prenatal doctor visit cost

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How Much Does It Cost to Have a Baby? Expenses from Pregnancy to Delivery

Many or all of the products featured here are from our partners who compensate us. This influences which products we write about and where and how the product appears on a page. However, this does not influence our evaluations. Our opinions are our own. Here is a list of our partners and here's how we make money .

Having a baby is expensive — sometimes alarmingly so. Costs related to pregnancy, childbirth and postpartum care average nearly $19,000 for individuals covered by large group insurance plans, according to a July 2022 study by Peterson Center on Healthcare and KFF, a health policy nonprofit. Insurance covers most of the costs, with the average woman paying about $2,850 out of pocket.

Differences between actual prices as well as insurance coverage can span tens of thousands of dollars. Navigating the costs of nine months of pregnancy — and then the cost of raising a baby — can seem overwhelming, but knowing what to expect can help. Read this guide to understand your coverage as well as which expenses to expect and when.

Beware of major differences in cost and coverage

Any guide to medical bills and your share of the cost should come with several disclaimers.

Prices vary from city to city and even hospital to hospital. Researchers at the University of California, San Francisco found in 2014 that in the Golden State, the cost of an uncomplicated vaginal birth varied widely — from $3,296 to $37,227, depending on the hospital. Cesarean sections ranged from $8,312 to almost $71,000.

If you have health insurance , coverage differences are similarly dramatic. The Affordable Care Act requires most health plans to cover maternal and newborn care. But because ACA requirements remain broad, insurance coverage isn’t uniform.

Price and out-of-pocket cost estimates are handy but are estimates. The only way to know for certain what you’ll pay is to contact your medical providers and health insurance company. The more work you’re willing to do on the front end, the less likely you’ll get surprise bills.

Get a handle on your insurance

If you’re unsure how your health insurance works, now's the time to research your benefits. You could take an entire course in understanding your policy and still likely have questions. Consider this a cram session. Your top two study areas include:

Learning about out-of-pocket costs: copays, coinsurance and deductibles .

Making sure your doctors are in your provider network, if possible.

Contact your health insurance company — with policy number in hand — and ask the key questions below. Make sure to write down whom you talked to and the date.

Are prenatal care, labor and delivery covered benefits under my policy?

Do I need a referral from my primary care doctor to see an OB-GYN or other specialists?

Will I need pre-authorization for any prenatal care?

What prenatal tests are covered (ultrasounds, amniocentesis, genetic testing, etc.)?

What common prenatal, labor and delivery needs are not covered by my policy?

Which hospitals in my area are in my insurance policy’s network?

What do I need to do to ensure that my newborn is covered from the moment of delivery?

How long of a hospital stay is covered after delivery?

Does my policy cover a private room or suite, or will I have to share a room?

If you’re interested in nontraditional deliveries, like a home birth with a midwife, ask about coverage for these.

Throughout your pregnancy and into your baby’s well-child visits, err on the side of caution. If you are unsure about your coverage and want to be doubly safe, call your insurance company to get confirmation in advance.

Watch out: Depending on your medical providers’ billing practices and your due date, you could have to pay two deductibles if your prenatal care happens in one calendar year and your baby is delivered in the next.

Some providers package their charges to insurance companies in what’s called “global billing,” which can include all prenatal and delivery charges. Ask your OB-GYN whether they plan to use global billing so you’ll know where you stand.

» MORE: How do insurance deductibles work?

Uninsured? Seek help

If you don’t have health insurance, you’re looking at tens of thousands of dollars in care over the next nine months.

Despite requiring health insurance companies to offer well-woman and maternity care, the Affordable Care Act doesn’t consider pregnancy a “qualifying event.” You will have to wait until your child is born to sign up for a new plan under the ACA.

But ACA insurance plans aren’t your only option. If you meet income requirements, you could be eligible for Medicaid , which covers many maternity care costs.

If you’re forced to pay cash for maternity care, these steps can help:

Comparison and price shop for prenatal visits, tests and your labor and delivery.

Explain to your doctor and all medical providers that you are a cash-paying customer. They often offer discounts for uninsured peoples.

Negotiate lower balances and payment plans on your medical bills.

Ask the hospital about “charity care” programs that may be available.

Consider a maternity package, increasingly offered by hospitals as a way for new parents to get all of their maternity and childbirth expenses covered under one price.

Prepare for how much it costs to have a baby

For all medical care from pregnancy to birth to recovery, the Peterson and KFF study places the total at $18,865. This is an average based on insurance benefits claims data from 2018 through 2020. The data included enrollees in large employer private health plans. Researchers compared health spending between female enrollees who gave birth and those who didn’t.

The type of delivery can have a big impact on the total cost. Pregnancies that resulted in a vaginal delivery averaged $14,768, compared with $26,280 for those involving a cesarean section.

Insurance pays most of that. The study reported out-of-pocket expenses of $2,655, on average, for vaginal delivery. The average balance for a C-section was $3,214.

» MORE: How to handle your medical bills

Averages can help you prepare. But unless you pay upfront for a maternity package, there’s no single, knowable price tag on pregnancy and childbirth. Labor and delivery might loom in your mind as the most expensive part of the experience, but a routine pregnancy requires several standard appointments and tests. Special concerns about your health or your baby’s could mean more doctor visits and interventions, all potentially coming at an additional cost.

It’s important to note that the cost breakdown below begins with a positive pregnancy test. If you hope to become pregnant after going through in vitro fertilization or some other fertility treatment, this guide can help you prepare for one phase of your journey to parenthood. You also may want to learn more about IVF costs .

Similarly, if you're looking to adopt a newborn, medical care for your baby’s birth mother may be a significant part of your expenses. NerdWallet can help you prepare for the other costs of adopting a child as well.

First trimester

If you have an uncomplicated pregnancy, you’ll see your doctor for monthly checkups during the first trimester. Typically, these are subject to a copay.

These visits will involve checking your weight, blood pressure, fundal height measurement and fetal heart rate as soon as it’s audible. Additional lab work and tests will come throughout and could cost extra.

Prenatal vitamins: Your doctor may prescribe these, or you can find them over the counter at most drugstores. Under a prescription, they’ll be subject to your copay. Bought over the counter, a bottle containing a one-month supply will cost about $10 to $30.

Lab work: Blood will be drawn for a series of lab tests including screening for common birth defects, your blood type, Rh status, hemoglobin measurements, and immunity and exposure to certain kinds of infections. If you have insurance, it’s likely that much of this will be covered, though it could be subject to your deductible. Costs vary widely.

Early ultrasound: If everything appears healthy, your doctor may not recommend an ultrasound this soon. However, a first-trimester transvaginal ultrasound may be necessary to establish the location of the fetus, how far along you are, viability of the pregnancy and number of fetuses. For people without insurance, the average cost of an early ultrasound is $1,423, according to 2022 data from FAIR Health, a national, independent nonprofit that uses health care claims data to provide cost estimates to consumers. For those with insurance coverage, the average amount billed to the insurer is lower — $586 — because of agreements between the provider and the insurance company. The amount an insured person pays out of pocket depends on their plan’s cost-sharing rules.

