During pregnancy, a series of routine tests are carried out, and others are only carried out if there is a specific problem. There are tests that can be done at any moment, such as blood tests, but others require a specific moment of your pregnancy, so that the result is precise.  

Prenatal tests in the first trimester

In the first trimester, more in-depth tests are carried out in order to determine the status of the pregnancy. Some of these tests are repeated throughout the different trimesters, while others are only done once.  

• Blood test. During your first appointment, your doctor will request a blood test in which he will check, amongst other things, your levels of iron, red blood cell count, your blood group and RH factor, the existence of antibodies for certain illnesses and of course, whether you are pregnant.

• Urine test. The urine test is requested along with the blood test and will serve to check if there are signs of diabetes or a urinary infection.  

• Measuring your blood pressure. During pregnancy, blood pressure undergoes changes and it is monitored in all prenatal appointments.

• Internal exam. The doctor will carry out an internal vaginal exam to check the opening of your cervix. He will also take a sample of your cervix cells in order to do a pap test and make sure everything is normal and there are no sexually transmitted diseases.  Besides, if your pelvis is not too wide, she will measure you to make sure you are wide enough for the baby to pass through during delivery.

• Ultrasound or sonogram. In the first ultrasound, the doctor will determine whether there is a fetal heartbeat, where the placenta is, whether there is an ectopic pregnancy and she also checks to see if the date of the pregnancy corresponds with the baby’s size.  

• Triple screen or triple marker. This consists of a blood test that determines whether there is a risk of the baby having certain anomalies. The results are only a probability. In the event of there being a result that would indicate the possibility of there being a problem, further tests such as an amniocentesis would be required to confirm this. 

• Chorionic villus sampling. It is usually done if there is a specific problem that must be ruled out because there was already a genetic anomaly in the family, or the suspicion that there could be one. This test must be performed between weeks 10 and 12 of pregnancy.  

Prenatal tests during the second trimester  

Some of the tests during this trimester are a follow-up of those that were done in the first trimester, and others are tests that are done specifically in this trimester.  

• Blood test. In this month, it is important to rule out anemia, due to the increase in blood volume during pregnancy and the increased need for iron.  

• Urine tests. The main objective is to rule out urinary infections, that are very common in pregnant women and to make sure there is no sugar in the urine, or proteins that could indicate the existence of a dangerous illness, known as preeclampsia. 

• Taking your blood pressure. The doctor will take your blood pressure to make sure you don’t have hypertension, especially if you are having frequent headaches.

• Ultrasound. In this trimester, around week 20, you should get another ultrasound done, in order to check the baby’s development, the position of the placenta and the amount of amniotic fluid.

• Glucose test. In this trimester, significant hormonal changes take place that can affect how blood sugar is processed. This test serves to rule out gestational diabetes, a very common illness in Latinas.

• Glucose curve. It is a very similar test to the previous one, but longer, that is carried out when the glucose test shows an abnormal result. The glucose curve can confirm whether there is gestational diabetes or not.  

• Amniocentesis. Amniocentesis can establish whether there is an anomaly in the baby’s chromosomes. This requires taking a sample of amniotic fluid through the belly.  

Prenatal tests during the third trimester

• The tests during this trimester still monitor the mother’s health and others are doBlood tests. Besides the routine checks for iron levels, in this month your blood clotting capability is measured in the event of anesthesia being used in the delivery.

• Urine tests. In this trimester it is important to check that there is no protein in the urine, in order to rule out preeclampsia, sugar or infections.

• Rectal-vaginal culture. The doctor will take a sample from the vagina and the anus to rule out any type of streptococcus infection that could be dangerous for the baby.

• Ultrasound. This ultrasound is performed to make sure the placenta and the umbilical cord are correctly placed for delivery.  

• Biophysical profile. The doctor sometimes requests this test, especially if the baby is late. This test combines a registry of the baby’s heartbeat with an ultrasound. To determine the amount of amniotic liquid there is and whether the baby is moving properly.

Cystic fibrosis is a hereditary illness. In order to find out if you or your husband is a carrier of the defective gene that causes it, you should undergo a blood test. The study of the chromosomes will determine if the gene is present or not.  

What is cystic fibrosis?

