Prenatal care is the health care you get while you are pregnant. It includes your checkups and prenatal testing. Prenatal care can help keep you and your baby healthy. It lets your health care provider spot health problems early. Early treatment can cure many problems and prevent others.

Your doctor or midwife will give you a schedule for your prenatal visits. If you are over 35 years old or your pregnancy is high risk because of health problems like diabetes or high blood pressure, your doctor or midwife will probably want to see you more often. You can also expect to see your health care provider more often as your due date gets closer.

Prenatal care is the health care you get while you are pregnant. Take care of yourself and your baby by:

• Getting early prenatal care. If you know you're pregnant, or think you might be, call your doctor to schedule a visit.
• Getting regular prenatal care. Your doctor will schedule you for many checkups over the course of your pregnancy. Don't miss any — they are all important.
• Following your doctor's advice.

Prenatal care can help keep you and your baby healthy. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care.

Doctors can spot health problems early when they see mothers regularly. This allows doctors to treat them early. Early treatment can cure many problems and prevent others. Doctors also can talk to pregnant women about things they can do to give their unborn babies a healthy start to life.

Your doctor will give you a schedule of all the doctor's visits you should have while pregnant. Most experts suggest you see your doctor:

• About once each month for weeks 4 through 28
• Twice a month for weeks 28 through 36
• Weekly for weeks 36 to birth

If you are older than 35 or your pregnancy is high risk, you'll probably see your doctor more often.

During the first prenatal visit, you can expect your doctor to:

• Ask about your health history including diseases, operations, or prior pregnancies
• Ask about your family's health history
• Do a complete physical exam, including a pelvic exam and Pap test
• Take your blood and urine for lab work
• Check your blood pressure, height, and weight
• Calculate your due date
• Answer your questions

At the first visit, you should ask questions and discuss any issues related to your pregnancy. Find out all you can about how to stay healthy.

Later prenatal visits will probably be shorter. Your doctor will check on your health and make sure the baby is growing as expected. Most prenatal visits will include:

• Checking your blood pressure
• Measuring your weight gain
• Measuring your abdomen to check your baby's growth (once you begin to show)
• Checking the baby's heart rate

While you're pregnant, you also will have some routine tests. Some tests are suggested for all women, such as blood work to check for anemia, your blood type, HIV, and other factors. Other tests might be offered based on your age, personal or family health history, your ethnic background, or the results of routine tests you have had. Visit the pregnancy section of our website for more details on prenatal care and tests.

Prenatal testing provides information about your baby's health before he or she is born. Some routine tests during pregnancy also check on your health. At your first prenatal visit, your health care provider will test for a number of things, including problems with your blood, signs of infections, and whether you are immune to rubella (German measles) and chickenpox.

Throughout your pregnancy, your health care provider may suggest a number of other tests, too. Some tests are suggested for all women, such as screenings for gestational diabetes, Down syndrome, and HIV. Other tests might be offered based on your

• Age
• Personal or family medical history
• Ethnic background
• Results of routine tests

There are two types of tests:

• Screening tests are tests that are done to see if you or your baby might have certain problems. They evaluate risk, but do not diagnose problems. If your screening test result is abnormal, it does not mean that there is a problem. It means that more information is needed. Your health care provider can explain what the test results mean and possible next steps. You may need diagnostic testing.
• Diagnostic tests show whether or not you or your baby have a certain problem.

It is your choice whether or not to get the prenatal tests. You and your health care provider can discuss the risks and benefits of the tests, and what kind of information the tests can give you. Then you can decide which ones are right for you.

You’re having a baby! Now what? When you’re about to be a new mom, it can feel like there’s a lot to do and learn. You’ll likely hear well-meaning advice from family, friends, and even total strangers. You may feel a mix of emotions. Whether you’re overjoyed or overwhelmed—or both—you can take steps to keep yourself and your baby healthy throughout pregnancy, and after.

