Pregnancy care - first trimester
Trimester means "3 months." A normal pregnancy lasts around 10 months and has 3 trimesters.
The word prenatal means before birth. The first trimester starts when your baby is conceived. It continues through week 14 of your pregnancy. Your health care provider may talk about your pregnancy in weeks, rather than in months or trimesters.
You should schedule your first prenatal visit soon after you learn that you are pregnant. Your doctor or midwife will:
Your doctor or midwife will listen for your baby's heartbeat, but may not be able to hear it. Most often, the heartbeat cannot be heard or seen on ultrasound until at least 6 to 7 weeks.
During this first visit, your doctor or midwife will ask you questions about:
You will have many visits to talk about a birthing plan. You can also discuss it with your doctor or midwife at your first visit.
The first visit will also be a good time to talk about:
You will also be given prenatal vitamins with iron if you are not already taking them.
In your first trimester, you will have a prenatal visit every month. The visits may be quick, but they are still important. It is OK to bring your partner or labor coach with you.
During your visits, your doctor or midwife will:
At the end of each visit, your doctor or midwife will tell you what changes to expect before your next visit. Tell your doctor or midwife if you have any problems or concerns. It is OK to talk about them even if you do not feel that they are important or related to your pregnancy.
At your first visit, your doctor or midwife will draw blood for a group of tests known as the prenatal panel. These tests are done to find problems or infections early in the pregnancy.
This panel of tests includes, but is not limited to:
An ultrasound is a simple, painless procedure. A wand that uses sound waves will be placed on your belly. The sound waves will let your doctor or midwife see the baby.
You should have an ultrasound done in the first trimester to get an idea of your due date. The first trimester ultrasound will usually be a vaginal ultrasound.
All women are offered genetic testing to screen for birth defects and genetic problems, such as Down syndrome or brain and spinal column defects.
Women who may be at higher risk for these genetic problems include:
In one test, your doctor or midwife can use an ultrasound to measure the back of the baby's neck. This is called nuchal translucency.
Another test, called chorionic villus sampling (CVS), can detect Down syndrome and other genetic disorders as early as 10 weeks into a pregnancy.
A newer test, called cell free DNA testing, looks for small pieces of your baby's genes in a sample of blood from the mother. This test is newer, but offers a lot of promise for accuracy without risks of miscarriage. It may reduce the need for an amniocentesis, and so is safer for the baby.
There are other tests that may be done in the second trimester.
Contact your doctor or midwife if:
Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 5.
Hobel CJ, Williams J. Antepartum care. In: Hacker N, Gambone JC, Hobel CJ, eds. Hacker & Moore's Essentials of Obstetrics and Gynecology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 7.
Ormandy J. Antenatal and postnatal care. In: Magowan B, ed. Clinical Obstetrics and Gynaecology. 5th ed. Philadelphia, PA: Elsevier; 2023:chap 23.
Smith RP. Routine prenatal care: first trimester. In: Smith RP, ed. Netter's Obstetrics and Gynecology. 4th ed. Philadelphia, PA: Elsevier; 2024:chap 207.
Williams DE, Pridjian G. Obstetrics. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 20.
BACK TO TOPReview Date: 5/14/2024
Reviewed By: John D. Jacobson, MD, Professor Emeritus, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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06/01/2025
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