Cystic fibrosis is an illness that affects the lungs and the digestive system. This illness is caused by a defective gene that causes the body to secrete a dense and sticky mucous. In the United States, there are at least 30.000 children and adults that suffer from this illness and 1 out of every 11.500 Hispanic children are born with this illness.  

This mucous obstructs the lungs and causes numerous and severe respiratory illnesses. Besides, the mucous also obstructs the pancreas and doesn’t allow the body to process food in a normal way.  

Cystic fibrosis does not have a cure and some years ago, it was very difficult for children to survive it. However, current treatments not only enable sufferers to survive it, but to have an almost normal quality of life.  

How to know if your baby has cystic fibrosis

Cystic fibrosis is hereditary, and for the baby to inherit it, both the mother and the father must have this defective gene. In order to know if you or your husband could be carriers of cystic fibrosis, you must undergo a chromosomal study. To know whether your baby has it or not during pregnancy, it is necessary to study the baby’s chromosomes by means of a test such as amniocentesis or chorionic villus sampling. 

When the baby is born, this illness is usually detected in the first few days or before the baby turns two. If the pediatrician detects certain symptoms she will probably request a sweat test or a genetic test to confirm the illness.  

Some of the symptoms of cystic fibrosis are:

• Constant coughing and phlegm

• Very frequent pneumonia and bronchitis

• Shortness of breath

• Very salty skin

• Not gaining weight despite eating a healthy amount

Treatment of cystic fibrosis

Although there is currently no known cure, thanks to current treatments, it is possible to survive many more years than before, and with a nearly normal quality of life. The symptoms are treated with drugs that reduce the density of the mucous, antibiotics to fight infections and bronchial dilators that make breathing easier despite the excessive phlegm.  

You may obtain more information about this illness in non-profit organizations such as the Cystic Fibrosis Foundation or in the encyclopedia of the National Library of Medicine.

Diabetes is an illness that affects Latinos especially. During pregnancy, there is a similar illness, known as gestational diabetes that is also more common amongst Latinas. To make sure there is no gestational diabetes, or to take the necessary steps if need be, the glucose test is carried out.  

What is the glucose test?

This test measures the sugar in your blood, in order to find out whether your body is processing what you eat efficiently or not. During pregnancy, a series of hormones are produced that may interfere with the functioning of insulin. Insulin is a hormone that enables cells to use the food you eat and to have the energy to continue carrying out their functions.

Throughout pregnancy, your doctor should have checked that there was no sugar in your urine, in the samples that are requested in every prenatal appointment. In the case of Latinas, it is even more important to get checked, due to our increased risk of having gestational diabetes.

The glucose test is done between weeks 24 and 28 of pregnancy and if the results indicate there is a problem with the processing of sugar, then the doctor will request a similar test, but longer in time, that is known as the glucose curve.  

What the test involves

It is a very simple test that is not too uncomfortable. You must go to your appointment on an empty stomach. When you arrive, they will give you a very sweet drink that tastes like orange soda, but a lot sweeter. It contains 50 grams of glucose, and is designed to see how your body handles high levels of sugar. The nurses will make a note of the time at which you drank the sugary drink and will ask you to come back in an hour.

During that hour, try to remain seated in case you get dizzy. After this time, they will draw blood in order to check your blood-sugar levels. You will get the results a few days later and if they are not within the normal range, then your doctor will probably want you do undergo the glucose curve.

The blood sugar value that is considered normal for a pregnant woman in these weeks is of 140 ml/dL, but take into account that this figure could vary depending on the hospital or lab that does your blood work.

The glucose curve

It is very similar to the previous test, but it requires a longer time. You will also have to go to your appointment on an empty stomach and spend some time at the doctor’s office or lab, so you should request the earliest possible appointment.

When you arrive, they will draw blood to have a reference of what your glucose level was on an empty stomach. Then you will be asked to drink a sugary drink, similar to the one used in the glucose test, but with twice the amount of sugar. After that you will have to wait for three hours, during which blood will be drawn in order to see how your body is processing the glucose.

The figures obtained are compared with a normal scale to check if you have gestational diabetes or not. Not all the figures may be outside the normal range, which would indicate that you have a tendency to have difficulties when it comes to processing blood sugar, but that you have not yet developed gestational diabetes.

This test, just like amniocentesis analyses chromosomes to check for anomalies, although the procedure used to obtain the genetic material is different.  

