Women's Health CT Logo

Getting Pregnant

We want to help you each step of the way and this area of our site can help answer your many questions about pregnancy and prenatal health care.

For most couples, chances of getting pregnant during any given menstrual cycle are about 25%. After 3 months of trying, about 60% of couples will conceive and after 12 months of trying, about 85% of couples will conceive.

  • The First Prenatal Visit and Subsequent Visits
    Initial visit

    If you did not have a pre-conception visit, the initial prenatal visit will include all of the evaluation and counseling, as well as instructions to take a prenatal vitamin with a folic acid supplement.

    Exam

    A detailed health history will be obtained to identify any potential risks to this pregnancy; the history will review prior pregnancies, health of the mother, the father and both their families, as well as any exposures to hazardous materials.

    Unless you’ve recently had an annual exam, this physical exam will be comprehensive and includes measurements of weight, blood pressure, evaluation of the size of the uterus including a pelvic exam. An estimation of the due date will be established.

    Lab Testing to screen for:

    • Cervical cancer if not done recently
    • Sexually Transmitted Infections including gonorrhea, syphilis, Chlamydia and HIV
    • Urinary tract infections, protein and sugar in the urine
    • Blood count and type including antibodies in the blood with Rh negative blood types
    • Rubella
    Follow up visits:

    At each prenatal office visit you can expect the following routine screenings; weight, urine testing to measure sugar and proteins - indicators of diabetes or pregnancy induced high blood pressure, blood pressure, measurement of the size of the uterus to check for fetal growth, an exam of the mother to address problems or discomfort, and the fetal heart beat. Additionally, a review of any concerns or problems you may have had prior to this visit that are not resolved.

    At points during your pregnancy, in addition to routine screenings, below are important education topics, testing and evaluations your clinician will perform to ensure the well being of the pregnancy.

    10-20 weeks                                                        

    Discussion and counseling regarding a genetic testing plan to screen for hereditary conditions such as sickle cell, Tay-sachs, fragile X, cystic fibrosis as well as testing to screen for risks of neural tube defects, Down Syndrome and Trisomy 18.

    18-20 weeks                      

    Second trimester ultrasound

    24 weeks    

    Counseling on the detection of preterm labor

    26-28 weeks                       

    Blood work: repeat blood count to assess for anemia, syphilis test (required by law), glucose tolerance test to screen for diabetes, and blood type antibody test if  indicated

    32 weeks                            

    Education on detection of fetal well being using “kick” counts

    34 weeks                            

    Begin childbirth education or refresher course

    36 weeks                       

    Universal Group B strep testing; Cord blood banking education

    37-40 weeks   

    Cervical exams begin

    40+ weeks                           

    Fetal monitoring, ultrasound and non-stress testing to evaluate fetal well being.  Repeat Group B strep as needed

  • Steps to a Healthy Pregnancy

    The best thing you can do to have a healthy baby is to follow these simple “steps”.

    Eat a well balanced, nutritious diet

    Now is the time to assure that you are getting all the nutrients you need. A diet which has a variety of protein, fruits, vegetables, whole grains and limits sweets and fats, is the key to a healthy mother and baby. Be sure to drink 6 - 8 glasses of water per day as water helps control you body temperature, transport nutrients throughout the body, digest food and eliminate waste products.

    Being under or overweight poses different risks to pregnancy. If you are over or underweight, now is the time to speak with your health care provider about ways to improve your nutritional status and manage your weight.

    Start taking multivitamins with folic acid

    Folate is important in the early development of a baby’s brain and spinal cord, also called the neural tube. These vital organs begin to form in the first 28 days of pregnancy. Lacking folate during this period may lead to neural tube defects, such as spina bifida.

    Folate is part of the B vitamin group. It is found most commonly in dark leafy vegetables, nuts beans and citrus fruits. In addition to increasing your dietary intake of folate, it is recommended that you take 400 mcg of folic acid per day prior to pregnancy. During pregnancy, the requirement for folate increases to 600 mcg.

    Avoid alcohol, smoking, and drugs


    Alcohol:

    Drinking alcohol during pregnancy can be harmful to you and your baby. Alcohol passes through the placenta to the fetus and stays in the fetus’ blood stream longer. Regular drinking may cause fetal alcohol syndrome. Babies born with fetal alcohol syndrome are usually small and weigh less than normal newborns. The most serious and preventable effect of drinking alcohol in pregnancy is mental retardation.

    Smoking:

    Smoking can harm both your and your baby's health. Women who smoke while they are pregnant have a greater chance of miscarriage, premature delivery, delivering a low birth-weight baby or stillbirth. Pregnancy is a good time to stop smoking! Many women find it easier to quit when they are pregnant. Once you quit, the risks to you and your baby go down immediately!

    Newborns and children who live with cigarette smokers get sick more often and stay sick longer, have more coughs, colds, ear infections, asthma attacks and are more likely to have heart disease, breathing problems or lung cancer when they grow up.

