- Adrienne Black
Prenatal Care in the US
If you aren’t familiar with what the typical course of prenatal care is, it can be confusing and concerning! Especially if the care is different in your country! It may help ease your worry if you understand what typical prenatal care in the United States may be. Keep in mind, Prenatal Care Providers (‘PCP’) make the decision on how they provide care and may vary on how they do things.
Prenatal care appointments begin after the surrogate has been released from the care of the Reproductive Endocrinologist. This is typically around 8-10 weeks of pregnancy, and this is when the surrogate will begin using her own health insurance for her care.
PCP are typically a Midwife or Obstetrician. If the pregnancy is high risk, like in the event of multiples, the surrogate may also see a Perinatologist or Maternal Fetal Medicine doctor.
In the United States, we typically do not receive physical proof or results of any testing, screening, or ultrasounds. PCP discuss results with patients, but rarely provide paper copies of the results.
Additionally, although a surrogate may ask for permission to take photos or video during ultrasounds, she may not be allowed to do either. It is up to the provider whether they will allow it.
9 and 12 weeks of pregnancy
The Surrogate and her prenatal care provider will go over the surrogate’s medical history and IVF records for the current surrogacy pregnancy.
Prenatal Care Provider will offer genetic testing and will likely check blood pressure and weight, order a urine screen for protein and sugar, and may order general bloodwork. They may also order an ultrasound, though it is not required and is by care provider discretion.
12-14 weeks of pregnancy
The PCP will go over any questions or concerns you may have, will discuss the results of any testing, and will check blood pressure, weight and urine.
16-18 weeks of pregnancy
The PCP will instruct the surrogate to schedule an appointment for the anatomy ultrasound. The anatomy ultrasound is typically completed between 18 and 22 weeks, takes 1-2 hours, provides measurements of the baby and is often recorded. You will get pictures of the baby.
The PCP will check blood pressure, weight and urine. They will measure the surrogate’s abdomen to check the baby’s growth, and they will listen to the baby’s heartbeat with a doppler.
20-22 weeks of pregnancy
The PCP will check blood pressure, weight and urine. They will measure the surrogate’s abdomen to check the baby’s growth, and they will listen to the baby’s heartbeat with a doppler.
24-26 weeks of pregnancy
The surrogate will also be instructed to complete the Gestational Diabetes test. This test is completed at a lab, takes 1-3 hours, and requires 2-4 blood draws after drinking a very syrupy, sugary drink.
The PCP will check blood pressure, weight and urine. They will measure the surrogate’s abdomen to check the baby’s growth, and they will listen to the baby’s heartbeat with a doppler.
28-30 weeks of pregnancy
The PCP will give the surrogate a Rhogam shot if she is RH negative (which is not common). They will discuss the gestational diabetes testing results and address any questions or concerns about the pregnancy or the gestational diabetes results.
The PCP will check blood pressure, weight and urine. They will measure the surrogate’s abdomen to check the baby’s growth, and they will listen to the baby’s heartbeat with a doppler and will feel for the baby’s position in the uterus.
At this time, the surrogate may need to register at her delivery hospital or birthing center so that all of her information is in their system.
32-36 weeks of pregnancy
The surrogate will begin seeing her Prenatal Care Provider every 2 weeks.
The PCP may perform the Group B strep test and may check the surrogate’s cervix to identify if there is any change in cervix length.
The PCP will check blood pressure, weight and urine. They will measure the surrogate’s abdomen to check the baby’s growth, and they will listen to the baby’s heartbeat with a doppler and will feel for the baby’s position in the uterus.
36-42 weeks of pregnancy
The surrogate will now see her Prenatal Care Provider every week.
The PCP may check the surrogate’s cervix, but this is not mandatory and is only done at the request of the surrogate.
The PCP will check blood pressure, weight and urine. They will measure the surrogate’s abdomen to check the baby’s growth, and they will listen to the baby’s heartbeat with a doppler and will feel for the baby’s position in the uterus.
If the surrogate carries past 40 weeks of pregnancy, she may be asked to have additional monitoring. The surrogate and her PCP will also discuss a possible new birthing plan and talk about the possibility of an induction. Inductions are a medical decision discussed between the surrogate and her Prenatal Care Provider. You can learn more about induction here.