What is chorionic villus sampling

This test requires obtaining a sample of chorionic villus to analyze the baby’s chromosomes. Chorionic villi are the tiny fingerlike projections that attach the amniotic sac to the uterus. These villi have some of the baby’s cells, which are then cultured to obtain a sample of the baby’s chromosomes.  

Although it is a test similar to amniocentesis, chorionic villus sampling is done between weeks 10 and 12 of pregnancy. That is, it can be carried out five weeks before amniocentesis. Also, the results come back earlier.  

This test can establish whether there is a problem in the chromosomes, such as Down’s syndrome and it can also look for specific genes such as that for cystic fibrosis, if there is a family history of that. This test does not detect other problems such as spina bifida.  

How the test is carried out

The villus sample may be obtained in two ways: with a procedure similar to a gynecological exam or with a procedure similar to the amniocentesis.  

In the first case, your doctor will disinfect the external and internal parts of your vagina. She will then introduce a very small tube and will vacuum the villi. It is a very similar procedure to when the doctor takes a sample of your cervix in order to carry out a pap smear.  

The other procedure is through the belly. This entails inserting a needle in your belly and extracting a small sample of villi through the needle.

Potential risks

This procedure has a higher risk of miscarriage than amniocentesis; there is one miscarriage for every 100 to 200 tests. There is a risk for the babies of mothers who have undergone this test to have defects in their extremities or the jaw. However, this only happens in one out of every 1000 to 3000 pregnancies. When the test is done after the tenth week of pregnancy, the risks are even lower.  

Chorionic villus testing is usually done when there is a history of a previous baby with chromosomal problems or if there is a family history of a certain genetic disease, such as cycstic fibrosis, and there is a probability of the baby having one of those genes.  

In the event that you decide to undergo this test, make sure that the doctor or technician who is going to carry it out is experienced, to minimize the risks. If a villus sample is obtained on the first attempt, the test won’t have to be repeated and therefore the risks will decrease.  

When to call the doctor

This test does not puncture the amniotic sac; it only takes villi from the exterior. After the procedure it is normal to spot a little or to feel discomfort. However, if you are leaking fluid (it could be amniotic fluid) or if you feel contractions or more pain, you should call your doctor immediately or go to the hospital, to make sure you are not in preterm labor.

The triple screen or triple marker test is a probabilities test. It indicates the possibility of the fetus having an anomaly, but it does not provide a surefire diagnostic such as amniocentesis. If the test shows there could be a problem, it can be confirmed or ruled out by implementing other tests.  

What is the triple screen test?

It is a blood test that measures the presence of a substance called alpha-fetoprotein along with the mom’s blood levels of two hormones: estriol and gonadotropin. It measures three components; that are why it’s called triple screen (although nowadays there are many other tests that measure more than three components). 

If the levels of alpha-fetoprotein and estriol are low, and the level of gonadotropin is high, it is considered that the baby could have some chromosomal anomaly, such as Down’s syndrome.  

Other analyses of the mother’s blood

Besides the triple screen in the latest years, other kinds of analyses are also being carried out such as the quadruple marker. This measures one more hormone, called inhibin A, which determines more precisely the possibility of having a problem.

There is another test that is being used more and more and that measures the level of a hormone and a protein in the mother’s blood: PAPPA-A and B-HCG respectively.

Both the triple screen and this test are done between weeks 15 and 20 of pregnancy.

Nuchal translucency screening test

A test that is being widely used lately in combination with blood tests is the nuchal translucency screening test. This test helps determine whether the baby has Down’s syndrome. It is basically an ultrasound that checks the baby’s neck fold. Babies with Down’s syndrome usually have a thicker than normal neck fold. This test, along with blood-tests, is very reliable.   

Because this test involves interpreting the ultrasound images, it is important that the technician doing it is experienced. Nuchal translucency screening is done between weeks 11 and 13 of pregnancy.  

False positives

If the test results indicate there could be an abnormality, don’t fret. These tests only indicate the possibility that something is amiss, but they don’t confirm it (like an amniocentesis does).

There are several reasons for which there could be a false positive result, but the most common are:  

• There is more than one baby on the way, and therefore hormonal levels vary.

• The weeks of pregnancy hadn’t been properly calculated and the baby is in fact older or younger.  

• Cigarettes, insulin or obesity could also alter hormonal levels.  