Cell-free fetal DNA testing: After 10 weeks of pregnancy, your baby’s blood can be screened for genetic conditions. This testing is typically performed only for at-risk pregnancies, and costs can run upward of $4,000 for people without insurance, according to FAIR Health.

Chorionic villus sampling, or CVS: This test looks for many of the same genetic abnormalities as a cell-free fetal DNA test does but analyzes the tissue surrounding the baby, similar to an amniocentesis. The test looks for Down syndrome, cystic fibrosis, sickle cell anemia and other genetic abnormalities. Most insurance plans will cover CVS in high-risk pregnancies, though you could be responsible for out-of-pocket costs if it's subject to your deductible.

A medical bill often includes multiple charges for a single procedure. One charge covers the work of professionals who performed the procedure or interpreted test results. Another charge comes from the facility where the procedure was performed, covering the use of equipment and supplies. For this article, cost estimates combine these charges, which were each provided by FAIR Health.

Second trimester

Through the end of your second trimester (week 28), you’ll continue with monthly prenatal visits. In addition, you’ll likely need:

Glucose screening: Used to test for gestational diabetes, this bloodwork is typically done around weeks 24 to 28. If you’re not insured, you could pay about $240, according to FAIR Health.

Maternal blood screening: This blood test looks for four substances that could be evidence of possible birth defects. Costs vary widely by location and coverage.

Amniocentesis: An amniocentesis is the analysis of amniotic fluid surrounding your baby. It looks for genetic conditions like Down syndrome and is usually covered by insurance when medically necessary. The average cost to someone without insurance is $1,933, according to FAIR Health.

Ultrasound: The main ultrasound during a pregnancy occurs around 18 to 22 weeks, according to the American Congress of Obstetricians and Gynecologists. Your doctor will look for things such as the overall health and position of your baby and placenta, and your ovaries and cervix. It’s at this ultrasound that your doctor will be able to determine your baby’s sex — if the little one is willing to reveal that. This ultrasound is usually covered by insurance.

Third trimester

By your third trimester, basically every lab test that needs to be done has been done. Your monthly checkups will likely be every two weeks from weeks 28 to 36 and then weekly until the baby’s birth.

Birthing classes: These classes help you prepare for labor and delivery and are often covered by health insurance. If you’re a new parent, you might also be interested in classes that introduce you to breastfeeding or newborn care. Without insurance coverage, these classes can cost $50 to $200 each.

The largest expense you can expect during this last phase of pregnancy is the cost of labor and delivery.

Labor and delivery

Your itemized bill for labor and delivery will be immense, in ink and paper, if not cost. Hospitals in the U.S. often bill per service, and each hospitalization represents a series of small services and related fees.

It’s common to be billed for each doctor who attends to you and for each pill and IV fluid pouch as well as the use of your room, among many other things. Because these prices vary from hospital to hospital, the total cost of childbirth can be difficult to estimate.

On average, someone covered by insurance would see their insurer billed $6,230 for a vaginal delivery or $5,252 for delivery via cesarean section, according to FAIR Health. The cost to the person varies, depending on cost-sharing rules in their insurance plan.

For expectant parents without insurance, the average cost of giving birth ranges from about $10,000 for vaginal delivery to about $12,000 for a C-section.

If you have to be induced, need an unexpected C-section, receive an epidural or get a snack, the charges climb. Doulas, midwives and birthing tubs are typically considered optional and thus additional, too.

If you’re insured, determining how much you’ll pay will include knowing what’s covered and how much your share of the bill will be, including deductibles and coinsurance.

To try to lower childbirth charges:

Call the hospital’s billing office to get an estimate of total charges, and apply that to what you know about your policy specifics.

If possible, set aside enough money to cover any remaining deductible for the year, plus your coinsurance share of the expected charges and some cushion for unexpected denials and charges.

If you have access to a health savings account or flexible spending account through your employer, you can set aside these anticipated expenses using pretax dollars.

Consider a maternity package: It offers all the normally itemized features of a delivery for a flat fee. Many of these packages come with payment options and discounts for those paying cash, with some costing about $3,000 to $8,000.

On a similar note...

How much is the average prenatal care cost? Where can I go for free prenatal care? Find the answers to these questions and more here and get your pregnancy started on a healthy note.

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How Much Does Prenatal Care Cost?

If you’re facing an unplanned pregnancy, the odds are that you aren’t 100 percent financially ready to raise a child.

However, if you plan to carry your pregnancy to term, you will need to accept that there are certain costs involved in doing so safely. Your prenatal care costs will just be the start of the expenses you can expect during your pregnancy and the years to come of raising your child. It’s important to understand exactly what these costs entail before you get any further in your pregnancy.

In this article, you’ll find out a little more about the average prenatal care cost for a woman in your situation. If you’re worried about the cost of prenatal care and delivery, you will also find resources for free prenatal care and affordable prenatal care to make this journey a little easier on your growing family. We know the details of pregnancy can be confusing — and that’s why we’re here to help.

Prenatal care is a necessary part of every pregnancy — not just to protect your baby’s health but to protect yours, as well. Before you get carried away buying baby supplies and other necessities for when your baby comes, you first need to be prepared for the costs of the next nine months.

You may ask: “How much does it cost for prenatal care?”

The answer to this question will depend upon several factors , including your insurance situation, the status of your pregnancy and the professionals that you choose.

According to the Kaiser Family Foundation , the average prenatal care cost for a typical pregnancy is about $2,000 . This estimate accounts for about 12 doctors’ visits at about $100 to $200 each, as well as routine blood tests, urinalysis and at least one ultrasound. You should also expect to spend money on basic prenatal vitamins (which may or may not need to be prescribed by your physician) and any additional ultrasounds or testing that your doctor recommends.

If your pregnancy requires more visits or testing than the average pregnancy does, you can expect your total cost for prenatal care to be a bit higher.

There’s one important caveat to keep in mind: When we talk about average prenatal care cost, we are only referring to the medical expenses you will incur during your pregnancy. Unfortunately, not all insurance policies will cover childbirth and delivery costs at the same rate as prenatal care costs. On average, the cost of staying at the hospital for a child delivery is $3,500 per stay . Make sure you are prepared for this financial burden when you are calculating your overall cost for prenatal care.

Is There Such a Thing as Free Prenatal Care?

For most women, free prenatal care is entirely possible. If you have insurance, your prenatal care cost is generally covered as preventative care. According to the Kaiser Family Foundation, private insurance pays on average about 87 percent of the costs for prenatal care for women.

