First pregnancy check. The first pregnancy check-up generally takes place around the tenth week of pregnancy.
If you are two weeks late, it is best to contact your midwife or doctor to make an appointment for this first check-up.
If you are 36 or older, or if there are genetic disorders in the family, it is important that you indicate this when making the appointment. As you get older, the risk of certain birth defects is greater. These deviations can be detected with the help of early investigations.
Some examinations must already be performed during the tenth week of pregnancy. If you are eligible for further research into hereditary abnormalities (prenatal diagnosis), it is advisable to consider whether you would like to have such an examination done.
When to the midwife, doctor or gynecologist?
This vision also includes giving birth and giving birth at home. The guidance of a pregnant woman is usually done by the obstetrician or doctor and sometimes by the gynecologist.
A gynecologist check may be necessary if you have a medical indication. With a medical indication, the risk of complications during pregnancy or delivery is increased. Often the delivery then has to take place in the hospital. The obstetrician or general practitioner assess on the basis of guidelines whether you have a medical indication and refers to you if necessary.
See also, First signs of delivery
When is it advisable to consult your obstetrician or gynecologist between the first and the next checkup?
- if you lose blood through the vagina
- if you get pain in your lower abdomen, which gets worse and worse
- if you get severe abdominal pain that extends to your shoulder
- if you suddenly feel very ill, and you feel dizzy and sweat heavily
- if you experience other problems, such as a greatly increased vaginal discharge or pain when urinating.
Pregnancy is a major event. Many pregnant women enjoy talking about problems with someone they can trust. Do not hesitate to consult your midwife. He can refer you to a specialized care provider if necessary.
Intake first pregnancy check
During the first consultation, the intake interview (case history) takes a large part of the time. The midwife asks you questions about you, your health, the health of your partner, illnesses/specifics in the family, and any previous pregnancies/births/children.
Determining the calculated date During the first pregnancy check, the midwife or doctor determines:
- the due date and
- the number of weeks that you are pregnant
The midwife does this with the information you provided during the intake interview.
Determining the indication for ultrasound At the start of pregnancy, an obstetrician can request an ultrasound scan for various reasons.
Reasons for an ultrasound scan can be:
- if there is doubt about the correct duration of the pregnancy, for example, if your menstrual cycle is irregular
- if there is doubt as to whether the fruit is alive
Naturally, the midwife will discuss this with you so that you can prepare for this.
Physical examination during pregnancy check
During the first pregnancy checkup, the midwife performs a physical examination and examines the following:
The size of the uterus
when you first visit the midwife/doctor, he tries to feel the size of the uterus. From a pregnancy of about twelve weeks, the uterus can be felt just above the pubic bone. No internal investigation is therefore required for this.
The midwife examines whether the size of the uterus corresponds to the duration of the pregnancy.
If the midwife has doubts about this, he can propose to have an ultrasound scan performed. This ultrasound examination, made early in the pregnancy, can show the exact duration of the pregnancy. This can be used to calculate the date on which the birth is expected.
The baby’s heartbeat
If the pregnancy has indeed progressed to around eleven to twelve weeks, the midwife can use a device to let you hear the baby’s heartbeat.
Of course, the pregnancy is still fairly young; if the midwife does not hear the heartbeat, that does not mean that the heart is not beating. In such a case you can return to the consultation hour after one or two weeks; usually, it is possible to make the heart heard.
Your blood pressure is usually measured at every check. It is an important indicator of how your body processes the pregnancy. In addition, good blood pressure is important for the health of the developing fruit.
The blood pressure is displayed in an upper pressure and under pressure. For example 130/70, 130 is then the upper pressure and 70 the negative pressure.
It is mainly about the height of the underpressure. This rises somewhat at the end of the pregnancy. If it rises earlier in pregnancy, you and your baby may need to be checked more often.
At the first check, the midwife usually examines your urine. This is then tested for protein and sugar.