Even though false positives happen sometimes, the great advantage of these tests is that they hold no risk of causing a miscarriage.  On the other hand, the fact that a false positive occurs does not imply that you need to have an amniocentesis. Some moms prefer to go for a level II ultrasound. 

In general, if there is a positive result, the tests are repeated in order to confirm the result, before going for more invasive tests to find out whether there is a problem.

Amniocentesis is one of the genetic tests that are most commonly carried out during pregnancy in order to determine whether there are chromosomal anomalies in the baby. It is a test that has a small risk of miscarriage, because it involves extracting a little bit of liquid from the amniotic sac. The results are reliable, as it is not a screening test.  

What is amniocentesis?

The objective of an amniocentesis is to obtain a small amount of amniotic fluid in order to take baby cells to analyze its chromosomes. The liquid is obtained by inserting a needle in the mother’s belly. This liquid usually contains some of the baby’s skin cells and when they are cultured, a kind of snapshot of these chromosomes is obtained.

By pairing off and observing chromosomes, you can find out if there is an extra chromosome that may cause an alteration in the baby’s development. For example, in Down’s syndrome –one of the most common anomalies- the baby has three chromosomes in the 21st pair, instead of just two. Amniocentesis can also check the genes, the smallest parts that chromosomes are composed of; to ensure that there is not a specific hereditary problem.

Although rare, it could happen that no cells are found in the extracted fluid, or that the culture is not successful. In this case the extraction must be done all over again. Amniocentesis is carried out between weeks 15 and 18 of pregnancy.

Reasons to undergo an amniocentesis

In general, amniocentesis is offered routinely to women over 35, because they are statistically at a higher risk of having a baby with a chromosomal alteration. Besides, it is also used in order to rule out any anomaly if the screening tests show the possibility of there being a problem. It is also used to locate the existence of hereditary genes that cause some illness such as hemophilia.

Currently there are very few illnesses that may be cured with the baby in uterus. What the amniocentesis results provide is information that may help the parents determine whether to go on with the pregnancy, and if so, what measures should be taken during delivery.  

Amniocentesis is an option that a pregnant woman may use or not. Some mothers decide they do not want to have this information at hand because they would have the baby anyway, and others prefer to undergo this test in order to rule out any possible option even when they are under 35 years old. 

How an amniocentesis is done

There is no special preparation required for this test, although you should take a few days off after having it done, in order to rest. This is because a small puncture is performed on the amniotic sac, and it must be given time to close. Plan to have your partner or a family member go with you, to feel more at ease.  

In order to carry out the test, you will be asked to lie down and expose your belly. They will disinfect the area where the needle will be inserted and you may be offered local anesthesia to avoid discomfort.

Before inserting the needle, the doctor will check which the best location is by means of an ultrasound. Don’t worry: he won’t prick your baby. Babies instinctively move away from it.

You may feel a slight prick, just like when you get a blood test, but that’s all. It isn’t a painful test. The doctor will guide the needle using the ultrasound, until it reaches the appropriate point, and will proceed to extract the amniotic fluid. He won’t extract much; only the equivalent of a couple of tablespoons. Then all you have to do is go home and be on bed rest for at least 24 hours, or 48 if you can. The results should be ready in a couple of weeks.  

After the test

There is a small risk of a miscarriage or an infection right after the test. For every 200 to 400 amniocentesis that are carried out, there is one miscarriage and one infection happens for every 1000 amniocentesis.

It could be normal to have a small leak of fluid after the test, but if the amount increases or doesn’t stop after a few hours, you should contact your doctor immediately.  

You should also call your doctor or go to the hospital if you feel painful contractions or if you are bleeding or have any symptom of preterm labor. 

Of all the tests you will have done during your pregnancy, this will probably be your favorite. By means of the ultrasound, also known as sonogram, you will be able to see images of your baby sleeping or moving her hands and feet. On the other hand, the ultrasound will also provide your doctor with invaluable information concerning your pregnancy and your baby’s development.

How is an ultrasound done?

It is a very simple painless procedure. If you are in your first months of pregnancy, they will ask you to drink a lot of fluids and not to urinate before you come to the appointment. When the uterus has not yet grown too much, a full bladder makes it easier to see.

