A positive home test is the beginning of a long relationship with a maternity team. The first antenatal visit is longer than any that follow, because it establishes your baseline, identifies anything that needs extra attention, and dates the pregnancy accurately.
Knowing what to expect makes it far less overwhelming.
When to Book the First Appointment
Ideally between six and eight weeks from your last period. Earlier than five weeks and a scan may not yet show what it needs to, meaning you will simply be asked to return.
Book sooner than that if you have bleeding, severe one sided pain, a previous ectopic pregnancy or miscarriage, diabetes, thyroid disease, epilepsy, high blood pressure, or you are taking regular medication. Some medicines need reviewing urgently in early pregnancy, and that conversation should not wait.
The History Your Doctor Takes
Expect detailed questions. This is the foundation of your care plan, so accuracy matters more than brevity.
- Date of your last menstrual period and your usual cycle length
- Previous pregnancies, deliveries, miscarriages and terminations
- Any complications in previous pregnancies, particularly high blood pressure or gestational diabetes
- Medical conditions, surgeries and all current medicines including supplements
- Family history of diabetes, high blood pressure, twins or genetic conditions
- Whether you and your partner are related by blood, which affects genetic risk
Nothing here is judgemental. Withholding information about a previous termination or a medication you are embarrassed about only makes your care less safe.
The Examination and Measurements
Your weight, height and blood pressure are recorded and will be repeated at every visit, because the trend matters more than any single reading.
Blood pressure at this stage is particularly important. A raised reading in the first trimester suggests pre existing hypertension rather than a pregnancy condition, and that distinction changes how you are monitored for the rest of the pregnancy.
The First Trimester Blood Tests
A panel of tests is drawn at the first visit. Each has a specific purpose.
- Haemoglobin: anaemia is very common in Indian women and is easier to correct early
- Blood group and Rh typing: Rh negative mothers need anti D injections
- Thyroid function: untreated hypothyroidism affects fetal brain development
- Blood sugar: to identify diabetes present before pregnancy
- HIV, hepatitis B and syphilis: all treatable in ways that protect the baby
- Urine test: for infection and protein
These tests exist because each one changes management when abnormal. Our laboratory reports them together so the first review is complete.
The Dating Scan
An ultrasound in the first trimester confirms the pregnancy is inside the uterus, checks the heartbeat, counts how many babies there are, and dates the pregnancy from the measurement of the fetus.
This dating is more accurate than your period dates, and it is the date used for every subsequent decision, including when induction would be considered. If your cycles are irregular, this scan is the only reliable way to know how far along you are.
The nuchal translucency scan, between eleven and fourteen weeks, is a separate scan that combines with blood markers to assess the chance of chromosomal conditions.
Folic Acid and Other Supplements
Folic acid reduces the risk of neural tube defects such as spina bifida, and the neural tube closes by around twenty eight days, often before a woman knows she is pregnant. That is why it is recommended before conception where possible.
- Folic acid: through the first trimester, at a higher dose if you have diabetes, epilepsy or a previous affected pregnancy
- Iron: usually started after the first trimester when nausea settles
- Calcium: from the second trimester
- Vitamin D: deficiency is widespread in India even with abundant sun
Do not take vitamin A supplements or unprescribed herbal preparations. High dose vitamin A is harmful to the fetus.
Questions Worth Asking at This Visit
Come with these written down, because it is easy to forget them in the moment.
- What is my expected delivery date based on the scan?
- Is my haemoglobin adequate, and do I need iron now?
- Are any of my current medicines a problem in pregnancy?
- How often will I be seen, and which scans are planned?
- What weight gain is appropriate for my build?
- Who do I contact out of hours, and what counts as an emergency?
That last one is the most important. Make sure you leave knowing exactly where to go at two in the morning if something worries you.
Warning Signs in Early Pregnancy
Contact your obstetrician or attend the hospital without waiting if you have:
- Heavy bleeding, or bleeding with pain
- Severe pain on one side of the lower abdomen, particularly with shoulder tip pain or faintness, which may indicate an ectopic pregnancy
- Vomiting so persistent you cannot keep fluids down for a day
- Fever above 38 degrees
- Burning on passing urine with back pain
Our obstetric emergency service operates around the clock, and it is always better to be seen and reassured.
The first antenatal visit is long, detailed and occasionally overwhelming, but it is the visit that shapes everything after it. Bring your old records, your medicine boxes, and your questions.
Our antenatal care programme at T. Nagar runs from confirmation of pregnancy through to delivery, and Dr. Santoshi Nandigam sees new bookings in the gynaecology department.
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