    Drugs:

    It is important to know that even drugs purchased over -the-counter and prescription drugs that are safely used when you are not pregnant may cause harm to your baby during pregnancy. It is always safe to check with your doctor before taking any drug.

    If you use cocaine, marijuana or other street drugs, now is the time to stop. Your health care provider will work with you to find the best way for you to quit.

    Avoid exposure to harmful substances and chemicals

    Now is the time to identify, reduce or eliminate any exposure you may have in you home and at your work place. Items such as cleaning solvents, lead, mercury, paint thinners and removers, radiation, insecticides may pose a threat to the developing fetus. Discuss with your employer and concerns you may have about workplace exposures, and be sure to read the label safety remarks before you use any paints, cleaners, chemicals and bug sprays.

    Cat litter may carry Toxoplasmosis gondii, a parasite which can be a serious threat to the developing fetus. Toxoplasmosis is one of the most common infections. The risks to the fetus are different with each trimester of pregnancy. If possible, have someone else change the kitty litter box. If you have outdoor cats, be sure to wear gloves while gardening and avoid children’s sandboxes.

  • Signs, Symptoms, Confirmation and Next Steps
    Pre-natal visits

    A missed period is often the first sign of pregnancy. This can be followed, for some women, by early symptoms of fatigue and morning sickness which is a feeling of nausea or “blahs” that occur in waves throughout the day. Your breasts may become tender and fuller; the nipple areas become much more sensitive and darker in color.

    You might find yourself getting up one extra time at night to go to the bathroom, as your growing uterus puts pressure on your bladder

    You may notice a little bloody spotting in early pregnancy and this can be frightening. Often this is normal and can be caused by the attachment of the embryo into the uterine wall. Sexual intercourse may also result in a little spotting, because the cervix is swelled with a new blood supply. If you experience any bleeding – at any time during pregnancy – you should consult your physician.

    A pregnancy test checks for the presence of human chorionic gonadotropin (HCG) in your urine. If you have already missed your period, a home pregnancy test may offer an initial clue whether or not you are pregnant.

    Next Steps:
    • Early and ongoing prenatal care is the best step for a healthy pregnancy.
    • Schedule a pregnancy confirmation visit at your Ob Gyn physician’s office.
    • If you haven’t already started, be sure to take folic acid and prenatal vitamins.
  • Problems Getting Pregnant

    As a general rule, you should not be concerned about infertility (inability to get pregnant) unless you and the same partner have not conceived after one year of well-timed, unprotected, regular intercourse.

    35% of infertility is due to a female factor.  If the following factors apply to you (the female partner), you may want to seek help sooner:

    • if you are over 30 years old, you may want to seek help after 6 months of trying to conceive
    • if you have a history of pelvic inflammatory disease (PID) or other sexually transmitted infections
    • if you have irregular, absent, or painful periods
    • if you’ve miscarried

    As 30% of infertility is due to the male factor and another 20% involves factors in both the male and female partners.  You may consider seeking help sooner than one year if the male partner has a known low sperm count, has had sexually transmitted diseases, prostate infections, or reversal of surgical sterilization. If any of the above factors applies to you and/or your partner, you should consult your Ob Gyn and discuss when it would be time to see a fertility specialist.

  • Routine Prenatal Care

    Routine prenatal care includes visits to an Ob Gyn physician, nurse midwife, nurse practitioner, or advanced practice registered nurse who cares for women.  These visits span pre-conception through delivery and are important to ensure a healthy mother and baby. Over the course of a pregnancy you can expect to have 12-15 office visits. These visits provide an excellent opportunity for you to be screened, counseled and most importantly to ask questions and voice concerns about your pregnancy

    The Pre-Conception Visit

    The visit is geared toward evaluating and counseling women who are considering pregnancy regarding risks, and appropriate steps to ensure a healthy pregnancy. These include:

    • Evaluating your health and any pre-existing medical conditions that may affect you or your baby’s health during pregnancy. If you have any specific medical conditions such as asthma, diabetes, cardiac disease, or epilepsy, etc, you may need early and more frequent evaluations to keep you healthy. You and your health care provider will want these conditions in good control prior to and during pregnancy
    • Reviewing family history for any genetic conditions that could complicate a pregnancy, and referring to a genetic counselor for further testing and consultation when indicated.
    • Screening for urinary tract infections, virus exposure, sexually transmitted infections, blood type and Rh, cervical cancer, and high blood pressure.
    • Evaluating vaccine history and making sure vaccinations are up to date.
    • Advising on the “do’s and don’ts” including taking multivitamins with folic acid to prevent neural tube defects. Avoiding alcohol, smoking and drugs, reducing exposure to harmful substances and chemicals
    • Discussing diet and exercise; if you are over or underweight now is the time to be sure to eat a well-balanced, nutritious diet and drink plenty of water.
Find a Physician/Clinician
-or-