During the appointment you will be asked to lie down and uncover your belly. Then the nurse will apply gel to your belly, in order for a gadget called a transductor to better slide on the surface. The transductor is rather small in size (depending on the model it could be the size of a deck of cards) and emits sound waves that are registered in a computer and then converted to images of your baby. You will be able to see these images on a screen.

Ultrasounds have been around for forty years already and are considered safe for both the baby and the mom.  

Vaginal ultrasound

Sometimes, for the ultrasound that is done in the first few weeks, a vaginal transductor is used instead of the one used on the belly.  The baby is still very small and this helps to get a clearer image.

In order to carry out a vaginal ultrasound, a small transductor is introduced in the vagina, which is the size and shape of a tampon, and is shielded with a condom. The technician will move the transductor around to find the clearest image of the baby, and to take the necessary measurements once it finds the baby.  

What an ultrasound can tell the doctor

Ultrasounds provide information about the baby’s structure and internal organs, as well as the placement of the placenta, amongst other things. The first ultrasound, besides being the most exciting for you and the father-to-be, because you will see your baby’s heartbeat for the first time, will also provide your doctor with very important information concerning:  

• The baby’s age. The dates you give to your doctor may not coincide with the baby’s size. By using an ultrasound, the doctor can determine how many weeks and days old the baby is, based on its development stage.

• Position of the placenta and the fetus. Thanks to the images of your uterus, your doctor can determine if the placenta is correctly placed or if it is in a position that could create problems during pregnancy or birth, such as what is known as placenta previa. Placenta previa could be one of the causes of vaginal bleeding. 

• Number of babies. More than one mom-to-be is surprised during the first ultrasound, to find that she is carrying ¡two or more babies! 

• Amniotic fluid. The ultrasound enables to see if the baby is floating in an adequate amount of amniotic fluid, or if there is not enough fluid and something has to be done about it.  

• Heartbeat. This is one of the first things your doctor will be looking for in the first ultrasound. Listening to your baby’s heartbeat for the first time is a very emotional experience. Try to share this moment with the dad-to-be.  

The ultrasound also helps rule out important issues such as an ectopic or extra-uterine pregnancy. Through the images, it can also be determined whether all the baby’s basic structures (heart, spine, brain, etc.) are forming correctly.

Your first memories

When the doctor or the technician is done with the ultrasound, he or she will give you the best images of the baby in print. They are your first pictures for the baby album! In some facilities they may even let you videotape the ultrasound so that you can watch it at leisure at home. Ask if this is possible, beforehand, so you can take a videotape, CD or DVD with you to the appointment.  

If there is something that you are watching that you don’t understand, ask your doctor or technician to clarify, but take into account that sometimes technicians are not authorized to comment on what they are seeing and only the doctor may do so.  

Level II ultrasound

It is a normal ultrasound, just as others that you get done throughout your pregnancy, that doesn’t require special equipment to carry it out. The difference is that the technician or your doctor carries out a much more in-depth exam of all the baby’s structures. For example, he or she explores the four heart chambers, the spine, the brain, lungs and all internal organs in general.  

This type of ultrasound is usually done if the mother decides not to have an amniocentesis, in order to make sure all is well.  

3D ultrasound

In the last years, technological advances have made it possible for ultrasound images to be seen in 3D. This enables to clearly see parts of the body that you could not see so well before, such as the toes, placement of the ears, etc.  

3-D ultrasounds don’t always produce good images where you can see the baby clearly. This depends on a series of circumstances such as their placement, the amount of amniotic fluid or simply the precision of the machine.  

Past generations didn’t know how a baby was doing practically until it was born. Technical resources were much more limited than they are nowadays, as well as the understanding of the origin of some problems during pregnancy.  Technological advances in the last decades have also reached the OB/Gyn field, and nowadays they offer a series of routine tests to check the status of the baby that is on the way.

Every test must usually be done at a certain time and some are only carried out if a particular problem is observed. In general, prenatal tests may be divided into three different groups.  

Imaging tests

The ultrasound or sonogram has become an indispensable tool to monitor the baby, since its introduction 40 years ago. Since then, no problems have been documented because of its usage.  Ultrasounds work in a similar way as radars do: images are obtained by means of the sound waves emitted by a gadget they will rub over your belly, or introduce in your vagina. Then the technician or the doctor will interpret those images to see if everything is ok. The ultrasound can determine whether there is a heartbeat, where the placenta is, or if there are visible malformations.

