Prenatal Visits and Tests: Schedule, Screenings and Vaccines

Typical visit schedule

• First visit: usually around 8-12 weeks.
• Every 4 weeks until about 28 weeks, every 2 weeks until 36 weeks, then weekly until birth.
• More visits if you have twins, high blood pressure, diabetes or other conditions. Visits can be in a group or partly by video.
• Most visits: blood pressure, weight, urine check, the baby's heartbeat, and from about 20 weeks a measurement of your belly (fundal height). Bring your questions.

First visit

• Health and pregnancy history, medicines, and a physical exam.
• Blood tests: blood type and Rh factor, antibody screen, blood count (anemia), immunity to rubella and chickenpox, hepatitis B, hepatitis C, HIV and syphilis (often repeated later in pregnancy). Urine for infection. Pap test if you're due.
• A dating ultrasound, especially if your last period date is unsure. Early ultrasound sets the most reliable due date.
• Screening for depression, anxiety and safety at home happens now and later.
• You may be offered low-dose aspirin if you're at higher risk of preeclampsia (ideally started before 16 weeks).

Genetic screening and testing (all optional)

• Carrier screening: checks whether parents carry conditions such as cystic fibrosis, spinal muscular atrophy or sickle cell disease. Best before or early in pregnancy.
• Cell-free DNA (NIPT): a blood test from 10 weeks that screens for conditions like Down syndrome. Most accurate screen, but not a diagnosis.
• Nuchal translucency ultrasound (11-14 weeks), often with blood tests (first-trimester screen).
• Quad screen: a blood test at 15-22 weeks.
• Diagnostic tests give a definite answer and carry a small miscarriage risk: CVS at 10-13 weeks or amniocentesis from 15 weeks. Usually offered after a positive screen, but anyone can choose one.
• A genetic counselor can help you decide what, if anything, you want to know.

Mid and late pregnancy

• Anatomy ultrasound at about 18-22 weeks: checks organs, growth and the placenta.
• Glucose screening for gestational diabetes at 24-28 weeks (earlier if at higher risk). If high, a longer test follows.
• Rh-negative: a shot of anti-D immune globulin at about 28 weeks, again within 72 hours after birth if the baby is Rh-positive, and after bleeding, a fall or a procedure.
• Blood count is rechecked around 28 weeks. Syphilis is now commonly rechecked for everyone in the third trimester and at birth, and HIV sometimes is too.
• Group B strep swab at 36-37 weeks. If positive, you get IV antibiotics in labor; it doesn't mean anything is wrong now.
• Some people choose induction at 39 weeks. If you go past your due date, extra monitoring (non-stress tests, fluid checks) usually starts around 41 weeks, along with a plan for induction.

Vaccines in pregnancy

• Tdap (whooping cough): every pregnancy, at 27-36 weeks, ideally early in that window.
• Flu: any trimester during flu season.
• RSV: one dose at 32-36 weeks from September through January, or plan for a baby RSV antibody shot instead. Ask which fits.
• COVID-19: ACOG continues to recommend vaccination in pregnancy, while federal advice changed in
• Ask your provider what's right for you now.

Feeling the baby move

There's no single required kick count. Once movements are regular (often by 28 weeks), learn your baby's usual pattern. Some providers suggest timing how long it takes to feel 10 movements, often within 2 hours. A clear slowdown is a reason to call the same day, not to wait for your next visit.

Questions worth asking

• Who do I call after hours, and where do I go in labor?
• Which screening tests do you suggest for me, and what would a result change?
• Is my blood pressure, weight gain and the baby's growth on track?
• When should I call about contractions or my water breaking?
• Which medicines, vaccines and activities are fine for me?

When to check in

Call your provider or labor and delivery right away if the baby is moving less, you have bleeding or leaking fluid, a headache that won't go away or vision changes, or regular contractions before 37 weeks. See the pregnancy warning signs guide.