Getting good pregnancy or antenatal medical care is a chance to start being a concerned parent. There are substantial health benefits: research has shown that women who see a doctor or nurse-midwife for regu­lar antenatal checkups are less likely to have premature and low-birth-weight babies than those who do not.

Many women look forward to their appointments, know­ing that it's a chance to ask questions of their healthcare practitioners and get helpful advice about coping with any uncomfortable symptoms. Besides, at most visits, a mum-to-be gets to listen to the beat of her baby's heart (an exciting and reassuring sound) and maybe even catch a glimpse of her child-to-be on an ultrasound screen.

The first antenatal visit

Here's what to expect at - and bring to - your first antenatal visit:

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. Pelvic exams usually include checking for inflammation or lesions on the genitalia, inspecting the condition of the vagina and cervix, and feeling for any abnormal­ities of the ovaries or uterus.

Medical history:
You and the baby's father will be asked about your medical, family and reproductive health histories. If the dad can't be there, be sure to ask him about his medical history before the appointment. This is critical because it will help your practitioner anticipate - and sometimes prevent .­problems that might arise for you or your baby. For example, diabetes, epilepsy, depression or heart problems may complicate pregnancy.

Laboratory tests:
Routine tests include blood typ­ing, a check for immunity to rubella (German measles), a blood count and a urine culture. The blood typing will determine if you're type A, B, AB or 0, and if you're Rh-negative or -positive (prob­lems may arise if you're Rh-negative and the foetus is Rh-positive). It's important to check for immunity to rubella because contracting this disease while you're pregnant could lead to serious complications for the baby. If you don't have immunity, you'll have to be diligent to avoid possi­ble sources of infection, and you can get vaccinated after the baby is born. The blood count indicates if you're anaemic or have a low platelet count, which can affect blood clotting. The urine culture looks for evidence of a urinary tract infec­tion. In addition, even if you are at low risk for sexually transmitted infections, your practitioner will test your cervix for chlamydia and gonorrhoea and your blood for hepatitis Band syphilis. If you are of African descent, you will be tested for sickle cell trait. All pregnant women should be offered HIV testing.

Due date:
Your practitioner will calculate your due date at this visit. Bring all the informa­tion that might be helpful: your menstrual record, including the date of your last period; when you did any home pregnancy tests; records if you happened to perform ovulation detection or took 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 calculate your due date using ultrasound.
 
Risk assessment:
In addition to medical, reproductive and family histories, your practitioner will probably ask about your diet; medication use; exposure to drugs, alcohol, or cigarettes; and personal and social issues.
 
Genetic concerns:
Bring along a copy of your and the father's family trees, noting the regions of the world your ancestors came from and any known medical problems immediate family members have had (cystic fibrosis, sickle cell disease or trait, men­tal retardation, congenital heart diseases, etc.). Depending on your situation, your practitioner may refer you to a specialist for genetic testing or coun­seling.

Nutritional counseling:
Women who are overweight, and particularly women who are underweight or who have eating disorders, must pay special attention to their nutritional needs in pregnancy. Vegetarians, especially vegans, need to be careful that they're getting adequate protein and vitamins. If you have special concerns, this is a good time to see a dietitian. Also, let your practitioner know if you take vitamin or nutritional supplements, as some of these can be toxic in pregnancy.