Sometimes the midwife sees reason to have your urine examined by your doctor. For example, there may be a bladder infection.
In the further course of the pregnancy, your urine is not examined at every check-up. If you develop high blood pressure, people are usually asked to take urine. Protein can get into your urine under the influence of high blood pressure.
Your midwife measures your weight at the first check-up. This is no longer done as standard for later checks during pregnancy. The importance of weight changes is less important than previously thought.
A Blood test during pregnancy check
Blood will be taken from you or you will be referred for a blood test to a puncture laboratory. Your blood will be tested for:
- blood type and rhesus factor
- hemoglobin level
- presence of a number of antibodies
- antibodies against hepatitis B
- antibodies against the venereal syphilis
Blood type test and rhesus factor
The red blood cells have certain characteristics, these are located on the outside of the blood cell. Important characteristics are the blood type and rhesus factor. There are four blood groups: A, B, AB, and O. It is important that your blood group is known. If you lose a lot of blood during delivery, it can be quickly absorbed with the right blood transfusion.
The rhesus factor is present in some people (rhesus positive) and in others (rhesus negative) not present. Sixteen percent of Dutch women are rhesus negative.
If you are rhesus negative, you may be expecting a child who is rhesus positive, for example, if the child’s father does have the rhesus factor.
During pregnancy, but especially during delivery, a small amount of rhesus positive blood from the child may end up in your bloodstream. Your body responds to this by making antibodies. These remain present in your body.
During the pregnancy of a subsequent child who is rhesus positive, these antibodies can reach the unborn child via the umbilical cord and break down the blood cells there. The child may already develop anemia in the womb, which can have serious consequences for the child’s development.
To prevent this, every rhesus negative mother who is expecting her first child will have a blood test in the thirtieth week of pregnancy. This time on rhesus antibodies.
An anti-rhesus D-immunoglobulin injection against rhesus antibodies may then be given within a week. This substance ensures that the rhesus negative mother does not make antibodies against the red blood cells of her unborn child.
After delivery, a little blood is taken from the baby’s umbilical cord. The rhesus factor of this blood is also checked. If it appears that the child’s rhesus is positive, the mother will receive another injection of antithesis-D-immunoglobulin within forty-eight hours after birth.
In a subsequent pregnancy, the rhesus negative mother cannot break the blood of the child in the womb.
Determination of hemoglobin level
If the hemoglobin level is too low, there is anemia. Hemoglobin is a substance in the red blood cells that is important for the transport of oxygen through the body. In every pregnancy, it is normal for a slight fall in hemoglobin.
Research for hepatitis B
Hepatitis B is an inflammation of the liver by a virus. This virus can also infect the child during birth. If you are a carrier of this virus, your child will receive an injection of hepatitis B immunoglobulin after birth to prevent it from going through the infection. It also receives a number of injections with the hepatitis B vaccine during the first year of life.
Testing for antibodies against red blood cells Due to previous pregnancies or blood transfusions, you may have antibodies in your blood that endanger your child’s health. If this is the case, further research is needed to find out the exact cause. Your midwife will discuss this with you.
Research on lues (syphilis) Lues is a sexual disease that you can carry with you unnoticed. Your child can also be infected with lues, especially later in pregnancy. It is important that lues is treated quickly.
Possible additional blood tests during pregnancy checkup
Research on rubella
Twenty years ago, all pregnant women were examined whether they had antibodies against the rubella virus. Rubella infection during pregnancy can cause birth defects in the child.
From 1962 all women were vaccinated against rubella. Checking for rubella antibodies is therefore seldom necessary, except for women born before 1962 and for women born abroad.
If there are no antibodies present, then it is useful to proceed to vaccination after birth.
HIV testing Blood tests can also be used to determine whether you have infected with the HIV (AIDS) virus. HIV can be transmitted to the baby, especially during delivery and by breastfeeding. Treating the mother with medication reduces the chance of the child becoming infected.