“First, don’t expect the worst. Expect the best,” says Dr. Kimberly Yonkers, a researcher and psychiatrist at Yale University. “While some information or statistics might seem scary, keep in mind that the vast majority of the millions of pregnancies in the U.S. each year are healthy.”

Sometimes it’s helpful to focus on the positive aspects of pregnancy, and on the things you can control, like what you eat and how much you exercise. There may even be a silver lining to “morning sickness,” the nausea and vomiting you might get during pregnancy. One NIH-funded study found that nausea and vomiting early in pregnancy is associated with reduced risk for pregnancy loss.

Healthy eating is always important, but it’s even more so during pregnancy. A well-balanced diet can help ensure that you and your baby get all the nutrients you both need. Select a variety of fruits, vegetables, whole grains, lean meats or other protein sources, and low-fat dairy products.

Be sure to get enough of the vitamin folate, found in foods like orange juice and leafy green vegetables. Experts recommend that all women of childbearing age add to, or supplement, their diet by taking 0.4 mg (400 micrograms) of folic acid, a form of folate, every day. Taking folic acid supplements at least a month before becoming pregnant and throughout the first 3 months of pregnancy can lower a baby’s risk for certain birth defects by as much as 70%. Other nutrients that play essential roles during pregnancy are found in most prenatal vitamins.

For your baby’s safety, avoid certain foods such as raw fish, undercooked meat, deli meat, and unpasteurized cheese. Fish and shellfish can contain varying levels of methylmercury—a toxic metal—that may harm an unborn baby. During pregnancy, choose options that generally have low levels of this metal, such as shrimp, canned light tuna, salmon, pollock, and catfish. Pregnant women can eat up to 12 ounces of these fish each week.

While you may want to eat twice as healthy while pregnant, try not to eat twice as much. In an NIH study of more than 8,000 pregnant women, 73% gained more than the recommended amount of weight. The study found that gaining too much during pregnancy can raise the risk for gestational high blood pressure, cesarean section, and larger infants.

“It’s common for women to think that when they’re pregnant, they can ‘eat for two.’ But that’s a myth,” says Dr. Uma Reddy, an obstetrician and gynecologist at NIH. “You only need to eat a little more during pregnancy, not double the amount you usually eat.” In general, pregnant women need to eat about 300 extra calories per day.

Keeping your body moving while you’re pregnant can help you stay strong, feel and sleep better, and prepare your body for birth. Walking groups for moms and prenatal yoga classes might be a good place to find support and community while staying active. “With a few considerations, most women can continue their regular levels of physical activity throughout pregnancy,” Reddy says.

Since gaining too much or too little weight during pregnancy can raise the risk of problems for both you and your baby, talk to your health care provider about the right amount of weight gain based on your pre-pregnancy weight. Ask about how much food you should eat, the nutrients you’ll need, and the amount and type of physical activity that’s safe for you.

Also talk to your doctor about any medications and supplements you take, chemicals or potentially toxic things you’re exposed to, and any habits or behaviors you may be concerned about, like alcohol or drug use. Together, you can make a plan to help keep yourself and your developing baby safe.

You might be surprised to learn that some aspects of your health might be easier to improve while you’re pregnant. “Our research is showing that previously existing depression often improves, substance misuse significantly decreases, and that women generally get rid of a lot of negative health habits during pregnancy, at least temporarily,” Yonkers says.

For instance, some women may find that changes like eliminating alcohol or cutting back on caffeinated coffee is easier than before pregnancy, or they may just feel less interested in these drinks. “Smoking is another habit that women often find is easier to control during pregnancy,” Yonkers says.

When you’re pregnant, your teeth and gums might be the last thing on your mind. But your gums are more likely to become inflamed or infected because of the changes in your body. Make sure you keep up your regularly scheduled checkups. And, wash those hands! “A lot of people forget about handwashing, but this simple action makes a big difference and can really help you avoid some viruses that can be dangerous to your unborn baby,” Reddy says.

