Until you reach 32 weeks of pregnancy, visits to our office are typically every 4-6 weeks. Between 32 and 36 weeks, your visits will be every other week, then weekly thereafter. This schedule may vary and some women may need to be seen more often.
We believe it is important for you to have the ability to direct the course of your prenatal care. You can choose to see as few or as many of us as you like. Just let the schedulers know what your preference is each time you make your return appointment.
Our number one focus is the health of you and your baby! In order to make sure that you are both doing well, we will suggest performing some routine tests. During your first visit, we order lab work to check for anemia, blood type and Rh factor, thyroid function, urinalysis, immunity to rubella and screen for hepatitis B and syphilis. We will also offer you testing for HIV, screen for chlamydia and gonorrhea, do cystic fibrosis carrier screening and check for gestational diabetes as needed. We will also perform a pap test if you are due for one.
Genetic counseling with the UCSF Perinatal Diagnostic Center in Marin is available if you will be 35 years or older at the time of delivery and if you or your partner have a family history of genetic conditions.
There are several screening and/or testing options available for all women to detect fetal abnormalities in the 1st and 2nd trimesters:
- 10-15 weeks – Chorionic Villus Sampling (CVS), done by a perinatologist instead of an amniocentesis and usually reserved for women over 35 or families with a history of genetic conditions
- 11-14 weeks – Integrated Screening, a blood test that screens for Down’s Syndrome and Trisomy 18 AND a targeted sonogram called a Nuchal Translucency
- 15-20 weeks – AFP test, a blood test that screens for Down Syndrome, Trisomy 18 and neural tube defects (cleft lip, cleft palate, spina bifida) which can be done on its own or as the final part of the Integrated Screening
- 16-18 weeks – Amniocentesis, done by a perinatologist and usually reserved for women over 35, families with a history of genetic conditions or as a follow up to positive genetic screening results
- New genetic screening options including a non-invasive blood test called Cell free fetal DNA testing (Harmony) is also available through the Perinatal Diagnostic Center when clinically indicated
If your labs results show that you are Rh Negative, you will receive one or more shots of Rh Immune Globulin (RhoGAM) to keep you from becoming sensitized to Rh-positive blood that your baby may have. We will be happy to discuss the use of RhoGAM with you in greater detail if you will need it.
Between 24-28 weeks, we screen for anemia and gestational diabetes. You should be screened for gestational diabetes because the hormones produced by the placenta during your pregnancy can alter your response to insulin. Gestational diabetes is usually not detectable by you or your clinician without a blood test and it can have effects on both you and your baby. The majority of women who test positive are given nutritional counseling for diet modification and are taught to monitor their blood sugars daily. A small group of women will require medication, serial sonograms and early antenatal testing at Marin General Hospital’s Family Birth Center.
The last routine test is done between 35-37 weeks is called Group Beta Strep (GBS). It is an easy, painless test using a cotton swab around the outside of your vagina and anus. The GBS organism is normally present in about 20% of men and women. If it is found, it is not considered to be an infection, but newborns are very sensitive to it and it could possibly cause an infection in your baby. If you test positive for GBS, we will recommend antibiotics during labor to prevent transferring this organism to your baby.