Expecting a baby means navigating roughly 40 weeks of medical appointments, body changes, lifestyle adjustments, and planning. The sheer volume of advice can feel overwhelming, so this guide breaks it down into the steps that actually matter, from your first prenatal visit through packing your hospital bag.
Schedule Your First Prenatal Visit
As soon as you get a positive pregnancy test, call to schedule your first prenatal appointment. This initial visit is one of the longest you’ll have because it establishes a baseline for your entire pregnancy. Expect a physical exam that may include a breast and pelvic exam, and possibly a Pap test if you’re not current on screening.
Blood work at this visit covers more than you might expect. Your provider will check your blood type and Rh factor (a protein on red blood cells that can cause complications if yours differs from the baby’s), confirm immunity to rubella and chickenpox, and screen for infections including hepatitis B, syphilis, chlamydia, gonorrhea, and HIV. You’ll also give a urine sample to check for urinary tract infections, which are common in early pregnancy and can cause problems if left untreated.
Key Screenings Throughout Pregnancy
After that first appointment, prenatal visits typically follow a predictable rhythm: monthly through week 28, every two weeks until week 36, then weekly until delivery. Several specific screenings are scheduled along the way.
Between 24 and 28 weeks, you’ll have a glucose screening to check for gestational diabetes. This involves drinking a sugary solution and having your blood drawn about an hour later. If you have risk factors for diabetes or had gestational diabetes in a previous pregnancy, your provider may run this test in the first trimester instead. Your provider will also discuss optional genetic screening tests, which can be done at various points depending on the type of test and your preferences.
Nutrition and Prenatal Vitamins
A prenatal vitamin fills nutritional gaps that diet alone often can’t cover. Iron is one of the most important: the recommended amount starts at 30 mg per day in the first trimester and increases to 60 mg per day in the second and third trimesters, when your blood volume expands significantly. Iodine, which supports your baby’s brain and thyroid development, is recommended at 150 micrograms per day. Folic acid is critical in the earliest weeks of pregnancy for preventing neural tube defects, which is why many providers recommend starting it before conception if possible.
Not all prenatal vitamins contain the same amounts of these nutrients, so check the label rather than assuming any bottle off the shelf meets the recommendations. If a particular vitamin makes your nausea worse (a common complaint in the first trimester), try taking it with food or before bed. Some people tolerate gummy versions better, though these often lack iron, so you may need a separate supplement.
Foods to Avoid
Pregnancy suppresses parts of your immune system, making you more vulnerable to foodborne illness. Pregnant women are 10 times more likely to get a Listeria infection than the general population, and Listeria can cause miscarriage, stillbirth, or serious newborn illness.
The highest-risk foods include:
- Raw or undercooked meat and poultry: cook all meat to safe internal temperatures
- Soft cheeses made from unpasteurized milk: brie, camembert, blue-veined cheese, queso fresco, queso blanco, and similar fresh soft cheeses
- High-mercury fish: shark, swordfish, king mackerel, and tilefish
- Raw or undercooked eggs: including dishes like homemade Caesar dressing or runny yolks
- Unpasteurized milk and juice
- Unwashed produce: rinse all fruits and vegetables thoroughly before eating
Low-mercury fish like salmon, tilapia, and shrimp are safe and encouraged because they provide omega-3 fatty acids that support fetal brain development.
Exercise During Pregnancy
The current recommendation is at least 150 minutes of moderate-intensity aerobic activity per week, spread across multiple days rather than crammed into one or two sessions. If you were already active before pregnancy, you can generally continue your routine, including vigorous exercise. Research on strenuous exercise in the second trimester found that 30 minutes of hard effort was well tolerated by both mothers and babies, even in women who were previously inactive.
Activities with strong safety evidence include walking, stationary cycling, aerobic exercises, dancing, resistance training with weights or bands, stretching, and water aerobics. Swimming and water-based exercise are especially popular later in pregnancy because buoyancy takes pressure off joints and the lower back. The main activities to avoid are those with a high risk of falling or abdominal impact, like downhill skiing, contact sports, and horseback riding.