However, depending upon your insurance policy, you may be expected to pay certain co-pays or deductibles for your prenatal care. One of the first things to do when you discover your pregnancy is to review your insurance policy and contact an insurance representative. They should be able to tell you more about which prenatal care services are covered by your policy and what kind of out-of-pocket cost of prenatal care and delivery you can expect.

Don’t have insurance? You can still purchase an insurance plan even after finding out about your unplanned pregnancy. The federal government prohibits group health insurance from treating pregnancy as a pre-existing condition. However, you will want to avoid most individual health insurance plans, as they can treat pregnancy as a pre-existing condition and refuse to cover your prenatal care costs. It’s a good idea to research insurance policies to ensure you get the coverage you need for affordable prenatal care.

If you are wondering how to get free prenatal care because you are not financially prepared for your unplanned pregnancy, you might consider adoption as one of your options. If you are looking for free prenatal care, it’s more likely that you will struggle to afford the costs of raising your child. But, if you choose to place your child for adoption, you will receive free prenatal care and other living expenses assistance from your adoption agency. Adoption will cover your pregnancy costs , and you will get the satisfaction of placing your child with a family who is 100 percent prepared for the costs of parenthood to give your child the best opportunities possible.

How to Find Affordable Prenatal Care

If you’re in a tight financial spot, you may be looking for cheap, low-cost prenatal care to work with your personal budget. Whether you have insurance or not, there are a few steps you can take to find affordable prenatal care near you:

• Apply for Medicaid: Medicaid is a government-sponsored health insurance program for low-income families. If you are pregnant, you can apply for Medicaid to receive adequate prenatal and postpartum care. You will need to contact your local Medicaid office for more information about the requirements in your state and the steps you’ll need to take to obtain coverage.
• Find a low-cost prenatal care clinic: There are many family-planning clinics that exist to help women in your situation. Consider finding your local Planned Parenthood or community health center for prenatal care that usually comes at a fraction of the cost at a larger, private obstetrician’s office.
• Shop around with your insurance: If you have insurance, your first step should be to contact your provider and find out which local clinics and physicians will accept your insurance. Your insurance can usually provide an estimate for its clients’ average prenatal care cost. Think smart about what kind of services you want and which you don’t need during your prenatal care, and search out generic prescriptions for any medications that your physician provides.

The cost for prenatal care in the United States can certainly seem overwhelming at times for expectant mothers, especially if you had no prior plans to become pregnant. But, with a little research and preparation, finding affordable prenatal care to keep yourself and your baby healthy is not as hard as it may seem.

For more information about prenatal care costs in your area and how to get free prenatal care, please contact a local family-planning clinic.

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Health costs associated with pregnancy, childbirth, and postpartum care

By Matthew Rae Twitter ,  Cynthia Cox Twitter , and  Hanna Dingel

July 13, 2022

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Pregnancy is one of the most common reasons for a hospitalization among non-elderly people. In addition to the cost of the birth itself, pregnancy care also involves costs associated with prenatal visits and often includes care to treat psychological and medical conditions associated with pregnancy, birth, and the post-partum period.

To examine the health costs associated with pregnancy, childbirth, and post-partum care, we examined a subset of claims from the IBM MarketScan Encounter Database from 2018 through 2020 for enrollees in large employer private health plans. We look at health spending (both the amount paid by insurers and that paid out-of-pocket by enrollees) for female enrollees of reproductive age who give birth, compared to those who do not give birth, holding age constant.

We find that health costs associated with pregnancy, childbirth, and post-partum care average a total of $18,865 and the average out-of-pocket payments total $2,854 for women enrolled in large group plans. We also examine how pregnancy, childbirth, and post-partum health spending among large group enrollees varies by the type of delivery, finding these costs for pregnancies resulting in a vaginal delivery average $14,768 ($2,655 of which is paid out-of-pocket) and those resulting in cesarean section (C-section) average $26,280 ($3,214 of which is paid out-of-pocket).

How we measure the cost of pregnancy, birth, and post-partum care

Some previous analyses of the cost of pregnancy and childbirth have looked at the cost of specific services , such as vaginal and cesarean delivery, or services with a pregnancy diagnosis code . However, looking only at specific claims can miss other care associated with pregnancy and birth, such as psychological care, physical therapy, or treatment of other conditions that arise because of pregnancy but are not necessarily billed as a pregnancy related expense.

In this analysis, we take a different approach. Using a regression model controlling for age, we look at the average difference in health spending for women of reproductive age who give birth compared to those of the same age who do not give birth. The benefit of this approach is that it allows us not only to look at the cost of the delivery, but also at all health costs associated with pregnancy, childbirth, and postpartum care.

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We limit the analysis to people who give birth in a hospital (either a live birth or stillborn) and do not include pregnancies that end in abortion or miscarriage. This analysis only includes the cost of the pregnancy, delivery, and post-partum recovery for the woman, and not any subsequent health spending for care of the infant.

How much does pregnancy, childbirth, and post-partum care cost?

We estimate that pregnant women of reproductive age (ages 15 to 49) enrolled in large group health plans incur an average of $18,865 more in health care costs than women who do not give birth. This additional health spending associated with pregnancy, delivery, and post-partum care includes both the amount paid by insurance (an average of $16,011) and that paid out-of-pocket by the enrollee (an average of $2,854). There is significant variation around these averages, and costs vary significantly by the type of delivery.

Women who give birth incur nearly $19,000 in additional health costs and pay almost $3,000 more out-of-pocket than those who do not give birth

How much pregnancy-related health spending is for hospitalizations and outpatient care.

While pregnant women typically have frequent outpatient office visits prior to giving birth, most pregnancy-related health spending is for the delivery. Women in large group plans with a pregnancy incur an average of $19,906 more in inpatient and outpatient costs than women of the same age who do not give birth. But prescription drug spending averages $1,040 less for women who give birth than for those who do not. Pregnant women are less likely to use prescription drugs than women of the same age who are not pregnant. Birth control pills ( oral contraceptives ) are one of the most used types of prescription drugs for women of reproductive age and some other prescription drugs are unsafe to take during pregnancy. However, these data only include spending on retail prescription drugs and therefore likely miss most out-of-pocket spending on prenatal vitamins or over-the-counter drugs that pregnant women may use.  

When looking at out-of-pocket costs over the course of a pregnancy, we find that pregnant women enrolled in large group health plans spend an average of $2,924 more on inpatient and outpatient care than women who are not pregnant spend out-of-pocket, while pregnant women spend an average of $70 less out-of-pocket on prescription drugs. In total, out-of-pocket costs are $2,854 higher for pregnant women than for those of the same age who do not give birth.

These out-of-pocket costs only include amounts paid for cost-sharing (deductibles, coinsurance, and copayments) under the health plan. Therefore, out-of-pocket spending on fertility care is generally missed because these services are not often covered by insurance. Similarly, we do not include any balance bills sent by out-of-network providers directly to patients. We previously estimated that 10% of in-network admissions for maternity care included an out-of-network charge putting patients at risk for surprise medical bills. However, as of January 2022, the No Surprises Act prohibits surprise billing by out-of-network providers when a patient was admitted at an in-network hospital.