You may be tempted to schedule an earlier delivery. As eager as you might be to meet your new baby, studies show that it’s important to wait until at least 39 weeks of pregnancy unless there are medical reasons to deliver early.

There’s a lot to think about when you’re pregnant. It’s normal to have a variety of strong emotions during this period. But if you’re struggling with certain feelings or thoughts, it’s important to seek help. “Get help and talk to someone you trust,” says NIH’s Dr. Triesta Fowler, a pediatrician and coordinator of the Moms’ Mental Health Matters initiative. “You’re important and you matter. Though the baby is often the primary focus, women need to understand that they are just as important.”

Getting early and regular prenatal care is the best thing you can do to keep yourself and your baby healthy while you’re pregnant. Every woman and each pregnancy is unique. See your health care provider throughout your pregnancy to ask about what’s right for you, and to help you stay physically and mentally healthy.

After Baby Arrives

As you adjust to being a mom, be sure to take care of yourself too!

• Connect with other moms. Look for a moms’ group in your community or online.
• Make time for yourself. Do something you enjoy, like listening to music, reading a book, watching a favorite show, or taking a hot bath without interruption.
• Be realistic. No need to strive for perfection. Do what you can.
• Ask for help. Don’t be afraid to ask family and friends for help, whether it’s caring for the baby or doing household chores.
• Rest when the baby rests. Sleep is just as important for you as it is for the baby.

Once you're pregnant, early and regular prenatal care is important to keep yourself and your developing infant healthy.

During your first prenatal visit, your health care provider may talk to you about the following ways to help have a healthy pregnancy:

• Take folic acid.
• Do not use alcohol, tobacco, or drugs.
• Talk to your health care provider about medications.
• Avoid exposure to toxic substances.
• Follow a healthy diet.
• Eat a safe diet.
• Limit caffeine intake.
• Talk to your health care provider about physical activity.
• Maintain a healthy weight.
• Talk to your health care provider about your nutrition status, including vitamin B12 and iron levels.
• Get regular dental checkups.
• Prevent infections that can affect your pregnancy.

Begin or continue to get at least 400 micrograms of folic acid by taking vitamin supplements every day to reduce your child's risk of neural tube defects. In the United States, enriched grain products such as bread, cereal, pasta, and other grain-based foods are fortified with folic acid. A related form, called folate, occurs naturally in leafy, green vegetables and orange juice, but folate is not absorbed as well as folic acid. Also, it can be difficult to get all the folic acid you need from food alone. Most prenatal vitamins contain 400 micrograms of folic acid. If you have had a child with an NTD before, taking a larger daily dose of folic acid (4 mg) before and during early pregnancy can reduce the risk for recurrence in a subsequent pregnancy.

Drinking alcohol, smoking, and taking drugs during pregnancy can increase your child's risk for problems such as fetal alcohol spectrum disorders (FASDs), sudden infant death syndrome (SIDS), and other problems.

FASDs are a variety of effects on the fetus that result from the mother drinking alcohol during pregnancy. The effects range from mild to severe, and they include intellectual and developmental disabilities; behavior problems; abnormal facial features; and disorders of the heart, kidneys, bones, and hearing. FASDs last a lifetime although early intervention services can help improve a child's development. FASDs are completely preventable: If a woman does not drink alcohol while she is pregnant, her child will not have an FASD. Currently, research shows that there is no safe amount of alcohol to drink while pregnant. According to one recent study supported by the NIH, infants can suffer long-term developmental problems even with low levels of prenatal alcohol exposure.

Other research shows that smoking tobacco, smoking marijuana, exposure to second-hand smoke, and taking drugs during pregnancy can also harm the fetus and affect infant health. One study showed that smoking tobacco or marijuana and using illegal drugs doubled or even tripled the risk of stillbirth, fetal death after 20 weeks of pregnancy. Likewise, drinking alcohol, smoking tobacco, and exposure to second-hand smoke during pregnancy increases the risk of SIDS, the sudden, unexplained death of an infant younger than 1 year old. Research also shows that smoking marijuana during pregnancy can interfere with normal brain development in the fetus, possibly causing long-term problems.

