From Conception to Postpartum: Testing 101

Jun 25, 2024
Dr. Kimberly Spair and her three children.

Discovering you’re pregnant can cause a rush of emotions. It is a time of significant change, from excitement and anticipation to overwhelm and sometimes confusion. In the beginning, it’s easy to feel as though you’re navigating unchartered territory without a compass. Trying to understand all the essential testing and decisions that need to be made can make your head spin, to say the least. 

If you feel this way, let me reassure you that you’re not alone- you’re not alone in feeling overwhelmed and trying to navigate this time in your life!  Within my practice, I have supported thousands of women through the various stages of pregnancy, and nearly every woman I have worked with has felt this way at least once during their journey.  As a mother of three, I understand entirely the whirlwind of emotions that can be experienced during this time.  That is why in today’s blog, we discuss everything about pregnancy testing and support to help you feel more prepared, calm, confident, and clearheaded going into this beautiful journey.  Let’s get started!

The Pre-Pregnancy Period

Trying to conceive can be very stressful for many women.  It can feel like you’re just guessing your way through the process.  Ovulation predictor kits can be unclear, and the stress that goes into monitoring your hormones can feel never-ending and lead to repeated unnecessary blood draws for many women. 

Mira is one tool that I have found to be extremely helpful during the pregnancy journey.  Mira is a comprehensive at-home fertility monitoring platform that tracks your LH, E3G, PdG, and FSH levels without the need for a blood draw.  It also tells you your six most fertile days, predicts and confirms ovulation, and quantifies your hormone readings.  It is an easy-to-understand, fast-acting tool that can help you with your fertility goals.  I love Mira so much because it enables you to test your hormone levels using a urine sample.  As a result, it decreases the need for large blood draws.  Within 20 minutes, your results are sent to an app on your phone.  You can use the code “reclaimersofhealth” for 17% off testing with Mira!

Pregnancy testing and ultrasounds.

Pregnancy Testing and Screening

Of course, during pregnancy, we want to do what we can to keep our bodies and our growing baby healthy.  Ensuring we attend all of our prenatal appointments and communicating any concerns with our OBGYNs and midwives is essential in accomplishing that.  During your appointments, your OBGYN or midwife will discuss with you what testing and screenings are recommended during your pregnancy. Many women ask me which tests are truly useful, which ones I would personally decline, and which ones might have a less invasive alternative. This is something I address on a case-by-case basis with each client based on their individual history and risk factors, but the following list is a general timeline of different imaging and blood tests your provider may recommend during pregnancy. This timeline is a guide, and each doctor or midwife may vary in the timing or type of testing. If you have risk factors during your pregnancy, such as hypertension, diabetes, obesity, etc, your testing may differ slightly from the list below. 

First Trimester

4-7 weeks: 

One of the goals of your first prenatal appointment is to confirm your pregnancy (using urinalysis) and your baby’s health.  During weeks 4-7, an ultrasound may be done to determine viability and check for fetal heart tones. Usually, your provider will perform a complete physical examination, measuring your weight and blood pressure. Your provider may also recommend a pap smear and pelvic and breast examination. 

12 weeks:

You may be given the option for a nuchal translucency sonogram at 12 weeks. This test is performed via ultrasound and measures the amount of fluid behind your baby’s neck. The amount is used to calculate your baby’s chances of chromosomal or genetic abnormalities and can determine its risk of having congenital conditions such as Down syndrome. 

During this time, blood work may also be performed.  Your provider will typically test for the following:

  • Blood type
  • CBC
  • Creatinine (kidney function)
  • Fasting glucose (diabetes screen)
  • HIV
  • Syphilis
  • Hepatitis B and C
  • Screening for immunity to Rubella 

Genetic screening is also an option at the 12-week mark. Your provider will discuss many different types of genetic tests with you. Typically, the most basic one is screening for increased risk of Down Syndrome, Neural Tube Defects, and Trisomy 18.

Second Trimester 

16 weeks:

At the 16-week mark, your provider may recommend a second genetic screening test, depending on the type initially ordered and the results. 

20 weeks:

At week 20, an ultrasound scan, called an anatomy sonogram or anomaly scan, may be performed. This scan checks the developmental health of fetal organs and body parts and can detect certain congenital defects. It is during this scan that you can also learn your baby’s sex if this was not already determined via genetic testing.

24-28 weeks:

Your provider may recommend a gestational diabetes screening during weeks 24-28. This may include a one-hour glucose tolerance test and another CBC blood test to check for anemia.

Pregnancy testing in the third trimester.

Third Trimester

28-34 weeks:

At the 28-to-34-week mark, your provider may order a growth sonogram. This scan evaluates fetal growth and development, fetal position, and amniotic fluid and gives an overall picture of your baby’s health.

35-36 weeks:

At this point in your pregnancy, your provider may have you repeat an HIV and syphilis blood test. Group B strep testing may also be performed.  Group B Streptococcus (GBS) is a common bacteria in the lower digestive tract.  Sometimes, GBS can be detected in the vaginal area of a pregnant woman.  If this is the case, the concern then arises because babies can be exposed to the bacteria during labor and contract a life-threatening illness.  The good news is that the chances of this happening are very slim.  Nonetheless, GBS testing can help prevent pregnancy complications and adverse outcomes from occurring. 

37-40 weeks:

During weeks 37 to 40, your provider may recommend that dilation checks begin.

40+ weeks:

If you go past your “guess date,” your provider may want to perform a BPP sonogram (biophysical profile) to ensure your baby’s movement is appropriate, your heart rate, muscle tone, and breathing are healthy, and your amniotic fluid levels are normal.  

Again, many women ask me which tests are truly useful, which ones I would personally decline, and which ones might have a less invasive alternative. This is something I discuss on a case-by-case basis with each client based on their individual history and risk factors. 

Postpartum support with Dr. Kimberly.

Postpartum Support

We receive tremendous support from our providers during pregnancy and our frequent prenatal appointments.  But what about after we have our baby?  Having a baby (especially our first baby) creates so much change within our lives and family, and it can be helpful to have additional support during the postpartum phase of the journey as well. This is why we offer a support package for moms at this stage (and any stage in the child-bearing journey). 

Fertility/ Pregnancy/ Postpartum Support Package

This package receives priority booking.  It contains appointment options for pre-conception after that positive test, one each trimester, one birth coaching call, one postpartum support call, a nursing/lactation call, and two postpartum support follow-up calls.  We receive so much positive feedback about this package as it gives mamas the support they need to approach pregnancy and health confidently. 

This package includes the following:

  • 50-minute consultation may occur pre-conception, during pregnancy, or postpartum.
  • 8 x 25-minute follow-up calls to be used for:
    • Birthing Support – birthing practices and prep
    • Postpartum recovery support
    • Nursing/Lactation consultation
    • Postpartum support follow-up 
    • Postpartum support with a focus on nutrition, herbs, supplements and encouraging wellness while breastfeeding

If you are further along in your pregnancy and wish to take advantage of this package, you can simply start where you are with a one-hour call and add the additional time to the end of your package for postpartum and infant support. 

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