and development is rising, as researchers now have strong evidence that illicit fentanyl is causing the problems.

Hospitals have identified at least 30 newborns with what has been identified as “fetal fentanyl syndrome,” NBC News has learned. The babies were born to mothers who said they’d used street drugs, particularly fentanyl, while pregnant.

“I have identified 20 patients,” said Dr. Miguel Del Campo, a medical geneticist at Rady Children’s Hospital in San Diego who specializes in children exposed to drugs and alcohol in utero. “I fear that this is not rare, and I fear kids are going unrecognized.”

The syndrome was first identified in 10 babies last fall by geneticists at Nemours Children’s Health in Wilmington, Delaware. The infants had specific physical birth defects: cleft palate, unusually small heads, drooping eyelids, webbed toes and joints that weren’t fully developed. Some had trouble feeding.

Published research about the babies caught Del Campo’s attention. He’d previously diagnosed some children with similar abnormalities with fetal alcohol syndrome, even though their mothers denied drinking while pregnant.

“After reading the paper and thinking about things,” he said, “I have recognized the potential for exposure to fentanyl.”

Dr. Karen Gripp, a geneticist at Nemours, and her team were the first to identify the 10 babies with fetal fentanyl syndrome last fall. “This is another huge piece of the puzzle” explaining the defects, she said.

The birth defects in the babies closely resemble a rare genetic condition called Smith-Lemli-Opitz . It’s a condition that affects how fetuses make cholesterol, which is critical for the brain to develop properly. But none of the babies had Smith-Lemli-Optiz.

The mothers’ reported drug use was a strong clue as to what was causing the defects, but there was no scientific evidence that fentanyl stopped cholesterol production in developing fetuses.

When Gripp and a team of researchers at the University of Nebraska Medical Center exposed human and mouse cells to fentanyl, they discovered that the drug directly disrupted their ability to make cholesterol.

“This is not something that people had known before, that fentanyl interferes so significantly with cholesterol metabolism,” Gripp said. “This is so important because cholesterol needs to be synthesized as the embryo develops.”

Their paper explaining the connection was published in Molecular Psychiatry in June.

Who is at risk

Illicit fentanyl use during pregnancy is a known risk factor for preterm birth and stillbirth. Babies born after significant fentanyl exposure in utero may have seizures, vomiting, diarrhea and be irritable, fatigued and have trouble feeding.

But despite a rise in fentanyl misuse, even during pregnancy , there is no indication of a concurrent rise in birth defects. And most babies exposed to fentanyl in utero aren’t born with the defects that are hallmarks of the fetal fentanyl syndrome.

The new research helps to explain that.

While two copies of the gene that causes Smith-Lemli-Optiz result in the syndrome, cells with just one copy of that gene were more likely to be affected by fentanyl exposure.

That is, a single copy of the gene may make some babies more vulnerable.

“Not everyone is equally susceptible,” Dr. Karoly Mirnics, one of the study authors and director of the University of Nebraska Medical Center's Munroe-Meyer Institute, said in a press release announcing the results. “The potentially adverse effects of any medication or chemical compound might depend on your genes, lifestyle and environmental factors. One drug might not cause problems for me and might be catastrophic for you.”

Gripp expects the number of documented fetal fentanyl cases will rise with awareness and continued research.

“The group is growing,” she said. “We anticipate that there will be many more patients.” 

Del Campo, also an associate professor at the University of California San Diego, said it’s critical to diagnose babies appropriately with fetal fentanyl syndrome so doctors can follow them long term.

“We need to know how these kids are doing. I have some 2 year-olds that are very concerning,” he said. “They’re just not growing or developing.”

Erika Edwards is a health and medical news writer and reporter for NBC News and "TODAY."

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Breaking’s Olympic Debut

A sport’s journey from the streets of new york all the way to the paris games..

Hosted by Sabrina Tavernise

Featuring Jonathan Abrams

Produced by Sydney Harper Luke Vander Ploeg Shannon M. Lin and Will Reid

Edited by Lexie Diao MJ Davis Lin and Ben Calhoun

Original music by Dan Powell Marion Lozano and Diane Wong

Engineered by Alyssa Moxley

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More than 50 years after its inception, “breaking” — not “break dancing,” a term coined by the media and disdained by practitioners — will debut as an Olympic sport.

Jonathan Abrams, who writes about the intersection of sports and culture, explains how breaking’s big moment came about.

On today’s episode

Jonathan Abrams , a Times reporter covering national culture news.

Background reading

The Olympic battles in breaking will be a watershed moment for a dance form conceived and cultivated by Black and Hispanic youth in the Bronx during the 1970s.

Breakers are grappling with hip-hop’s Olympic moment. Will their art translate into sport?

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Jonathan Abrams writes about the intersections of sports and culture and the changing cultural scenes in the South. More about Jonathan Abrams

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