How do pregnancy and childbirth costs vary by type of delivery?

Health costs associated with pregnancy, childbirth, and post-partum care vary significantly based on whether the baby is born by cesarean section or vaginal delivery. Over the course of their pregnancy, delivery, and post-partum period, large group enrollees who give birth via cesarean section incur an average of $26,280 more in healthcare costs than those who do not give birth. By contrast, this amount for women with a vaginal delivery averages $14,768.

Pregnancies resulting in C-sections are associated with higher health spending and out-of-pocket costs than those resulting in vaginal deliveries

The higher costs associated with pregnancies that result in cesarean section are not only because of the higher cost of the delivery, but also include higher costs before and after the birth, which may be associated with greater service intensity for care of complications or underlying health conditions that can lead to cesarean section and recovery from the surgery.

Average out-of-pocket costs associated with pregnancy, childbirth, and post-partum care are also higher for women who deliver via cesarean section ($3,214) than for those with vaginal deliveries ($2,655). However, while the average total cost of a pregnancy resulting in a cesarean section ($26,280) is 77% higher than a pregnancy resulting in a vaginal delivery ($14,768), average out-of-pocket costs are 21% higher for women who give birth by cesarean section ($3,214) than those with a vaginal delivery ($2,655). This is largely because enrollees with an inpatient admission often hit their plans’ deductible or out-of-pocket maximum, so higher-cost hospitalizations do not always lead to higher out-of-pocket costs for the admission.

What are the implications of high out-of-pocket costs for pregnancy and childbirth?

The frequency and intensity of services associated with pregnancy and childbirth can lead to considerable out-of-pocket expenses for new parents, particularly those covered by private insurance.

On average, over the course of their pregnancies, pregnant women enrolled in large employer health plans incur $2,854 more in out-of-pocket costs than similar women who are not pregnant. These costs are more than many families can afford. Roughly one third of multi-person households and half of single-person households would not have the liquid assets needed to cover typical out-of-pocket costs associated with pregnancy and childbirth in private health plans. About half of people who give birth in a given year are covered by private insurance, and the remainder are mostly covered by Medicaid, which generally has little or no out-of-pocket liability.  

Medical care for the infant can result in even more out-of-pocket costs for families with private insurance coverage. And these out-of-pocket health costs arrive just as these parents begin taking on additional costs of caring for a child. Many new parents also experience income losses due to a lack of paid parental leave, which can leave many new parents vulnerable to incurring medical debt .

Limitations

This analysis has some limitations, including that we do not control for health status before the pregnancy. It is possible women who give birth are somewhat healthier on average going into their pregnancies than women of the same age who do not give birth. Conversely, it is also possible that health conditions present before pregnancy may be incidentally discovered during pregnancy. Although we do not control for health status, health status and spending are strongly correlated with age, for which we do control.

We are only including health spending that happens through the health plan, so do not include care that is paid fully out-of-pocket, which would include most fertility treatments (as this care is often not covered by insurance).

We describe our findings as applying to pregnant women, though some of the births included were for female enrollees under the age of 18. The MarketScan sex variable is binary and our analysis is limited to the classification on the health record.

This analysis uses claims from the IBM Health Analytics MarketScan Commercial Claims and Encounters Database, which contains claims information provided by a sample of large employer plans. MarketScan allows for enrollees to be tracked for their duration at one contributing employer, and we used a subset of claims for enrollees covered in each of three years, 2018 through 2020. All dollar values are reported in 2020 nominal dollars. To make MarketScan data more representative of large group plans, weights were applied to match counts in the Current Population Survey for enrollees at firms of a thousand or more workers by sex, age and state. Weights were trimmed at eight times the interquartile range.

We further limited the sample to female enrollees between ages 15 and 49 who were continuously enrolled during the 2018-2020 period, to avoid including costs for women who changed coverage during the pregnancy. In total, this analysis used claims for almost 2,267,200 female enrollees, which represents about 15% of the estimated 14,800,000 women of reproductive age enrolled in large group market plans (plans offered by employers with one thousand or more workers) in 2018.

IBM assigns a DRG to each admission using the Centers for Medicare & Medicaid Services (CMS) Grouper. This method selects a DRG for the admission based on the diagnosis and procedures a patient received during the stay. We identify women as having a pregnancy if, between August 2018 and September 2020, they had an admission that was designated as a delivery (783-788, 796-798 and 805-807). We then modeled spending for these enrollees between January 2018 and December 2020, controlling for age and whether they had multiple pregnancy related admissions over that period. This method does not include the cost of pregnancy for enrollees who do not give birth (i.e., those pregnancies ending in a miscarriage or abortion).  

Claims data available in MarketScan allows an analysis of liabilities incurred by enrollees with some limitations. First, these data reflect cost sharing incurred under the benefit plan and do not include balance-billing payments that beneficiaries may make to health care providers for out-of-network services or out-of-pocket payments for non-covered services, meaning that we may understate the costs associated with pregnancy. Secondly, claims data show the retail cost for prescription drugs and do not include information about the value of rebates that may be received by payers. Third, when showing how spending is divided across types of care (i.e., health services and prescriptions), we combine spending on inpatient and outpatient care because global billing is commonly used for maternity services. In claims data, inpatient costs will therefore sometimes include all services for routine prenatal care, delivery services, and postpartum care since the global maternity claim is typically billed the day of delivery. Lastly, sex is defined as reported on the claim, and we are unable to identify the gender identity of the enrollee.

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Your First Prenatal Visit

If you did not meet with your health care provider before you were pregnant, your first prenatal visit will generally be around 8 weeks after your LMP (last menstrual period ). If this applies to you, you should schedule a prenatal visit as soon as you know you are pregnant!

Even if you are not a first-time mother, prenatal visits are still important since every pregnancy is different. This initial visit will probably be one of the longest. It will be helpful if you arrive prepared with vital dates and information. This is also a good opportunity to bring a list of questions that you and your partner have about your pregnancy, prenatal care, and birth options.

What to Expect at Your First Pregnancy Appointment

Your doctor will ask for your medical history, including:.

• Medical and/or psychosocial problems
• Blood pressure, height, and weight
• Breast and cervical exam
• Date of your last menstrual period (an accurate LMP is helpful when determining gestational age and due date)
• Birth control methods
• History of abortions and/or miscarriages
• Hospitalizations
• Medications you are taking
• Medication allergies
• Your family’s medical history

Your healthcare provider will also perform a physical exam which will include a pap smear , cervical cultures, and possibly an ultrasound if there is a question about how far along you are or if you are experiencing any bleeding or cramping .

