Midwifery Care – Starting Prenatal Visits

Your first prenatal visit

These are the tests you will receive at your first prenatal visit.

Blood type
This test determines your blood type (O, A, B or AB) and whether 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.

Antibody screen
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.

Urine culture
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.

Syphilis (RPR)
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.

Varicella (Chickenpox)
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 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.

Your second prenatal visit

During this visit, you will have an exam performed by one of our midwives. Testing may include:

Pap smear
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.