There are different types of ultrasounds, but they are all based on the same system for obtaining images by means of sound waves.

Screening tests

These tests provide information on the baby’s well-being, but they are not definitive data because all they give is a probability: the probability rate that your baby has of having a genetic defect or any other kind of anomaly.  

Screening tests can often provide what is known as a “false positive” result. They initially indicate there could be a problem, but when the tests are repeated, or other more conclusive tests are done, it turns out that there was no such problem. For that reason, if you get a “false positive” result, try not to fret until you get the results of the final tests.

Screening or probability tests are usually carried out by means of a blood test, or a blood test in combination with imaging tests, such as an ultrasound.  

Genetic tests

These tests, contrary to screening tests, do offer a definite and final result. Genetic testing takes a sample of the baby’s genetic material in order to analyze it and establish whether there is an anomaly in the baby’s chromosomes. This genetic material may be obtained in different ways, depending on your phase of pregnancy.  

Within genetic testing, the most widely known is amniocentesis, that is carried out between weeks 15 and 18 of pregnancy. However, there are other tests that may be done even before that.  

Some of these tests are offered routinely, because of the mother’s age or in the event that she may be at risk because of her personal medical history of having had a baby with a chromosomal alteration. Other times, these tests are carried out in order to confirm or rule out a positive screening test.

In either case, remember that carrying out these genetic tests is a recommended by your doctor, but you can always opt out of them. It is important that you are aware of the information you will get from each test, and that you consider whether it is worth running the small risk of miscarriage they entail if the information you get is going to dispel your fears.  

Always share your doubts with your doctor, and comment with her all the information that could help determine whether it is advisable for you to undergo genetic testing or not (for example, if there is a hereditary genetic illness in your family).

If you still have doubts or concerns after speaking with your doctor, you can always request an appointment with a genetics counselor. Your doctor’s office may offer those services. If not, ask your doctor for a referral.

If you live in a state that has a high percentage of Hispanic population, you may be able to find a Latino doctor. If you are more comfortable speaking Spanish and you feel more at ease with the Latino culture that could be an advantage. However, unfortunately, the percentage of Latino doctors is still very small compared to Anglo doctors, so you may not luck out.   

Cultural differences

In order to provide you with the best possible care, your doctor needs to know all the details of your medical history. In order to speak with your doctor with confidence, you must feel rapport with him or her. In general, the attitude of Latino doctors is a little different to that of Anglo doctors. Our culture values eye contact, a handshake, smiling and chatting. And although there are Anglo doctors that could be just as warm as or warmer than a Latino doctor, in general they value efficient time-management, which some patients could mistake for a distant attitude.  

This cultural sensitivity for some women is more evident during pregnancy, because hormones make us feel a lot more sensitive emotionally. That’s why it could be difficult to establish rapport with a doctor whom we perceive as being cold or distant.  

A different attitude

If your doctor’s attitude seems cold and you don’t feel comfortable, but you can’t switch doctors, do keep in mind he or she has a different attitude, but that it is not necessarily distant or worse.  

The fact that he or she doesn’t follow certain cultural customs, such as chatting at the beginning of the appointment, or smiling more often, doesn’t mean he or she can’t provide appropriate treatment. In fact, this direct attitude is probably due to the doctor having very little time available to spend with you, and wanting to provide you with the best possible care.  

Establishing the best possible communication

In the time you have available with your doctor, it is important that you can provide her with all the information required so that you and your baby are able to get the best prenatal care.  For example, if you are taking herbs or home remedies or any kind of medication that wasn’t prescribed by a doctor, your practitioner needs to know.

If you are not completely at ease during the appointment, you may forget a question you wanted to ask. You’ll leave the doctor’s office feeling a lot better if you write down your questions beforehand. Make sure the list is short, because regular prenatal appointments usually don’t last as long as the first one.   

In addition to having a written list of questions, you should ask if there is something that the doctor has said or prescribed that you don’t understand or with which you don’t agree.  In our culture, it may be considered bad manners to ask questions because it may seem like we are questioning the diagnostic or the doctor’s orders, but your practitioner will not get angry or be offended because you ask questions.  

If you aren’t as fluent in English as you are in Spanish, you could ask a family member who speaks English to come with you, or request the services of an interpreter. If your doctor works in a hospital that obtains Federal funds, there is probably an interpreter on the premises, to help Spanish-speaking patients.

