Prenatal Appointments timeline

As a parent-to-be, staying on top of your prenatal care appointments is essential to ensuring a healthy pregnancy and birth. In this blog, you will learn what to expect at a freestanding birth center vs a hospital based system.

In the early weeks of pregnancy it is important to take time to choose a provider and decide where you would like to give birth whether that is a hospital, birth center or at your home. You have a few weeks to do this. Do your research! If you are interested in birth center care, schedule consultations and tours to choose the place that feels most comfortable. At Twin Cities Birth Center we require a tour and consultation before starting maternity for all new patients and for people that have not had care with us in 3+ years. The following is a timeline of prenatal appointments at Twin Cities Birth Center and most out of hospital birth centers. Partners and other children are welcome to join.

You will see that the prenatal appointments are 30-60 minutes each time which is different that hospital based care. OB or hospital midwife appointments are usually 5-15 minute, a very brief check in to make sure health is good. It is important to us at TCBC that you have longer visits to build a relationship with each midwife and have space and time to ask questions and be heard and supported. The midwife will also provide education at each visit to help prepare you for labor, birth and postpartum. It is also vital to keep your body as healthy as possible during pregnancy to remain low risk. Out of hospital birth centers only attend low risk births.

Initial Consultation + Tour, 30 minutes+

This is typically scheduled around 4-8 weeks in pregnancy but can be at any time in pregnancy if you are wanting to transfer your care. At TCBC, this is a one on one consultation which allows this visit to be personalized. Many people will bring specific questions based on their research, past history and preferences. First we talk about the care provided at the birth center and then a full tour is given. At the end of this appointment, you can start care with us if you choose and make your next appointments. Some people wish to take time and think about it before officially deciding, which is absolutely ok!

Virtual Intake With a Nurse, 30 minutes - 1 hour

Once you have made the decision to start care at the birth center, your first appointment will be a virtual intake with a nurse. This happens around 7-10 weeks. The nurse will go over your health history in depth. She will also go over the genetic testing avaiable to you. Genetic testing and screenings are a personal choice. We give you the information and you can decide what is best for you and your family. The nurse will also talk about things like appropriate exercise and things to eat and not to eat, as well as supplements and vitamins that are recommended.

Optional Early Ultrasound

TCBC offers early ultrasounds starting at 8 weeks. This is a dating ultrasound. Dating ultrasounds are not required. If you do not know when your last period was, it would be highly recommended to solidify an estimate due date. Often people choose to have an early ultrasounds for peace of mind but we leave that decision up to you! The best time to do this type of ultrasound is between 8-12 weeks.

First Prenatal Visit With a Midwife, 1 hour

At your first prenatal visit which happens around 12 weeks, you will have pregnancy labs drawn, this is very standard. The midwife will also go over things to help keep your body healthy and ask you do do a diet diary for 5 days. This helps the midwives see things like how much protein you are taking in and how you feel each day. At 12 weeks, this is when the uterus peeks over the top of your pubic bone, allowing us to hear the baby’s heart beat with a doppler. This will be done at each visit along with taking your blood pressure and weight.

16 Week Prenatal Visit, 30 minutes

This is a standard visit with a midwife. The midwife will discuss exercise and activity as most people are starting to feel better at this point.

20 Week Prenatal Visit + Anatomy Scan/Ultrasound, 1 hour and 15 minutes

The 20 week ultrasound/anatomy scan is the one ultrasound that we require at TCBC. It gives us a good look at growth and organ development which is important to know, especially with delivering outside of a hospital. This scan is about 45 minutes. Before or after your ultrasound you will have a 20 week prenatal appointment with a midwife.

24 Week Prenatal Visit, 30 minutes

At 24 weeks the midwife will discuss the glucose test which tests your body for gestational diabetes. This test happens at 27 weeks. We have a few different options for this test which is different that most clinics. We have the standard glucose drink, a dye free version of the standard drink, a natural sugar option called the Fresh Test. Some people will opt to test their blood sugar at home, four times a day for a week as another alternative.

27 Week Prenatal Visit, 1 hour

At the beginning of the 27 week appointment, we will have you drink the option that sounds best to you, you have 5 minutes to drink this tasty treat. Not everyone thinks it is very tasty but why not try! People seem to really enjoy the Fresh Test option and it tends to not make people feel nauseous. After you are finished, you will have your prenatal visit with a midwife. Once it has been one hour since your final sip, we will do a quick blood draw. This test tells us how well or not so well your body processes sugar. If it comes back too high, we will do a 3-hour glucose test. If that also comes back high, you will be diagnosed with gestational diabetes. You can still receive care at the birth center as long as your blood sugar can be controlled with diet. If you were to need insulin, you would need to transfer out for hospital based care.

30 Week Prenatal Visit, 30 minutes

At your 30 week prenatal appointment, we will have a general check in with you about how things are going and how you are feeling about your upcoming birth. We will also make sure that you have all of your classes scheduled. We have 4 complimentary classes. They are Childbirth Education (in-person, 3 hours and required for anyone who has never birthed outside of a hospital), Breastfeeding (in-person, 2.5 hours and required for first time parents choosing to breastfeed), Anticipating Labor and Birth (virtual video, 45 minutes and required for everyone), and Early Home Care (virtual, via Zoom, 1.5 hours and required for everyone).

33 Week Prenatal Visit, 30 minutes

We will discuss optimal baby positions and how to encourage baby to settle into an optimal position. We will also do some education about eye ointment and vitamin K for your baby. If you are having a boy we will talk about circumcision if you have questions or are trying to decide whether or not to have this procedure done.

36 Week Prenatal Visit, 1 hour

There is a lot that happens at the 36 week appointment. There will be a lab test done to test you for Group B Strep (GBS), this is a swab that you will do yourself in the bathroom. If this test comes back positive, we will discuss antibiotics in labor. We offer an optional position ultrasound at this visit to confirm that your baby is head down. We will go over a lot of information about postpartum decisions such as, newborn procedures, what you would like to do with your placenta and have you fill out birth certificate paperwork.

38 Week Prenatal Visit - 40 Week Prenatal Visit, 30 minutes

Starting at 38 weeks, you would come every week until your baby is born. TCBC care goes until 42 weeks to give your body time and patience to go into labor. 38-40 week prenatal appointments are check ins to make sure you and your baby are still doing well and growing.

41 Week Prenatal Visit - 1 hour+

If you reach 41 weeks in pregnancy, you will come in for a prenatal visit as well as a non-stress test for your baby and an Ultrasound called a Biophysical Profile (BPP). These additional tests at 41 weeks help us ensure that your baby is healthy, non-stressed and ready to keep going to 42 weeks if you get that far.

If you reach the point of pregnancy of getting close to 42 weeks, we will do a check in at 41 weeks, 4 days to start talking about inducing labor naturally. Out of hospital birth centers do not do drug inductions like pitocin. We rely on natural methods such as castor oil under supervision of a midwife.

If you are interested in starting care at Twin Cities Birth Center, we would love to have you come in for a consultation! You can request that appointment here.