• Due date parameters: Your practitioner will calculate your due date at this visit. Bring all the information that might be helpful: your menstrual record, the date of your last period, when you did any home pregnancy tests, when your pregnancy test became positive, records if you happened to perform ovulation detection or basal body temperatures, and the date of conception if known. If you're not sure when your last period was or when you conceived, your practitioner can check your due date using ultrasound.



• Risk assessment: In addition to medical, reproductive, and family histories, your practitioner will probably address your nutritional state, medication use, exposure to drugs/alcohol/cigarettes, and personal and social issues.



• Physical examination: You will have a full physical examination, including a pelvic exam and--if you have not had one in the past year--a Pap test.



• Laboratory testing: Routine tests include blood typing, a check for immunity to German measles (rubella), a blood count, and urine culture. Even if you are at low risk for sexually transmitted infection, your practitioner will test your cervix for chlamydia and gonorrhea and your blood for hepatitis B and syphilis. If you are of African descent, you will be tested for sickle trait. All women should be offered HIV testing in pregnancy.



• Education: Becoming educated about potential pregnancy risks can help you to decrease or eliminate them. If you smoke, your practitioner may talk to you about whether you would be willing to quit, at least for the duration of your pregnancy. Smoking increases the risk of miscarriage, as well as poor fetal growth and preterm birth.



• Genetic concerns: This includes possible referral for genetic testing or counseling. Bring along a copy of your family tree, if you can, noting the regions of the world your ancestors came from and any known medical problems they might have had (cancer, heart disease, diabetes, etc.) The first visit is a good time to start thinking about how much genetic evaluation you want for the pregnancy. Your personal values will play a role in the testing you undertake. For more information, see The Triple Check Decision and Screening for Cystic Fibrosis in Pregnancy.



• Nutritional counseling: Women who are overweight, and particularly women who are underweight or who have eating disorders, require special attention to their nutritional needs in pregnancy. If you are at increased risk, this is a good time for assessment and counseling by a dietitian. Also let your practitioner know if you take vitamin supplements, as some vitamins can be toxic in pregnancy.



• If you have medical problems or risk: Find out how the pregnancy may affect your health, as well as how your health may impact your pregnancy and baby. Learn what you can do to take the best care of yourself and your baby during the pregnancy. If carrying a child is expected to pose risks to your health, this visit can give you a realistic idea of the demands the pregnancy may make on you and your family.



• Getting to know your doctor or midwife: This is a good chance for you and the baby's father to get to know your practitioner and to see how your styles and values match up.

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