Blood will be drawn and several laboratory tests will also be done, including:

• Hemoglobin/ hematocrit
• Rh Factor and blood type (if Rh negative, rescreen at 26-28 weeks)
• Rubella screen
• Varicella or history of chickenpox, rubella, and hepatitis vaccine
• Cystic Fibrosis screen
• Hepatitis B surface antigen
• Tay Sach’s screen
• Sickle Cell prep screen
• Hemoglobin levels
• Hematocrit levels
• Specific tests depending on the patient, such as testing for tuberculosis and Hepatitis C

Your healthcare provider will probably want to discuss:

• Recommendations concerning dental care , cats, raw meat, fish, and gardening
• Fevers and medications
• Environmental hazards
• Travel limitations
• Miscarriage precautions
• Prenatal vitamins , supplements, herbs
• Diet , exercise , nutrition , weight gain
• Physician/ midwife rotation in the office

Possible questions to ask your provider during your prenatal appointment:

• Is there a nurse line that I can call if I have questions?
• If I experience bleeding or cramping, do I call you or your nurse?
• What do you consider an emergency?
• Will I need to change my habits regarding sex, exercise, nutrition?
• When will my next prenatal visit be scheduled?
• What type of testing do you recommend and when are they to be done? (In case you want to do research the tests to decide if you want them or not.)

If you have not yet discussed labor and delivery issues with your doctor, this is a good time. This helps reduce the chance of surprises when labor arrives. Some questions to ask include:

• What are your thoughts about natural childbirth ?
• What situations would warrant a Cesarean ?
• What situations would warrant an episiotomy ?
• How long past my expected due date will I be allowed to go before intervening?
• What is your policy on labor induction?

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When to schedule a prenatal visit

Prenatal visitation schedule, how should i prepare for a prenatal visit, what happens during prenatal visits, how can i make the most of my pregnancy appointments.

Make an appointment for your first prenatal visit once you're aware you are pregnant – when you receive a positive home pregnancy test, for example. Booking it around week 8 of pregnancy is typical.

You'll come back regularly in the weeks and months following that initial appointment. Most people have between 8 and 14 prenatal visits throughout the course of their pregnancy.

During this time, you'll see a lot of your healthcare practitioner. That's why it's so important to choose someone you like and trust. If you're not comfortable or satisfied with your provider after your first visit or visits, don't be afraid to find someone with whom you have a better connection.

Typically, a pregnant woman will visit their doctor, midwife , or nurse practitioner every four weeks during the first and second trimesters. In the third trimester, you'll be seen more often – usually every other week until 36 weeks, and then every week until the baby is born.

For more information on what happens at these visits, see:

Your first prenatal visit

Second trimester prenatal visits (14 weeks to 27 weeks)

Third trimester prenatal visits (28 weeks through the end of pregnancy)

The specific number of scheduled appointments you'll have depends on if your pregnancy is considered to be high-risk. This is determined by your medical history and whether you have any complications or conditions that warrant more frequent checkups, such as gestational diabetes , high blood pressure , or a history of preterm labor . If you've had any medical problems in the past or develop any new problems during this pregnancy, you may need more prenatal visits than the average pregnant woman.

In the weeks before each visit, jot down any questions or concerns in a notebook or a notes app on your smartphone. This way, you'll remember to ask your practitioner about them at your next appointment. You may be surprised by how many questions you have, so don't miss the opportunity to get some answers in person.

For example, before you drink an herbal tea or take a supplement or an over-the-counter medication , ask your provider about it. You can even bring the item itself – or a picture of the label – with you to your next appointment. Then, your doctor, midwife, or nurse practitioner can read the label and let you know whether it's okay to ingest.

Of course, if you have any pressing questions or worries, or develop any new, unusual, or severe symptoms , don't wait for your appointment – call your practitioner right away.

In addition to your list, you may want to bring a partner, friend, family member, or labor coach with you to some or all of your prenatal visits. They can comfort you, take notes, ask questions, and help you remember important information.

The goal of prenatal visits is to see how your pregnancy is proceeding and to provide you with information to help keep you and your baby healthy. It's important that you go to all of your prenatal appointments, even if you're feeling just fine and believe that everything is progressing perfectly.

Your practitioner will start by asking how you're feeling physically and emotionally, whether you have any complaints or worries, and what questions you may have. They'll also ask you about your baby's movements once you begin to feel them, typically during the second trimester. Your practitioner will have other questions as well, which will vary depending on how far along you are and whether there are specific concerns.

Your midwife, doctor, or nurse practitioner will also:

• Check your weight , blood pressure , and urine
• Check for swelling
• Measure your abdomen
• Check the position of your baby
• Listen to your baby's heartbeat
• Perform other exams and order tests, as appropriate
• Give you the appropriate vaccinations
• Closely monitor any complications you have or that you develop, and intervene if necessary

Near the end of your pregnancy, your provider may also do a pelvic exam to check for cervical changes. You will also discuss your delivery plan in more depth.

At the end of each visit, your practitioner will review their findings with you. They'll also explain the normal changes to expect before your next visit, warning signs to watch for, and the pros and cons of optional tests you may want to consider. Lifestyle issues will likely be a topic of discussion, as well. Expect to talk about the importance of good nutrition , sleep, oral health, stress management, wearing seatbelts, and avoiding tobacco , alcohol , and illicit drugs.

Many people look forward to their prenatal appointments but are disappointed to find that, with the exception of the first visit, they're in and out of the office in 10 minutes. A quick visit is typical and is usually a sign that everything is progressing normally. Still, you want to make sure your concerns are addressed – and that you and your baby are being well cared for.

Here are some things you can do to ensure that your prenatal visits are satisfying:

• Speak up. Your practitioner isn't a mind reader and won't be able to tell what you're thinking just by performing a physical exam. So, if anything is bothering you, say your piece. Are you having trouble controlling your heartburn ? Managing your constipation ? Suffering from headaches ? This is the time to ask for advice. Consult the notebook of questions you've been compiling. In addition to physical complaints, let your practitioner know if you have emotional concerns or fitness or nutrition questions.
• Ask the staff about the administrative stuff. Save your questions about things like insurance and directions to the hospital for the office staff so your practitioner has more time to answer your health-related questions. Go to the admin staff with any inquiries about payments, scheduling, office policies, and your contact information.
• Be open-minded. When talking with your doctor, midwife, or nurse practitioner, you should feel comfortable speaking freely. But remember to listen, too. Take notes if you find it helpful.

Keep in mind, too, that some days are busier than others. This is especially true during the COVID-19 pandemic. That doesn't mean your practitioner doesn't have to answer your questions, but sometimes a discussion can be continued at the next visit if it's a really busy day or if your practitioner needs to head to the hospital to deliver a baby.

At the same time, don't tolerate a healthcare practitioner who won't give you thorough answers, doesn't show reasonable compassion, or barely looks up from your chart. You and your baby deserve more than that.

Now that you know what to expect during all those prenatal visits, you might like a sneak peek at what else is in store. Here's an overview of the next nine months .

