Whether you've planned your pregnancy for years, or you're surprised that you're expecting, pregnancy is an exciting time and a memorable journey in a woman's life. You may be still absorbing the news, sitting in disbelief, or you may be just waiting to shout the news from the rooftops: You're pregnant! A baby is on the way! Wherever you fall on the continuum, we're here for you... every step of the way.

First Trimester (Weeks 0-13)

You saw the + on the home pregnancy test. Now what? Scheduling and attending regular prenatal visits will help ensure the best possible health for your baby. Even if you've been pregnant before and have a good idea of what to expect, it's important to see your provider in the first trimester.

1. In the first trimester, your provider will give you an estimate of the expected delivery date, also known as a "due date." Your personal health history and family history will be documented. At your first prenatal visit, and every visit after, your weight, blood pressure, and the size of your uterus will be monitored. These measurements can reassure you that your pregnancy is on track and going well.
2. Early detection of any problem usually means that the issue can be treated more easily. And some visits, you will be offered screenings for specific concerns. Prenatal screening tests are optional for all patients; they assess the risk of having a baby with a specific birth defect or genetic disorder. When a screening is positive, it means that you are in a higher risk category for a certain condition. It does NOT mean your baby has that condition. A normal or negative screen result suggests that you are in a lower risk category. It does not completely rule out the possibility of the concern. Your provider is happy to talk with you about the benefits and limits of prenatal screens. It is always your choice whether or not to have a screening test.
3. Your provider will recommend that you stop smoking if you smoke and that you avoid alcohol during your pregnancy. He or she will likely recommend a prenatal vitamin to ensure that you're getting the recommended daily requirements of key vitamins and minerals for you and your baby. A visit with our registered dietitian is also advised so that you can better understand the key nutrients that will serve as the building blocks for your baby's development. For example, Omega 3s are important for the baby's brain development, and you can easily add more to your diet by including more fish or taking a fish oil supplement.
4. Warning signs that you should be seen by your doctor include abdominal pain or severe lower back pain, vaginal bleeding, or excessive nausea or vomiting that prevents you from going about your day,
5. You'll also be given a CBHA Pregnancy Passport with key steps along the way to the healthy delivery of your baby. Completing these steps as you progress on your journey to delivery will give you peace of mind – and your choice of a car seat, high chair, or baby activity center!

Questions to ask your health care provider about a prenatal screen:

• What do you hope to learn from this screen?
• Are there risks to the screen?
• If the screen is positive, how likely is it my baby has a condition?
• If the screen is positive, what happens next?
• If the screen is normal, how likely is it that my baby could have the condition?
• What alternatives are there to having this screen?

Second Trimester (Weeks 14-28)

Many women find this trimester to be their favorite. The constant nausea and fear of miscarriage in the first trimester has subsided. Their energy surges. They can begin to feel the baby move. The heartbeat can be heard with a stethoscope. And they get their first glimpse of the baby at the 18-20 week ultrasound. We won't say it's smooth sailing from here because there's still the tiring and often uncomfortable third trimester around the corner, as well as labor and delivery, but overall, there's less to worry about in weeks 14-28.

1. Prenatal visits occur monthly during the second trimester. Your provider will measure your abdomen to track the baby's growth.
2. Your overall health is monitored closely, to check for edema (swelling, and a sign of preeclampsia), high blood pressure, varicose veins, and other common pregnancy issues.
3. Typically, an ultrasound will be done at 18-20 weeks. You will hear the baby's heartbeat and may be able to determine the gender if you want to know.
4. You may be tested for RH antibodies if you are Rh negative, and given an injection of Rhogam to keep antibodies from forming.
5. Your blood glucose levels will be checked at some point during the second trimester. This test will identify whether you are at risk for gestational diabetes.
6. This is a good time to schedule a routine dental exam. Gum disease, like gingivitis, is common during pregnancy, but regular cleanings can help. Oral health is connected to overall health, so extra attention to your teeth is in order.
7. Depending on your age, tests like the triple screen for Down syndrome may be advised.

Third Trimester (Weeks 29-40)

You're in the home stretch now! It won't be long until you meet your little one. Prenatal visits this trimester are focused on your baby's position and you being ready for delivery.

1. This is a good time to sign up and attend childbirth classes if you haven't already done so.
2. Prenatal appointments will occur every other week now, and every week between 36 and 40 weeks.
3. Your provider will regularly check the position of the baby by palpating your abdomen. If the baby is breech, gentle compressions will attempt to change his/her position.
4. Common tests and screenings during this trimester include: Group B Strep screen, blood tests to check iron levels, urine tests to check for protein levels that might indicate preeclampsia, ultrasound if you have low lying placenta or other developments indicated in second trimester ultrasound, and a non-stress test to more closely examine baby's heartbeat, especially if you are still pregnant past 40 weeks.
5. A pelvic exam during this trimester will determine if your cervix is thinning or dilating, which are signs that delivery is imminent.
6. If this is your first child, it's is a good time to interview pediatricians, so you know who your baby will be seeing those first important months of life.
7. Packing a bag for the hospital for your delivery is a good plan during these last several weeks. Here are some items others have found useful during their delivery stay:
   • Photo ID, insurance information, hospital forms, and your birthing plan if you have one
   • Toiletries and personal items: shampoo, conditioner, lotion, toothbrush, toothpaste, deodorant, face wash, hair brush
   • Lightweight clothing for optimal comfort
   • 2-3 maternity bras
   • Snacks and money for vending machines
   • Cell phone and charger
   • Hair accessories – ponytail holder, clips, headband etc…
   • Sweater or robe to keep you warm
   • Slippers
   • Nonskid socks
   • Eyeglasses or contacts with contact solution (if you use these)

Post-partum

It might feel like the birth is over and you have your healthy baby, so your time in the OB office is finished. But the postpartum appointment is important so your provider can make sure your body is healing from the delivery as it should. Nearly every bodily function is affected by pregnancy; you'll have peace of mind knowing yours are returning to business as usual. Postpartum appointments generally take place about 6 weeks after delivery.

1. A pelvic exam will allow your provider to ensure that your incision is healing if you've had an episiotomy or tear. By 6 weeks, your uterus should also have returned to its normal size (about that of a grapefruit).
2. If you're breastfeeding, a breast exam may be performed to check for mastitis, an infection of a milk duct.
3. Pregnancy takes a toll on the bladder and intestines as well as the rest of your body, so your doctor will likely want to ensure that they're back to their pre-pregnancy state as well.
4. Up to one-third of women experience postpartum depression in the first year after giving birth, so a routine screen for PPD is just as important as checking your overall physical health.
5. If you're having any breastfeeding challenges, this is an excellent time to mention those concerns. CBHA's lactation specialist can help you address those concerns and optimize your ability to breastfeed your new baby.
6. While resuming your sex life may be the last thing on your mind, your provider will likely talk to you about family planning and birth control so that you can fully recover from pregnancy and enjoy your baby before another is on the way.
7. Any other concerns you may have about your overall health can also be addressed at this postpartum visit.