Weight Gain: What’s Normal
How much weight you should gain depends on your pre-pregnancy BMI. The CDC guidelines for a single baby are:
- Underweight (BMI under 18.5): 28 to 40 pounds
- Normal weight (BMI 18.5 to 24.9): 25 to 35 pounds
- Overweight (BMI 25.0 to 29.9): 15 to 25 pounds
- Obese (BMI 30.0 to 39.9): 11 to 20 pounds
Most of this weight isn’t body fat. It includes the baby, placenta, amniotic fluid, increased blood volume, breast tissue, and fluid retention. Weight gain is typically slow in the first trimester (a few pounds total) and picks up in the second and third trimesters. Your provider will track your weight at each visit, so there’s no need to obsess over daily fluctuations at home.
Start Thinking About a Birth Plan
A birth plan is a document that communicates your preferences to your medical team. You don’t need to finalize it until the third trimester, but it helps to start thinking about your options earlier so you can ask informed questions at prenatal appointments.
The main categories to consider: Do you want to move around during labor or prefer continuous monitoring? Are you open to an epidural, or do you want to try laboring without pain medication first? Would you prefer IV pain relief? Do you want to use a shower or tub during labor if the facility allows it? What are your feelings about interventions like episiotomy or assisted delivery with forceps or vacuum? If a cesarean becomes necessary, do you want your partner in the operating room? Would you like a family-centered cesarean, which may allow skin-to-skin contact immediately after surgery?
Write your preferences down, but hold them loosely. Labor is unpredictable, and the goal is a safe delivery for you and your baby, whatever form that takes.
Choose a Pediatrician Before the Baby Arrives
Your baby will need a pediatrician for their first checkup within days of birth, so start researching providers during the third trimester. Many pediatricians offer “meet and greet” sessions where you can visit the office and ask questions before committing.
Ask whether the doctor is board-certified, which means they’ve passed a rigorous exam from the American Board of Pediatrics. It’s not legally required, so not every practicing pediatrician has done it. Ask about their residency training and what hospital they’re affiliated with. Beyond credentials, pay attention to how comfortable you feel talking to them. The relationship between your family and your pediatrician will last years, and trust and communication style matter as much as qualifications on paper.
Pack Your Hospital Bag
Have a bag ready by about 36 weeks, since labor can start earlier than expected. Hospitals provide more than most people realize for the newborn, including diapers, wipes, hats, socks, swaddling blankets, t-shirts, and everything for baby’s first bath. Your main job is packing what the hospital won’t have.
For you: your insurance card and hospital paperwork, a list of current medications with dosages, nursing bras or tanks (comfortable even if you don’t plan to breastfeed), loose-fitting pants or maternity leggings with a soft waistband, a robe, and lip balm, which is surprisingly essential during labor when your mouth gets dry. Bring your own toiletries, a phone charger, and a comfortable outfit to wear home.
For the baby: a going-home outfit and, most importantly, an approved infant car seat properly installed in your vehicle. The hospital will not discharge you without one. Install it well before your due date and consider having it inspected at a local fire station or car seat check event to make sure it’s secure.
Warning Signs That Need Immediate Attention
Most pregnancy discomfort is normal, but certain symptoms require urgent medical evaluation. Call your provider or go to the emergency room if you experience any of the following:
- A severe or persistent headache that worsens over time, comes on suddenly, or is accompanied by blurred vision or dizziness
- Vision changes such as flashing lights, bright spots, blind spots, blurriness, or double vision
- Extreme swelling of your hands or face, particularly if your fingers are hard to bend or your eyes are difficult to fully open
- Severe abdominal pain that is sharp, stabbing, or worsening, especially if paired with chest, shoulder, or back pain
- Difficulty breathing, tightness in your chest or throat, or trouble breathing while lying flat
- Chest pain that feels like pressure or tightness, or pain radiating to your back, neck, or arm
- Severe swelling, pain, or tenderness in one leg (usually the calf), which could signal a blood clot
Several of these are signs of preeclampsia, a dangerous condition involving high blood pressure that can develop after 20 weeks. These warning signs apply during pregnancy and up to six weeks after birth, since complications don’t always stop at delivery.