Onward Babe
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Let's get you ready

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Questions to ask

  • Can we confirm my due date with an ultrasound, and when will my first scan be?
  • Do I qualify for low-dose aspirin, and should I start by 16 weeks?
    It's often not offered unless you ask.
  • Which genetic screening options do you recommend for me, and what would each one tell us?
  • Should I be tested early for diabetes, given my history?
  • Is everything I'm taking — prescriptions, supplements, over-the-counter — safe to continue?
  • Which vaccines do you recommend for me, and when?
  • Who do I contact with questions between appointments, and how quickly should I expect a reply?

Things to bring

  • The first day of your last period, or your transfer date and embryo age if you did IVF
  • Every medication and supplement you take, with doses — bring the bottles
  • Your fertility clinic records and early hCG results, if you had treatment
  • Details of any previous pregnancies, losses or complications
  • Family history, including any genetic conditions

Tests to ask about

  • Your dating scan. A first-trimester ultrasound is the most accurate way to set your due date. After IVF, the due date is calculated from your transfer date and embryo age instead.
  • Genetic screening. Screening should be offered to everyone, whatever your age. Cell-free DNA, a blood test, can be done from 10 weeks and screens for Down syndrome and two other common chromosome conditions; screening for the sex chromosomes is now optional. A combined blood test and nuchal scan at 10–13 weeks is another option. Screening isn't a diagnosis — a positive result is confirmed with CVS or amniocentesis.
  • Carrier screening. If you and your partner haven't had it, it can still be done in pregnancy.
  • Low-dose aspirin. If you have one high-risk factor for preeclampsia, or more than one moderate one — including a first pregnancy, IVF, age 35 or over, or a BMI over 30 — ask about 81 mg a day from 12 weeks, ideally started before 16. Who qualifies.
  • Early diabetes testing. Routine screening for gestational diabetes is at 24–28 weeks, but with risk factors — such as PCOS, a higher BMI, a family history, or diabetes in a previous pregnancy — you can be tested at your first visit.
  • Vaccines. Flu in any trimester; Tdap at 27–36 weeks; RSV at 32–36 weeks in season. ACOG also recommends COVID-19 vaccination in any trimester; the CDC's page currently describes it as an individual decision, and federal vaccine policy is being contested in court.
  • Your mental health. ACOG recommends screening for depression and anxiety at the first visit and again later in pregnancy. If you're struggling, say so — it's common, and it's treatable.

Nail this down before you leave

  • Your due date and how it was worked out
  • Which genetic screening you've chosen, if any, and when results come back
  • Whether you qualify for aspirin, and when to start
  • Who to call with concerns, including after hours

Questions that work in any appointment

These four apply to any test, any treatment, any recommendation — and they're the ones that turn a pronouncement into a decision you're part of.

  • Does this evidence apply to my situation specifically?
  • What would this test change about our plan?
  • What are the benefits, the risks, and the alternatives?
  • What would make you recommend a different approach?

If they say everything looks normal

  • Which of the standard tests have actually been done, and which haven't?
  • If everything is normal, what would you look at next, and when?
  • Is there anything in my history that would make you consider additional testing?
  • What's the plan from here, and at what point would you change it?

What happens next

Around 10–13 weeks: genetic screening if you choose it, and often another scan.

Around 12–16 weeks: start low-dose aspirin, if you qualify.

In the second trimester: the anatomy scan at around 18–22 weeks, and diabetes screening at 24–28 weeks.

If you have a history of loss, APS or a medical condition, ask whether you should also see a maternal-fetal medicine specialist.

Notes from the appointment

Onward Babe is educational, not medical advice. Everything here is built from published research and professional guidelines so you can have a better conversation with the doctor who actually knows your situation.