According to the CDC, most women take at least one medication during pregnancy. The majority of medications have not been specifically studied for use in pregnancy. Talk to your health care provider about over-the-counter and prescription medications and herbal and vitamin supplements. Certain medications to treat acne and epilepsy and some dietary or herbal supplements can harm the fetus during pregnancy.

Taking prescription pain medications, specifically opioids, during pregnancy can pose serious risks to the fetus. Taking these medications during pregnancy doubles or even triples the risk for stillbirth. If taken regularly during pregnancy, the baby may go through withdrawal after birth, a situation called neonatal abstinence syndrome (NAS). Babies with NAS face a variety of symptoms and problems, some of them severe. The best way to protect your baby from these problems is to stop taking these medications during pregnancy.

During pregnancy, exposure to radiation, pesticides, some metals, and certain chemicals can cause birth defects, premature birth, and miscarriage. If you're not sure if something might be harmful to you or your fetus, avoid contact with it until you check with your health care provider.

If you work in a job on a farm, a dry cleaner, a factory, a nail or hair salon, you might be around or come into contact with potentially harmful substances. Talk to your health care provider and your employer about how you can protect yourself before and during pregnancy. You may need extra protection at work or a change in your job duties to stay safe.

A few examples of exposures that are known to be toxic to the developing fetus are:

Lead: Lead is a metal that may be present in house paint, dust, and garden soil. Any home built before 1978 may have lead paint. Exposure can occur when removing paint in old buildings (or if the paint is peeling) and working in some jobs (for example, manufacturing automotive batteries). Lead is also present in some well water and in water that travels through lead pipes. High levels of lead during pregnancy can cause miscarriage, stillbirth, low birth weight, and premature delivery, as well as learning and behavior problems for the child. Women who had exposure to lead in the past should have1 their blood levels checked before and during pregnancy. Call the National Lead Information Center for information about how to prevent exposure to lead at: 800-424-LEAD.

Radiation: Radiation is energy that travels through space. It can be in the form of X-rays, radio waves, heat, or light, or it can come from "radioactive" materials like dust, metals, or liquids that give off energy called radioactivity. Low exposures to radiation from natural sources (such as from the sun) or from microwave ovens or routine medical X-rays are generally not harmful. Because the fetus is inside the mother, it is partially protected from radiation's effects. Pregnant women or women who might be pregnant should make sure their dentists and doctors are aware of this so appropriate precautions can be taken with medical scans (X-rays or CT scans) or treatments that involve radiation. Pregnant women who may be exposed to radiation in the workplace should speak with their employer and health care provider to make sure the environment is safe during their pregnancy. Nuclear or radiation accidents, while rare, can cause high radiation exposures that are extremely dangerous, especially to the developing fetus.

Solvents: Solvents are chemicals that dissolve other substances. Solvents include alcohols, degreasers, and paint thinners. Some solvents give off fumes or can be absorbed through the skin and can cause severe health problems. During pregnancy, being in contact with solvents, especially if you work with them, can be harmful. Solvents may lead to miscarriage, slow the growth of the fetus, or cause preterm birth and birth defects. Pregnant women who may be exposed to solvents in the workplace should speak with their employer and health care provider to make sure the environment is safe during their pregnancy. Whenever you use solvents, be sure to do so in a well-ventilated area, wear safety clothes (such as gloves and a face mask), and avoid eating and drinking in the work area.

Many chemicals are commonly found in the blood and body fluids of pregnant women and their infants. However, much remains unknown about the effects of fetal exposure to chemicals. It's best to be cautious about chemical exposure when you are planning to get pregnant or if you are pregnant. Talk to your health care provider if you live or work in or near a toxic environment.

Choose a variety of fruits, vegetables, whole grains, and low-fat dairy products to help ensure the developing fetus gets all the nutrients it needs. Make sure you also drink plenty of water.

