Congratulations on your pregnancy! You've entered an exciting time of anticipation and preparation. Whether this is your first baby or a subsequent pregnancy, you have many decisions to make. The midwives of Greenville Midwifery Care & Birth Center are honored to support families throughout pregnancy, birth, and postpartum. Below is some information about prenatal care with our practice.
Once your pregnancy has been confirmed, the prenatal period officially begins. Prenatal care involves a series of regular exams and evaluations with your midwife. In an uncomplicated pregnancy, most women will see the midwife once a month until the 32nd week of pregnancy. At this point, you will be seen every two weeks. As you anticipate your baby’s arrival during your last month of pregnancy, you will have a visit with the midwife every week.
First Prenatal Visit
The initial prenatal visit is often the longest and is facilitated by our nurse. During this first visit, a detailed family history and lab work will be performed. The nurse will calculate your baby’s due date, which will serve as a reference point in future visits as the baby’s growth is assessed. During your first prenatal visit, the midwife will perform a complete physical examination that includes a pelvic exam and a pap smear, if needed. All prenatal visits include a measurement of your weight and a recording of your blood pressure. See below for a list of common blood tests performed during this initial visit.
This test determines your blood type (O, A, B or AB) and whether or not you have the Rh factor (Rhesus factor) on your blood cells. Rh is an inherited trait that refers to a specific protein found on the surface of red blood cells. If your blood has the protein, you are Rh positive. If your blood lacks the protein, you are Rh negative. If you are Rh negative and your baby is Rh positive, your baby could develop a life-threatening anemia.
This test detects unusual antibodies that can cause damage to your developing baby. If present, special tests and monitoring may be needed during pregnancy. If you are Rh negative and haven’t started to produce Rh antibodies, you will receive an injection of a blood product called RH immune globulin. This immune globulin prevents your body from producing Rh antibodies during your pregnancy.
Complete Blood Count (CBC)
This test checks your blood to determine if you have normal amounts of certain blood cells in your body. Abnormal levels of certain blood cells can be indicative of a disease process such as infection or anemia, or clotting disorders.
A specimen is obtained and sent to the lab to test for infection or the overgrowth of bacteria that could lead to urinary tract infection.
Rubella (German Measles)
A blood test to determine if you are protected from Rubella. Most adults have developed immunity to this virus through vaccination as children. Rubella contracted during pregnancy can have serious consequences for the developing baby such as heart problems, hearing and vision loss, intellectual disability, and liver or spleen damage.
A test for exposure to syphilis. Syphilis is a sexually transmitted disease that can be transmitted to the developing baby during pregnancy. Untreated babies can have health problems such as cataracts, deafness, or seizures, and death. Treatment for syphilis can be started early in the pregnancy so that the baby is not affected.
Hepatitis B (HBV)
A test for infection with the Hepatitis B virus which can cause severe illness, liver damage and even death. Many people are infected and don’t know they have symptoms. The virus is highly contagious and easily passed to the baby during the birth process. Must test negative to labor or birth in water.
Hepatitis C (HCV)
A test for infection with the Hepatitis C virus. The chances of your baby catching Hepatitis C from you are about 1 in 20. Hepatitis C can also cause liver damage and severe illness. Must test negative to labor or birth in water.
Human Immunodeficiency Virus (HIV)
A test that checks for the virus that causes AIDS. If you have HIV infection, special medications can be given during pregnancy and birth which can reduce the chances of you passing the virus to your unborn child. Mother must have a negative HIV screen to labor or birth in water.
Chickenpox contracted for the first time during pregnancy carries significant risks to the mother and baby. For example, 10-20% of pregnant women who get chickenpox will develop pneumonia. If contracted during the week prior to the baby’s birth, the baby can develop chickenpox shortly after birth, with the chance of death as high as 30%. Fortunately, most adults are immune to the virus. However, if you are unsure whether or not you had chickenpox as a child, we will order a test to determine immunity.
Hemoglobin (Hgb) Electrophoresis
A blood test for Sickle Cell Anemia, Thalassemia, and other genetic causes of chronic anemia. Certain ethnic groups are at higher risk for having these conditions. Women of African descent will receive automatic testing at the first prenatal visit. Women of southeast Asian or Mediterranean descent who demonstrate anemia with the first prenatal blood count will also be tested.
Second Prenatal Visit
During this visit you will have an exam performed by one of our midwives. Testing may include:
This is a screening test for abnormal cells on the cervix that can lead to cervical cancer. It is recommended that a woman receive a pap smear every 2-5 years, depending on age and risk factors.
Chlamydia and Gonorrhea
These are sexually transmitted diseases that if left untreated can cause severe pelvic infection, miscarriage, and infection in the newborn.
Routine Prenatal Visits
Ultrasound for Fetal Anatomy
A screening test for physical abnormalities in the developing baby. Like all screening tests, ultrasound cannot detect every potential problem that could occur with a developing baby. However, most major physical abnormalities can be found during this exam. Fortunately, most ultrasound results reveal a normally developing baby.
Changes in carbohydrate metabolism during pregnancy can lead to the development of diabetes during pregnancy (gestational diabetes). Because there is no certain way to predict who will develop gestational diabetes, it is recommended that all women be screened for this disorder. Low-risk women will be screened between 24-28 weeks; women with increased risk will be tested earlier in the pregnancy.
The standard screening test is called a glucose challenge test (GCT). You will be given a drink that contains 50 grams of glucose. A blood test will be performed one hour later to measure the amount of glucose (sugar) in your blood. An elevated glucose level could be indicative of gestational diabetes. In this case, a 3-hour glucose tolerance test (3-hr GTT) will be performed to determine if you have developed gestational diabetes.
A blood test (either by blood draw or finger-stick sample), measures the amount of oxygen saturation and hemoglobin on the blood cells. Decreased levels of these are indicative of iron-deficiency anemia.
Group B Strep (GBS)
A vaginal/rectal swab is sent to the lab to check for the overgrowth of the Group B strep bacteria. Group B Strep is normally found in our intestines as part of the normal gastrointestinal flora. Women who are found to be GBS-positive are said to be “colonized” with the bacteria. This simply means the bacteria is present in the woman’s body in amounts significant enough to yield a positive test result. For some women, the amount is large enough to show up in the urine during pregnancy. There are no symptoms of being colonized with GBS, and it usually does not lead to infection. However, because babies’ immune systems are immature, they are more prone to developing severe infection if exposed to the bacteria during birth. For this reason, it is recommended that any woman who is GBS-positive receive intravenous (IV) antibiotics during labor to decrease the risk of transmission from mother to baby.