Learn more:

• The ultimate pregnancy to-do list: First trimester
• 12 steps to a healthy pregnancy
• When will my pregnancy start to show?
• Fetal development timeline

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What happens at second trimester prenatal appointments

What to expect at your first prenatal appointment

What to expect from third trimester prenatal appointments

Prenatal testing

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

MedlinePlus. (2021). Prenatal care in your first trimester. https://medlineplus.gov/ency/patientinstructions/000544.htm Opens a new window [Accessed September 21, 2021.]

March of Dimes. (2017). Prenatal Care Checkups. https://www.marchofdimes.org/pregnancy/prenatal-care-checkups.aspx Opens a new window [Accessed September 21, 2021.]

Office on Women’s Health. (2019). Prenatal Care and Tests. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests Opens a new window [Accessed September 21, 2021.]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2017). What happens during prenatal visits? https://www.nichd.nih.gov/health/topics/preconceptioncare/conditioninfo/prenatal-visits Opens a new window [Accessed September 21, 2021.]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2017). What is a high-risk pregnancy? https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/high-risk Opens a new window [Accessed September 21, 2021.]

NIH: Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2018). What are some factors that make a pregnancy high-risk? https://www.nichd.nih.gov/health/topics/high-risk/conditioninfo/factors Opens a new window [Accessed September 21, 2021.]

March of Dimes. (2020). Over-the-Counter Medicine, Supplements, and Herbal Products During Pregnancy. https://www.marchofdimes.org/pregnancy/over-the-counter-medicine-supplements-and-herbal-products.aspx Opens a new window [Accessed September 21, 2021.]

Associates in Women’s Healthcare (2021). Preparing for Your First Prenatal Visit. https://www.associatesinwomenshealthcare.net/blog/preparing-for-your-first-prenatal-visit/ Opens a new window [Accessed September 21, 2021.]

National Health Service (UK). (2018). Your baby’s movements. https://www.nhs.uk/pregnancy/keeping-well/your-babys-movements/ Opens a new window [Accessed September 21, 2021.]

MedlinePlus. (2021). Prenatal care in your third trimester. https://medlineplus.gov/ency/patientinstructions/000558.htm Opens a new window [Accessed September 21, 2021.]

UCLA Health. (2021). Schedule of prenatal care. https://www.uclahealth.org/obgyn/workfiles/Pregnancy/Schedule_of_Prenatal_Care.pdf Opens a new window [Accessed September 21, 2021.]

UCR Health. (2021). Healthy Pregnancy: The Importance of Prenatal Care.   https://www.ucrhealth.org/2018/07/healthy-pregnancy-the-importance-of-prenatal-care/ Opens a new window [Accessed September 21, 2021.]

Mayo Clinic. (2020). Prenatal care: 1 st trimesters visits. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20044882 Opens a new window [Accessed September 21, 2021.]

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Prenatal care: 1st trimester visits

Pregnancy and prenatal care go hand in hand. During the first trimester, prenatal care includes blood tests, a physical exam, conversations about lifestyle and more.

Prenatal care is an important part of a healthy pregnancy. Whether you choose a family physician, obstetrician, midwife or group prenatal care, here's what to expect during the first few prenatal appointments.

The 1st visit

When you find out you're pregnant, make your first prenatal appointment. Set aside time for the first visit to go over your medical history and talk about any risk factors for pregnancy problems that you may have.

Medical history

Your health care provider might ask about:

• Your menstrual cycle, gynecological history and any past pregnancies
• Your personal and family medical history
• Exposure to anything that could be toxic
• Medications you take, including prescription and over-the-counter medications, vitamins or supplements
• Your lifestyle, including your use of tobacco, alcohol, caffeine and recreational drugs
• Travel to areas where malaria, tuberculosis, Zika virus, mpox — also called monkeypox — or other infectious diseases are common

Share information about sensitive issues, such as domestic abuse or past drug use, too. This will help your health care provider take the best care of you — and your baby.

Your due date is not a prediction of when you will have your baby. It's simply the date that you will be 40 weeks pregnant. Few people give birth on their due dates. Still, establishing your due date — or estimated date of delivery — is important. It allows your health care provider to monitor your baby's growth and the progress of your pregnancy. Your due date also helps with scheduling tests and procedures, so they are done at the right time.

To estimate your due date, your health care provider will use the date your last period started, add seven days and count back three months. The due date will be about 40 weeks from the first day of your last period. Your health care provider can use a fetal ultrasound to help confirm the date. Typically, if the due date calculated with your last period and the due date calculated with an early ultrasound differ by more than seven days, the ultrasound is used to set the due date.

Physical exam

To find out how much weight you need to gain for a healthy pregnancy, your health care provider will measure your weight and height and calculate your body mass index.

Your health care provider might do a physical exam, including a breast exam and a pelvic exam. You might need a Pap test, depending on how long it's been since your last Pap test. Depending on your situation, you may need exams of your heart, lungs and thyroid.

At your first prenatal visit, blood tests might be done to:

• Check your blood type. This includes your Rh status. Rh factor is an inherited trait that refers to a protein found on the surface of red blood cells. Your pregnancy might need special care if you're Rh negative and your baby's father is Rh positive.
• Measure your hemoglobin. Hemoglobin is an iron-rich protein found in red blood cells that allows the cells to carry oxygen from your lungs to other parts of your body. Hemoglobin also carries carbon dioxide from other parts of your body to your lungs so that it can be exhaled. Low hemoglobin or a low level of red blood cells is a sign of anemia. Anemia can make you feel very tired, and it may affect your pregnancy.
• Check immunity to certain infections. This typically includes rubella and chickenpox (varicella) — unless proof of vaccination or natural immunity is documented in your medical history.
• Detect exposure to other infections. Your health care provider will suggest blood tests to detect infections such as hepatitis B, syphilis, gonorrhea, chlamydia and HIV , the virus that causes AIDS . A urine sample might also be tested for signs of a bladder or urinary tract infection.

Tests for fetal concerns

Prenatal tests can provide valuable information about your baby's health. Your health care provider will typically offer a variety of prenatal genetic screening tests. They may include ultrasound or blood tests to check for certain fetal genetic problems, such as Down syndrome.

Lifestyle issues

Your health care provider might discuss the importance of nutrition and prenatal vitamins. Ask about exercise, sex, dental care, vaccinations and travel during pregnancy, as well as other lifestyle issues. You might also talk about your work environment and the use of medications during pregnancy. If you smoke, ask your health care provider for suggestions to help you quit.

Discomforts of pregnancy

You might notice changes in your body early in your pregnancy. Your breasts might be tender and swollen. Nausea with or without vomiting (morning sickness) is also common. Talk to your health care provider if your morning sickness is severe.

