Preventive check-ups for pregnant women

Every pregnant woman has a legal right to medical check-ups during pregnancy. The maternity guidelines record exactly which examinations are to be carried out and when. They are documented in the mother’s passport . Due to the legal anchoring, the check-ups are borne by the health insurance companies.

Why are there preventive medical check-ups?

The preventive appointments are intended to ensure that you and your baby are doing well and that you receive good advice on all issues relating to pregnancy. Risks are identified early and treated where possible. This increases the chances of a healthy child and a pregnancy and birth that is as symptom-free as possible. This good surveillance has resulted in significantly lower maternal and infant mortality rates in recent decades.

Prevention at a gynecologist or midwife?

It is best to find a midwife or gynecologist you trust for your check-ups. You can also split the check-ups between the midwife and the doctor. For example, many women are cared for by a midwife, but attend the three recommended ultrasound appointments and other prenatal diagnostic tests with a doctor. Many midwives criticize medical prenatal care, because as part of this care, significantly more than the recommended three ultrasound examinations and many optional tests are carried out, although there are no clear indications of risks. They argue that this makes many pregnant women feel insecure and unnecessarily classified as high-risk pregnant women.

What is examined during the preventive medical check-ups?

A total of around ten preventive appointments are planned. As a rule, these appointments include the following examinations:

• Ultrasound : Three ultrasound examinations are planned during pregnancy. However, gynecologists often carry out more. In the first few weeks of pregnancy, a vaginal ultrasound shows whether the fertilized egg has implanted properly in the uterus and is growing. From the 12th week of pregnancy, the ultrasound examination (also called screening) is performed on the abdominal wall. In this way, the growth and position of your baby can be examined. The nuchal translucency measurement can also be carried out later by ultrasound between the 12th and 14th week.
• Weight : Your weight gain will be checked at almost every appointment during pregnancy.
• Blood values ​​: Among other things, the number of your red blood cells (HB value) in your blood will be checked, as this is very important for your child’s oxygen supply. In addition, during one of the first examinations, your blood will be examined for antibodies against certain diseases, such as rubella. Your blood group and your Rhesus factor will be determined.
• Blood pressure : Your blood pressure will also be checked regularly.
• Urine testing : Your urine will be tested regularly for bacteria and other signs of disease so you can respond early if you become ill.
• Vaginal examination : The condition of your cervix and the position of the child are examined regularly.

Optional examinations during the check-ups

In addition to the examinations within the framework of the maternity guidelines, there are a few other optional examinations that your gynecologist could recommend if you have a special medical history, genetic predisposition in the family or, for example, if the mother is older. He is obliged to inform you comprehensively about possible risks and available tests. These optional tests often have to be paid for by yourself. Only in rare cases are they supported by the health insurance companies if there is a medical reason. Some tests, like amniocentesis, also come with a small but real risk to your baby’s health. They are therefore only recommended by your doctor or midwife if other risk factors speak in favor of them.Prenatal diagnosis ” more about possible optional examinations.

Dates of preventive examinations

In the first few months of pregnancy, check-ups should take place every three to four weeks. From the 32nd week, the interval between the examinations is shortened to appointments every two weeks. If the calculated due date is exceeded, the intervals are further reduced to every two days. If you have exceeded the limit for ten days, you should even come to the preventive medical check-up every day. The individual check-ups focus on the following:

• Initial check-up (5th to 7th week) : During your first visit to the doctor or midwife, the expected date of delivery and the progress of the pregnancy will be determined. Blood and urine will also be taken from you to test for various diseases and antibodies. Your blood group, your Rhesus factor and your hB value (percentage of red blood cells) will be determined. Your weight will be recorded and your blood pressure measured. Everything is recorded in your new maternity pass. Optional Tests: You can be tested for HIV. You can find out more about your first check-up appointment in our article “First examination ” .
• 1st check-up (9th to 12th week) : During your first check-up, your gynecologist or midwife will check your unborn baby’s heartbeat. Your blood pressure and weight will be measured. The level of the uterus and the cervix is ​​palpated. A urine sample will also be given, and a blood sample may also be taken. Optional tests : A test for toxoplasmosis is possible.
• 1. Ultrasound screening (9th to 12th week) : You can have the first ultrasound screening done at this or the next preventive appointment. The doctor can use the ultrasound to calculate the expected delivery date. A multiple pregnancy can now usually be determined. Optional examination: Should it be necessary, a chorionic villus biopsy can be carried out after this period . However, it is not part of normal preventive care and is only carried out if certain risk factors are present and after thorough medical advice. From the 12th week, the first trimester screening can also be carried out if you wish after a discussion with your doctor.
• 2. Preventive check-up (13th to 16th week) : This time the gynecologist or midwife will check the child’s position and the child’s heartbeat to see whether everything is going as usual. In addition, the growth of your uterus, your weight and your blood pressure will be measured.
• 3. Check-up (17 to 19 weeks) : During this appointment, the regular check-ups (blood, urine, weight, blood pressure, vaginal examination to determine the position of the child and the condition of the cervix) are carried out. Optional examination: An amniotic fluid examination can be carried out during this time . However, like the chorionic villus biopsy, it is only performed if certain risk factors speak in favor of it. Your doctor will advise you on this.
• 4th check-up (19th to 22nd week) : In addition to the regular check-ups (blood, urine, weight, blood pressure, vaginal examination to determine the position of the child and the condition of the cervix), the second ultrasound screening can now be carried out.
• 2nd ultrasound screening (19th to 22nd week) : The second ultrasound is used to check whether the child is still developing well. For this purpose, it is measured and the values ​​are compared with standard curves of fetal development. Particular attention is paid to organ development. The placenta and the amount of amniotic fluid are also checked.
• 5. Preventive check-up (23rd to 25th week): The regular check-ups take place (blood, urine, weight, blood pressure, vaginal check-up to determine the position of the child and the condition of the cervix). Optional check-up: If there is any suspicion, a glucose tolerance test can be carried out performed to rule out gestational diabetes. In addition, a second antibody search test can now be carried out on a pregnant woman with the blood group characteristic rhesus negative by taking a blood sample.
• 6. Check-up (26th to 28th week): The regular check-ups take place (blood, urine, weight, blood pressure, vaginal examination to determine the position of the child and the condition of the cervix).
• 7th check-up (29th to 32nd week) : In addition to the regular check-ups (blood, urine, weight, blood pressure, vaginal examination to determine the position of the child and the condition of the cervix), the third ultrasound screening can now be carried out. From now on, many doctors also use CTG to check the child’s heartbeat and the possible presence of early labour.
• 3. Ultrasound screening (29th to 32nd week) : The baby is also measured during the last ultrasound and compared with the standard curves for fetal development. The placenta and the amount of amniotic fluid are also examined this time.

From about the 32nd week, the check-ups take place every two weeks.

• 8. Check-up (34th to 35th week) : Your calculated due date is getting closer and closer. The final tests are done to ensure a smooth delivery. In addition, a so-called CTG is created with a contraction recorder to check whether you can already be diagnosed with contractions. The CTG also records the heart activity of the child. Midwives usually use a hearing trumpet for this.
• 9th check-up (36th to 37th week) : You’re almost there. This time, too, the regular examinations will be carried out and your baby and your contractions will be examined by CTG. Optional test: Now is a good time to swab the blood to rule out the presence of Group B streptococci . The test is not part of maternity guidelines, but is recommended nonetheless.
• 10. Preventive check-up (39th to 40th week) : Your due date is approaching. Almost all check-ups are now over. During this appointment, your cervix will be palpated more closely to determine whether it is already slightly open and whether the birth canal has already shortened further. The position of the baby’s head is examined. With the CTG, the heart sounds and your contractions are checked.

When the due date has passed

Not every baby comes on time. If your child has not yet been born, your doctor or midwife will ask you to visit every two days. If you exceed the deadline by more than ten days, there may also be daily checks. On these days, the usual examinations are then carried out as with the regular check-ups. A CTG will also be done to further check the heart sounds and your contractions. The ultrasound is used to regularly check whether there is still enough amniotic fluid and how the baby is doing. If the health situation for you or your baby deteriorates, your doctor will point this out to you and you may be advised to induce laborguess. But often a little patience helps, because almost all babies are born a few days later without further complications. So there is no reason to worry if you are a few days late.

Print out your pension plan

In our preventive care planner for pregnancy, you can enter the expected date of birth of your baby or the first day of your last period and all preventive care appointments will be listed for you. You can print out your pension plan here!