10 Questions to Ask Your OBGYN at the First Prenatal Visit

Congratulations, you are pregnant! After peeing on countless sticks, you are ready to see your OBGYN for that first prenatal appointment. A new pregnancy can fill you with so many emotions, ranging from excited to nervous to anxious. But, the first prenatal appointment can be an excellent time to get to know your OBGYN or Midwife as well as answer all your prenatal questions about what to expect in the coming months and hopefully relieve some of your anxiety.

As an OBGYN/fertility doctor and also having been in the shoes of a pregnant patient myself in the past (and currently!), I have a unique perspective on what is typically discussed at the first visit as well as what questions may still arise.

What to Expect at Your First Prenatal Visit

Before diving into the questions to ask your OBGYN, it's important to know what typically happens during the first prenatal visit. This visit is a cornerstone in your pregnancy journey, setting the stage for your prenatal care. Here’s a brief overview of what you can expect:

• A Comprehensive Health Evaluation: Your OBGYN or Midwife will start with a thorough health assessment, including your medical history, family history, and any previous pregnancies. This step is necessary for tailoring your prenatal care to your specific needs.
• Physical Examination: Expect a general physical exam, including checking your blood pressure, weight, and height. Your doctor may also perform a pelvic exam to check the uterus and pelvis and a Pap smear if you're due for one.
• Lab Tests: Several blood tests are standard during the first visit to check for blood type, Rh factor, iron levels, and possible exposure to infections. Urine tests are also common to screen for urinary tract infections and to check the levels of protein and sugar.
• Ultrasound: While not always performed at the first visit, an early ultrasound may be done to confirm the pregnancy, determine the due date, and rule out ectopic pregnancy. This is also a chance to see your baby for the first time.
• Discussion about Your Health and Pregnancy: This is where your prepared questions come into play. Your prenatal care provider will discuss your health and lifestyle as it relates to your pregnancy and what changes you may need to make to ensure a healthy pregnancy journey.
• Setting Expectations for Future Visits: Before you leave, your healthcare provider will outline the schedule for your prenatal appointments and discuss any immediate changes you should make in your lifestyle, diet, or medication regimen.

As you get ready for your first visit, consider asking the following 10 questions as you embark on your pregnancy journey:

1. Confirm your due date

You may be 1000% sure of your due date because you were tracking your periods and ovulation and timing intercourse (or you may have no clue!), but you should confirm your dates with your OBGYN as they may change depending on when ovulation and implantation occurred.

2. What lifestyle changes should be made?

Important questions to ask include: which foods should be avoided in pregnancy, exposures to environmental toxins, avoidance of certain beauty products (say goodbye to using retinol while pregnant!), recommendations on sleep and travel, etc.

3. What is an appropriate amount of weight gain in pregnancy?

Weight gain in pregnancy is normal and expected as the fetus grows, however, recommendations will vary on the amount of expected weight gain based on your pre-pregnancy BMI (measurement of your height and weight) with most of the weight gain occurring in the second and third trimesters. In general, pregnant individuals who have a normal BMI (18.4-24.9) can gain 25-35 lbs in pregnancy, those with a low BMI (< 18.4) can gain up to 40 pounds in pregnancy and individuals with a BMI over 30 should keep weight gain to 20 pounds.

4. What pregnancy symptoms can you expect each trimester?

Each trimester of pregnancy brings with it different symptoms you may experience, like fatigue, insomnia, and morning sickness, to name a few, and your OBGYN can be a great resource to let you know what is normal and what may require additional evaluation.

5. Which vitamins and/or supplements to be on

It is important to ask about any medications you may be on as well as any recommendations regarding prenatal vitamins. While it is best to start prenatal supplements prior to conception, if you haven’t started one yet, ACOG recommends a daily prenatal vitamin with folic acid to reduce the risk of neural tube defects.

6. What should you do in regards to exercise?

Exercise in pregnancy is safe and, in general, recommended for almost all pregnant and postpartum individuals. Exercise has been shown to increase the incidence of vaginal delivery, encourage healthy weight gain, reduce stress and anxiety as well as reducing the incidence of cesarean delivery, gestational diabetes and gestational high blood pressure. Depending on the type of exercise you perform, you may need to make modifications to your routine. As always, discuss with your OBGYN your own unique pregnancy and medical history regarding exercise.

7. How often will you be seen for prenatal appointments?

As you prepare for your prenatal appointments, you will find that (for uncomplicated pregnancies) appointments are usually every 4 weeks for the first 28 weeks, every 2 weeks until 36 weeks and then weekly thereafter until delivery. It is helpful to understand the flow of appointments and even schedule them in advance as OBGYN schedules can get full quickly.

8. Who will deliver you?

This is often a common question we get asked about who will be doing your delivery. Every clinic is different so it is important to discuss. In the past, many OBGYNs worked in solo or dual practices where it was almost guaranteed your own physician would deliver you. However, as a physician, those hours can be grueling so many practices now have multiple OBGYNs that will rotate in a call pool for delivery. Oftentimes you will be managed by the OBGYN you choose, but you will also likely see other OBGYns in their group so you can get to know several of the doctors in case one of them delivers you. If knowing exactly who will deliver you is extremely important, that may impact which OBGYN you ultimealtry choose to see.

9. Recommendations on genetic testing?

Your OBGYN will typically discuss options for genetic testing for the pregnancy that may range from non-invasive prenatal testing to more invasive options depending on your personal medical and pregnancy history as well as age.

10. What to know about your chronic medical conditions and possible impact on pregnancy?

If you have chronic medical conditions such as high blood pressure, diabetes, thyroid disorders etc. your doctor will likely talk to you about their possible impact on pregnancy and outcomes. You should discuss whether any medication you are taking for chronic medical conditions are safe in pregnancy and if the dose should be adjusted. Additionally, you should ask if you will need any additional follow-up or monitoring due to any chronic medical conditions.

As you navigate your first prenatal appointment, I always recommend writing down your questions in advance so you remember to ask what you need as those appointments can also feel overwhelming and it is easy to forget your own questions. Another tip is to bring your partner, a friend, or family member with you (if it is allowed) so they are able to take notes and listen to the advice and instruction as well!

If you find that you forgot to ask some of these questions, no worries. You have plenty of future visits to discuss with your provider!