A Doula's Guide to Pregnancy

June 26, 2017

Do you ever feel lost in the week-by-week of pregnancy? Sometimes what is standard and routine to your medical team, isn't so common to you! It can be helpful to have an overview idea of what to expect throughout pregnancy, as well as when you should start planning certain details. 

Here is your overview guide of what to expect in each trimester during most low-risk pregnancies, and when to start planning for the next steps!

What to Expect in the First Trimester

Weeks 4-8: Take a pregnancy test and find out you are pregnant! Be sure to call your OB or midwife to schedule that first visit to confirm the pregnancy, and figure out the due date! You also want to call your doula and get set up with your team. 

Week 8-12: Have your first appointment with your OB or midwife. Typically they will do a blood draw, urine test (this will happen at every visit), and check your vitals (also standard at each visit). They will also date the pregnancy by ultrasound measurement, either doing an internal ultrasound with a wand inserted into the vagina, or an external ultrasound using a wand on the belly. If you would like to do an early, non-invasive blood test combined with ultrasound around weeks 10-12 to reveal any possible genetic abnormalities, as well as find out the sex early, now is the time to have that done. More invasive genetic testing, called chorionic villus sampling, is also available between weeks 10-12.

What to Expect in the Second Trimester

Weeks 12-16: The early part of the second trimester is when you start to get some energy back! This is a great time to start looking into your childbirth education options. While you won't start a class just yet, knowing what is out there will give you a good head start. 

Weeks 16-20All pregnant women are offered an ultrasound at this stage of pregnancy to check not just the growth of the baby, but also the position of the placenta. If you are looking for more genetic screening, the MASFP blood test, and triple or quad screening are typically also offered around this time.

Weeks 20-24: If you haven't already, now is the time to go ahead and sign up and start your childbirth education classes. For first time parents, we suggest taking a multi-week group class especially, as it will give you plenty of time to talk to and learn from other couples, and aiming to end around 32-36 weeks gestation. We also suggest rounding out your classes by having a newborn care class and lactation class after you finish your childbirth classes. Many families also start or complete a Baby Registry now so that friends and family know exactly what to get for you at your showers.

Weeks 24-28: Glucose screening, a test to check for gestational diabetes, is offered standard at this point. This is also a good time to start interviewing and narrowing down your pediatrician choice! Finally, if you are wanting to write a Birth Plan (or Birth Preferences), this now is the time to start. A birth plan is a great tool to use in communicating with your doctor or midwife before the birth, and with the hospital when you go on your tour as well, so having it ready sooner rather than later can be helpful.

What to Expect in the Third Trimester

Weeks 28-32Around this time, you should be wrapping up your childbirth education classes, and taking any lactation or newborn care classes you have planned to take. A hospital tour is a great idea at this point as well! You are probably also having your baby showers around now, so this is a great time to start setting up your nursery, and figuring out what you still need to get. 

Weeks 32-36: Around 36 weeks you will be offered Group B Strep (GBS) screening, a swab of the vagina and rectum to test for GBS bacteria which can pose some risk to the baby at birth if present in the mother during labor. This is also the last calm before the final weeks, so now is a great time to get the carseat and have it installed with help from a local Car Seat Tech (most fire departments have one on staff!)

Weeks 36-40: Your doctor of midwife will start to offer cervical exams, although they are typically optional. Most insurance companies will let you order your breast pump by about 36 weeks, and now is also a good time to go ahead and pack your hospital bag. Sometimes it's helpful to start cooking double at dinner, and freezing half for quick, easy freezer meals once the baby arrives. Use these final weeks to finalize those last details too: setting up and organizing the nursery, washing and putting away baby clothes, and getting the carseat installed.

Week 40-42Once you hit your due date, you may be offered a non-stress test (NST) once or more a week until delivery. This non-invasive test is simply a 20 minute monitoring of your baby's heartbeat. Around 41 weeks a biophysical profile (BPP) will likely also be offered, which is a combo NST plus ultrasound to check on the baby's wellbeing, as well as the wellbeing of the cord, placenta, and fluid levels. Take this time to rest, distract yourself, and spend as much time enjoying your current family and life as well as you can!