The following circumstances have an increased risk of being infected with the HIV virus:
- you have varying sexual contacts now or in the past (do you also think about sexual contacts abroad during holidays, especially in countries around the Mediterranean)
- you have a partner from a country with a lot of AIDS
- you are addicted and come into contact with needles and syringes, which are passed on to each other
- you have had a blood transfusion in the Netherlands between 1980 and 1985, or at a later date abroad
- your partner is infected with HIV
- your partner is bisexual
Who can you take with you during your first pregnancy checkup?
Your partner is of course always welcome, also during the later checks. The first visit always takes longer than the following checks. During checks later in the pregnancy, others are also welcome, such as your mother, mother-in-law, girlfriend or sister.
The next pregnancy check
If the gynecologist, midwife or doctor has completed the first visit, he will make a follow-up appointment with you. At the start of pregnancy, this appointment follows four weeks, unless you are expected to return earlier for some reason.
General advice and precautions
After the physical examination, you usually receive a number of tips and advice, after which you can go home again.
Smoking is bad, quitting smoking is best. Smoking has a negative influence on the development and growth of the baby.
Do not eat (half) raw meat, wash vegetables well, wear gloves when working in the garden and do not touch the litter box.
Physically demanding work such as lifting, stooping, standing a lot and walking a lot can be adjusted better during pregnancy. It is better not to perform irregular shifts, especially night shifts, after twenty weeks of pregnancy.
If you are dealing with exposure to hazardous substances, it is wise to state the name of these substances with the midwife. He can then contact the RIVM information service.
Exercising during pregnancy is good. However, it is wise to avoid contact sports, but also sports where you can hit a ball against your stomach. Swimming and cycling are eminently suitable for continuing to do or to do during pregnancy.
This is advised against from the very beginning and throughout the entire pregnancy. Nitrogen bubbles form which is not known whether they can have an effect on the blood circulation of the unborn child. In addition, birth defects can occur when you go deep-sea diving at the very beginning.
Sauna and solarium
With these forms of relaxation the body temperature rises. Your body temperature must not exceed 38.9 ° C during pregnancy. It is advisable to avoid visiting the sauna and tanning bed, certainly early in the pregnancy
The use of the seat belt is mandatory in the car. You can place the shoulder strap above the uterus, the hip strap over the pelvis
Traveling by plane sometimes causes problems, because not every airline wants to transport women after a 32-week pregnancy. Flying is harmless to the pregnant woman.
What does affect the baby’s well-being is a sudden change from staying at sea level to staying in high mountains (> 2150 meters). The oxygen-depleted air can result in an oxygen deficiency in the unborn child, which ultimately leads to lower birth weight.
It is better to postpone traveling to the tropics. During pregnancy you are more susceptible to infections: a gastrointestinal infection is almost impossible to prevent in these areas.
Malaria occurs in many of these areas; means to prevent malaria infection must, in any case, be taken. You may not be vaccinated during pregnancy with weakened or live germs. An example of this is vaccination against rubella. If you work in healthcare, you may not receive vaccination with the so-called BCG vaccine.
Radiation as a result of X-ray examinations, for example, must be kept to a minimum. It is important that you state that you are pregnant; the uterus can then be shielded. No harmful influence of displays and microwaves has been demonstrated.
The midwife advises you to follow a pregnancy course. There are many types of pregnancy courses. It is important that you choose a course that suits you.
The advantage of such a course is that you get exercises in relaxation, breathing, and good posture. The latter is especially important because the pregnant womb provokes a hollow back. With the right advice, you can largely prevent this.
It is advisable to apply for maternity care after the first pregnant scap check. Most maternity centers benefit greatly from knowing early on how many maternity beds they can expect in a given month.
In some major cities, women must sign up before the eighteenth week of pregnancy. You can choose from different types of maternity care in the Netherlands. The care can vary from only assistance during delivery to day-care.
First pregnancy check