The guidelines for immunizations and medical exams have been designed to help you and your physician determine what preventive services are right for you. It is important to note that these guidelines are recommended for individuals who have no current disease symptoms or other specific risk factors. Depending on your individual lifestyle and family history, you may need some tests more frequently than others. For this reason, it is important to discuss these guidelines with your physician. For a printer friendly version of this page, click here. 

Routine Services for Healthy Pregnancies
Visit	Screenings	Counseling and Education	Immunizations, Supplements, Medications
Preconception Visit	Risk profiles Height and weight, BMI Blood pressure History and physical Cholesterol / HDL Cervical cancer screening Rubella (German measles) Rubeola  (measles) Varicella (chicken-pox) Domestic abuse Depression	Pre-term labor education and prevention Substance use (drugs / alcohol) Nutrition and weight Domestic abuse List of medications, herbal supplements, vitamins Accurate recording of menstrual dates	Tetanus booster* Rubella / MMR* Varicella / VZIG* Hepatitis B vaccine* Folic acid supplement         (*) if needed
Visit 1 6-8 Weeks	Risk profiles GC / Chlamydia Height and weight, BMI Blood pressure History and physical Rubella Varicella Domestic abuse CBC/Hemoglobin ABO / Rh / Ab Syphilis Urine culture HIV Blood lead screening* Hepatitis B S Ag Vaginal birth after cesarean* (VBAC) Depression         (*) if needed	Pre-term labor education and prevention Prenatal and lifestyle education Physical activity Nutrition Follow-up of modifiable risk factors Warning signs Course of care Physiology of pregnancy  Discuss fetal abnormality screen	Tetanus booster* Nutritional supplements* Influenza Varicella / VZIG* Pertussis         (*) if needed
Visit 2 10-12 weeks	Weight Blood pressure Fetal heart tones Fetal aneuploidy screening	Pre-term labor education and prevention Prenatal and lifestyle education Fetal growth Review labs from visit 1 Breastfeeding Physiology of pregnancy Follow-up of modifiable risk factors Nausea and Vomiting
Visit 3 16-18 weeks	Weight Blood pressure Fetal heart tones Fetal aneuploidy screening OB ultrasound (optional) Fundal height (uterus size) Cervical assessment*         (*) if needed	Pre-term labor education and prevention Prenatal and lifestyle education Follow-up of modifiable risk factors Physiology of pregnancy Second trimester growth Quickening	Progesterone*         (*) if needed
Visit 4 22 weeks	Weight Blood pressure Fetal heart tones Fundal height Cervical assessment* Depression         (*) if needed	Pre-term labor education and prevention Prenatal and lifestyle education Follow-up of modifiable risk Classes Family issues Length of stay Gestational Diabetes Mellitus (GDM)  RhoGAM*         (*) if needed
Visit 5 28 weeks	Pre-term labor risk Weight Blood pressure Fetal heart tones Fundal height Cervical assessment* Gestational Diabetes Mellitus (GDM) Domestic abuse Rh antibody status* Hepatitis B Ag* GC / Chlamydia*         (*) if needed	Pre-term labor education and prevention Prenatal and lifecycle education Follow-up of modifiable risk Work Physiology of pregnancy Pre-registration Fetal growth Awareness of fetal movement	ABO / Rh / Ab* (RhoGAM)*         (*) if needed
Visit 6 32 weeks	Weight Blood pressure Fetal heart tones Fundal height	Pre-term labor education and prevention Prenatal and lifestyle education Follow-up of modifiable risk factors Travel Sexuality Pediatric care Episiotomy Labor and delivery issues Warning signs / pregnancy-induced hypertension    Contraception VBAC
Visit 7 36 weeks	Weight Blood pressure Fetal heart tones Fundal height Cervix exam Confirm fetal position Culture for group B streptococcus	Prenatal and lifestyle education Follow-up of modifiable risk factors Postpartum care Management of late pregnancy symptoms Contraception When to call provider Discussion of postpartum depression
Visit 8-11 38-41 weeks	Weight Blood pressure Fetal heart tones Fundal height Cervix exam	Prenatal and lifestyle education Follow-up of modifiable risk factors Postpartum vaccinations Infant CPR Post-term management Labor and delivery update