Other 1st trimester visits

Your next prenatal visits — often scheduled about every four weeks during the first trimester — might be shorter than the first. Near the end of the first trimester — by about 12 to 14 weeks of pregnancy — you might be able to hear your baby's heartbeat with a small device, called a Doppler, that bounces sound waves off your baby's heart. Your health care provider may offer a first trimester ultrasound, too.

Your prenatal appointments are an ideal time to discuss questions you have. During your first visit, find out how to reach your health care team between appointments in case concerns come up. Knowing help is available can offer peace of mind.

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• Lockwood CJ, et al. Prenatal care: Initial assessment. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• Prenatal care and tests. Office on Women's Health. https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/prenatal-care-and-tests. Accessed July 9, 2018.
• Cunningham FG, et al., eds. Prenatal care. In: Williams Obstetrics. 25th ed. New York, N.Y.: McGraw-Hill Education; 2018. https://www.accessmedicine.mhmedical.com. Accessed July 9, 2018.
• Lockwood CJ, et al. Prenatal care: Second and third trimesters. https://www.uptodate.com/contents/search. Accessed July 9, 2018.
• WHO recommendations on antenatal care for a positive pregnancy experience. World Health Organization. http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/anc-positive-pregnancy-experience/en/. Accessed July 9, 2018.
• Bastian LA, et al. Clinical manifestations and early diagnosis of pregnancy. https://www.uptodate.com/contents/search. Accessed July 9, 2018.

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Prenatal care

Prenatal care is the health care you get while you are pregnant. 

What is prenatal care?

Prenatal care is the health care you get while you are pregnant. Take care of yourself and your baby by:

• Getting  early  prenatal care. If you know you're pregnant, or think you might be, call your doctor to schedule a visit.
• Getting  regular  prenatal care. Your doctor will schedule you for many checkups over the course of your pregnancy. Don't miss any — they are all important.
• Following your doctor's advice.

Why do I need prenatal care?

Prenatal care can help keep you and your baby healthy. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care.

Doctors can spot health problems early when they see mothers regularly. This allows doctors to treat them early. Early treatment can cure many problems and prevent others. Doctors also can talk to pregnant women about things they can do to give their unborn babies a healthy start to life.

I am thinking about getting pregnant. How can I take care of myself?

You should start taking care of yourself  before  you start trying to get pregnant. This is called preconception health. It means knowing how health conditions and risk factors could affect you or your unborn baby if you become pregnant. For example, some foods, habits, and medicines can harm your baby — even before he or she is conceived. Some health problems also can affect pregnancy.

Talk to your doctor before pregnancy to learn what you can do to prepare your body. Women should prepare for pregnancy before becoming sexually active. Ideally, women should give themselves at least 3 months to prepare before getting pregnant.

The five most important things you can do before becoming pregnant are:

• Take 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of  folic acid  every day for at least 3 months before getting pregnant to lower your risk of some birth defects of the brain and spine. You can get folic acid from some foods. But it's hard to get all the folic acid you need from foods alone. Taking a vitamin with folic acid is the best and easiest way to be sure you're getting enough.
• Stop smoking and drinking alcohol. Ask your doctor for help.
• If you have a medical condition, be sure it is under control. Some conditions include  asthma ,  diabetes ,  depression ,  high blood pressure ,  obesity , thyroid disease, or  epilepsy . Be sure your vaccinations are up to date.
• Talk to your doctor about any over-the-counter and prescription medicines you are using. These include dietary or herbal supplements. Some  medicines  are not safe during pregnancy. At the same time, stopping medicines you need also can be harmful.
• Avoid contact with toxic substances or materials at work and at home that could be harmful. Stay away from chemicals and cat or rodent feces.

I'm pregnant. What should I do — or not do — to take care of myself and my unborn baby?

Follow these do's and don'ts to take care of yourself and the precious life growing inside you:

Health care do's and don'ts

• Get early and regular prenatal care. Whether this is your first pregnancy or third, health care is extremely important. Your doctor will check to make sure you and the baby are healthy at each visit. If there are any problems, early action will help you and the baby.
• Take a multivitamin or prenatal vitamin with 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of folic acid every day. Folic acid is most important in the early stages of pregnancy, but you should continue taking folic acid throughout pregnancy.
• Ask your doctor before stopping any medicines or starting any new medicines. Some medicines are not safe during pregnancy. Keep in mind that even over-the-counter medicines and herbal products may cause side effects or other problems. But not using medicines you need could also be harmful.
• Avoid x-rays. If you must have dental work or diagnostic tests, tell your dentist or doctor that you are pregnant so that extra care can be taken.
• Get a flu shot. Pregnant women can get very sick from the flu and may need hospital care.

Food do's and don'ts

• Eat a variety of healthy foods.  Choose fruits, vegetables, whole grains, calcium-rich foods, and foods low in saturated fat. Also, make sure to drink plenty of fluids, especially water.
• Get all the nutrients you need each day, including iron. Getting enough iron prevents you from getting anemia, which is linked to  preterm birth  and  low birth weight . Eating a variety of healthy foods will help you get the nutrients your baby needs. But ask your doctor if you need to take a daily prenatal vitamin or iron supplement to be sure you are getting enough.
• Protect yourself and your baby from food-borne illnesses, including  toxoplasmosis  (TOK-soh-plaz-MOH-suhss) and  listeria  (lih-STEER-ee-uh). Wash fruits and vegetables before eating. Don't eat uncooked or undercooked meats or fish. Always handle, clean, cook, eat, and store foods properly.
• Don't eat fish with lots of mercury, including swordfish, king mackerel, shark, and tilefish.

Lifestyle do's and don'ts

• Gain a healthy amount of weight. Your doctor can tell you how much weight gain you should aim for during pregnancy.
• Don't smoke, drink alcohol, or use drugs. These can cause long-term harm or death to your baby. Ask your doctor for help quitting.
• Unless your doctor tells you not to, try to get at least 2 hours and 30 minutes of moderate-intensity aerobic activity a week. It's best to spread out your workouts throughout the week. If you worked out regularly before pregnancy, you can keep up your activity level as long as your health doesn't change and you talk to your doctor about your activity level throughout your pregnancy. Learn more about  how to have a fit pregnancy .
• Don't take very hot baths or use hot tubs or saunas.
• Get plenty of sleep and find ways to control stress.
• Get informed. Read books, watch videos, go to a childbirth class, and talk with moms you know.
• Ask your doctor about childbirth education classes for you and your partner. Classes can help you prepare for the birth of your baby.

Environmental do's and don'ts

• Stay away from chemicals like  insecticides , solvents (like some cleaners or paint thinners), lead, mercury, and paint (including paint fumes). Not all products have pregnancy warnings on their labels. If you're unsure if a product is safe, ask your doctor before using it. Talk to your doctor if you are worried that chemicals used in your workplace might be harmful.
• If you have a cat, ask your doctor about  toxoplasmosis . This infection is caused by a parasite sometimes found in cat feces. If not treated toxoplasmosis can cause birth defects. You can lower your risk of by avoiding cat litter and wearing gloves when gardening. 
• Avoid contact with rodents, including pet rodents, and with their urine, droppings, or nesting material. Rodents can carry a virus that can be harmful or even deadly to your unborn baby.
• Take steps to avoid illness, such as washing hands frequently.
• Stay away from secondhand smoke.