Avoid certain foods such as raw fish, undercooked meat, deli meat, and unpasteurized cheeses (for example, certain types of feta, bleu cheese, and Mexican-style soft cheeses). Always check the label to make sure the cheese is pasteurized.

Some pregnant women are concerned about the amount of fish they can safely consume. Certain fish contain methylmercury, when certain bacteria cause a chemical change in metallic mercury. Methylmercury is found in foods that fish eat, and it remains in the fish's body after it is eaten. Methylmercury in fish eaten by pregnant women can harm a fetus's developing nervous system.

According to the U.S. Food and Drug Administration (FDA), pregnant women can eat up to 12 ounces a week of fish and shellfish that have low levels of methylmercury (salmon, canned light tuna, and shrimp). Albacore ("white") tuna has more methylmercury than canned light tuna; pregnant women should consume 6 ounces or less in a week. Avoid fish with high levels of methylmercury (swordfish, king mackerel, and shark).

Some studies suggest that too much caffeine can increase the risk of miscarriage. Talk to your health care provider about the amount of caffeine you get from coffee, tea, or soda. Your health care provider might suggest a limit of 200 milligrams (the amount in about one 12-ounce cup of coffee) per day. Keep in mind, though, that some of the foods you eat, including chocolate, also contain caffeine and contribute to the total amount you consume each day.

Most women can continue regular levels of physical activity throughout pregnancy. Regular physical activity can help you feel better, sleep better, and prepare your body for birth. After your child is born, it can help get you back to your pre-pregnancy shape more quickly. Talk to your health care provider about the amount and type of physical activity that is right for you.

Gaining too much or too little weight during pregnancy increases the risk of problems for both the mother and the infant. Following a healthy diet and getting regular physical activity can help you stay within the recommended weight gain guidelines set by the Institute of Medicine.

The amount of weight you should gain during pregnancy depends on your pre-pregnancy weight and body mass index (BMI), which is your weight in kilograms divided by the square of your height in meters (kg/m). The following guidelines are for women who are pregnant with one fetus. The recommendations are different if you are pregnant with more than one fetus (such as twins).

• Women who are underweight (BMI less than 18.5) should gain between 28 and 40 pounds.
• Women at a normal weight (BMI between 18.5 and 24.9) should gain between 25 and 35 pounds.
• Overweight women (BMI 25 to 29.9) should gain between 15 and 25 pounds.
• Obese women (BMI more than 30) should gain between 11 and 20 pounds.

In a recent NICHD study of more than 8,000 pregnant women, 73% gained more than the recommended amount of weight. The study found that excessive weight gain during pregnancy increases the risk for gestational high blood pressure, cesarean section, and large-for-gestational-age infants.

Talk to your health care provider about the right amount of weight gain for you based on your pre-pregnancy weight.

Iron-deficiency anemia—when the body doesn't have enough iron—is common during pregnancy and is associated with preterm birth and low birth weight. Your health care provider may screen you for iron-deficiency anemia and, if you have it, may recommend iron supplements. Your health care provider may also recommend a vitamin B12 supplement if you are a vegan. (Vegetarians normally get enough vitamin B12 by eating eggs and dairy products.)

Your gums are more likely to become inflamed or infected because of hormonal changes and increased blood flow during pregnancy. Make sure you tell your dentist if you think you could be pregnant, but keeping up your regularly scheduled checkups is important. Some women may fear getting dental work during pregnancy, but a 2006 study and 2011 follow-up study showed no increase in preterm births or other adverse outcomes for pregnant women who received dental care.

Certain infections can affect pregnancy or the developing fetus. It's important to take steps to prevent such infections or get medical treatment before or during pregnancy.

Vaccinations can protect against many infections that can affect the mother's health, the pregnancy, the fetus, and even her newborn child. Some vaccines need to be given before pregnancy, so it's a good idea to review your vaccination history with your health care provider as part of your pre-pregnancy care. The Centers for Disease Control and Prevention provides recommendations about timing of vaccinations to help ensure a healthy pregnancy.