Even if you felt just great before your pregnancy and even if you still feel fine now that you’re pregnant, there are certain conditions that do not show symptoms until they are rather advanced: illnesses that, on the other hand affect us Latinas especially, such as gestational diabetes. Thanks to prenatal visits, your doctor may detect whether there is a problem and give you appropriate treatment.

From the beginning

If you are not yet pregnant, a visit to the doctor is in order. The doctor will make sure everything is fine and will prescribe folic acid and prenatal vitamins so you can prepare your body for pregnancy. However, if you didn’t see your doctor before getting pregnant, it’s never too late to request a prenatal visit. 

Once your home pregnancy test is positive, you can make an appointment for your first prenatal visit, because they will probably schedule it for a few weeks down the road.  In general, the first prenatal visit is usually longer than the others and they may not have such a big time slot available as soon as you would like. 

Medical history

Depending on the type of practice your doctor has, he or she will probably see you in his or her usual room, where patients are assessed, or you will be taken directly to an examination room. The nurse may ask you to undress and wear a smock while you wait for the doctor. Doctors may have several similar rooms, where they see their patients separately, in order to save time. It doesn’t matter where you are seen, because the questions and tests will be the same in any case.

One of the first things your doctor will ask is when you had your last menstrual period. With that date in mind, the doctor can calculate how many more weeks of pregnancy you have ahead of you and then contrast this data with the ultrasound you will get later on.

Besides asking you about your period, your doctor will want to know if this is your first pregnancy or if you have had a previous miscarriage or abortion. She will also ask if you’ve had a serious medical condition in the past, especially diabetes or hypertension: two of the illnesses that most affect us and that may have adverse effects on pregnancy.    

Another important question is if any person in your family was born with a genetic anomaly, in order to determine whether it is advisable to carry out certain genetic testing, in order to rule out the possibility of your baby having that condition. She will also make a note of whether you are taking any medication, if you smoke, drink, or carry out any other activities that could be harmful during pregnancy.  

Urine, blood pressure and weight

Before or after your doctor sees you, she will ask you to urinate in a cup and will also measure your blood pressure and weigh you. These tests enable the doctor to rule out infections or the presence of sugar or protein in your urine.  You will be weighed in order to have a point of reference and monitor your weight gain as the weeks go by.  These controls will be repeated in every doctor visit from now on.

Internal exam

After discussing all these matters with you, the doctor will carry out an internal exam in order to check your cervix. During pregnancy, the cervix is closed and sealed, and your doctor may see this by using a speculum, a device that is used to open the vagina and see the interior clearly.

The doctor will also take a sample of the cells that line the cervix to request a Pap smear, to make sure your cells are normal. The Pap smear will also determine if there are any STDs (sexually transmitted diseases) present, such as gonorrhea or Chlamydia. If your doctor doesn’t carry out theses tests in her practice, she will send you to a place where these samples can be taken.  

Blood tests

Lastly, the doctor will request complete blood work, in which – besides confirming your pregnancy- she will establish whether you suffer from or have suffered from any other illnesses. Your blood tests will determine whether you have had, amongst other conditions, rubella, HIV or syphilis. Besides, the test will also determine your RH factor and type.  If your RH is negative and your baby’s is positive, there could be an adverse reaction in your blood that would affect your baby.   

If your doctor thinks it is necessary because of your medical history, she will also request to know the glucose levels in your blood, to rule out diabetes. If you were to have diabetes, you may be able to undergo treatment to control the condition. Gestational diabetes is diabetes that is specific of pregnancy, and that could have the onset later on, but that a lot of Hispanic women suffer from.

Ultrasound or sonogram

In the event that your doctor has a sonogram or ultrasound machine in her practice, you may undergo an ultrasound in this first visit (if it isn’t much too early in the pregnancy). If she doesn’t have this device, she will refer you somewhere else to have the ultrasound done. The baby’s heartbeat cannot be detected until a few weeks into the pregnancy.  

Vitamins and next appointment

If you are not yet taking folic acid and vitamins, the doctor will prescribe them for you. Before leaving your doctor’s office, don’t forget to schedule your next appointment, as you will have to visit the doctor every month, and your visits will be more and more frequent in the last months.