I don't want to get pregnant right now. Should I still take folic acid every day?

Yes! Birth defects of the brain and spine happen in the very early stages of pregnancy, often before a woman knows she is pregnant. By the time she finds out she is pregnant, it might be too late to prevent those birth defects. Also, half of all pregnancies in the United States are not planned. For these reasons, all women who are able to get pregnant need 400 to 800 mcg of folic acid every day.

How often should I see my doctor during pregnancy?

Your doctor will give you a schedule of all the doctor's visits you should have while pregnant. Most experts suggest you see your doctor:

• About once each month for weeks 4 through 28
• Twice a month for weeks 28 through 36
• Weekly for weeks 36 to birth

If you are older than 35 or your pregnancy is high risk, you'll probably see your doctor more often.

What happens during prenatal visits?

During the first prenatal visit, you can expect your doctor to:

• Ask about your health history including diseases, operations, or prior pregnancies
• Ask about your family's health history
• Do a complete physical exam, including a pelvic exam and  Pap test
• Take your blood and urine for lab work
• Check your blood pressure, height, and weight
• Calculate your due date
• Answer your questions

At the first visit, you should ask questions and discuss any issues related to your pregnancy. Find out all you can about how to stay healthy.

Later prenatal visits will probably be shorter. Your doctor will check on your health and make sure the baby is growing as expected.  Most prenatal visits will include:

• Checking your blood pressure
• Measuring your weight gain
• Measuring your abdomen to check your baby's growth (once you begin to show)
• Checking the baby's heart rate

While you're pregnant, you also will have some routine tests. Some tests are suggested for all women, such as blood work to check for anemia, your blood type, HIV, and other factors. Other tests might be offered based on your age, personal or family health history, your ethnic background, or the results of routine tests you have had. Visit the pregnancy section of our website for more details on  prenatal care and tests .

I am in my late 30s and I want to get pregnant. Should I do anything special?

As you age, you have an increasing chance of having a baby born with a birth defect. Yet most women in their late 30s and early 40s have healthy babies. See your doctor regularly before you even start trying to get pregnant. She will be able to help you prepare your body for pregnancy. She will also be able to tell you about how age can affect pregnancy.

During your pregnancy, seeing your doctor regularly is very important. Because of your age, your doctor will probably suggest some extra tests to check on your baby's health.

More and more women are waiting until they are in their 30s and 40s to have children. While many women of this age have no problems getting pregnant, fertility does decline with age. Women over 40 who don't get pregnant after six months of trying should see their doctors for a fertility evaluation. 

Experts define infertility as the inability to become pregnant after trying for one year. If a woman keeps having miscarriages, it's also called infertility. If you think you or your partner may be infertile, talk to your doctor. Doctors are able to help many infertile couples go on to have healthy babies.

Where can I go to get free or reduced-cost prenatal care?

Women in every state can get help to pay for medical care during their pregnancies. This prenatal care can help you have a healthy baby. Every state in the United States has a program to help. Programs give medical care, information, advice, and other services important for a healthy pregnancy.

To find out about the program in your state:

• Call 800-311-BABY (800-311-2229). This toll-free telephone number will connect you to the Health Department in your area code.
• For information in Spanish, call 800-504-7081.
• Contact your local Health Department.

Did we answer your question about prenatal care?

For more information about prenatal care, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:

• American College of Obstetricians and Gynecologists Phone:  202-638-5577
• American Pregnancy Association Phone:  972-550-0140
• Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, HHS Phone:  800-370-2943 (TDD: 888-320-6942)
• March of Dimes Phone:  914-997-4488
• National Center on Birth Defects and Developmental Disabilities, CDC, HHS Phone:  800-232-4636 (TDD: 888-232-6348)
• John W. Schmitt, M.D., Associate Professor of Clinical Obstetrics and Gynecology, University of Virginia Medical School
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Health Costs Associated with Pregnancy, Childbirth, and Postpartum Care

Matthew Rae , Cynthia Cox , and Hanna Dingel Published: Jul 13, 2022

Pregnancy is one of the most common reasons for a hospitalization among non-elderly people. In addition to the cost of the birth itself, pregnancy care also involves costs associated with prenatal visits and often includes care to treat psychological and medical conditions associated with pregnancy, birth, and the post-partum period.

This analysis examines the health costs associated with pregnancy, childbirth, and post-partum care using a subset of claims from the IBM MarketScan Encounter Database from 2018 through 2020 for enrollees in large employer private health plans. It finds that health costs associated with pregnancy, childbirth, and post-partum care average a total of $18,865 and the average out-of-pocket payments total $2,854. The analysis also examine how pregnancy, childbirth, and post-partum health spending among large group enrollees varies by the type of delivery.

The analysis can be found on the Peterson-KFF Health System Tracker , an information hub dedicated to monitoring and assessing the performance of the U.S. health system.

• Health Costs
• Women's Health Policy
• Private Insurance
• Peterson-KFF
• Cost Sharing
• Reproductive Health

news release

• Women who Give Birth Incur Nearly $19,000 in Additional Health Costs, Including $2,854 More that They Pay Out of Pocket

Also of Interest

• KFF COVID-19 Vaccine Monitor: Pregnancy Misinformation – May 2022
• Medicaid Postpartum Coverage Extension Tracker
• Employer Coverage of Travel Costs for Out-of-State Abortion

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How Much Does Prenatal Care Cost?

While pregnant, it is very important for a woman to take care of herself and the baby by getting regular check-ups.  These check-ups, which start monthly, then turn to bi-monthly and eventually weekly, will help the doctor determine if everything is progressing normally with your pregnancy.

How much does prenatal care cost?

On average, the total prenatal visits will cost anywhere from $1,700 to $3,000 for the entire nine months during the pregnancy.   This is without insurance and doesn’t include the baby delivery.

According to Revolution Health , the average prenatal care cost of a prenatal visit is $133.  Throughout most pregnancies, the mother will see the doctor about 14 times.  Therefore, the total average cost is $1,862.

WebMD.com states that the average person pays around $2,000 for prenatal care.

Plan on spending anywhere from $95 to as much as $200 per visit without any sort of insurance.

Depending on the type of insurance you have, you will only have to pay a percentage of this.  Most insurance companies cover anywhere from 85%-90% of costs.  Basically, you will probably have to pay about $15 per visit out of pocket.

Prenatal care overview

At the first prenatal visit, the doctor will calculate your due date and give you information regarding not only your pregnancy but about your newborn baby.  The doctor will discuss with you things like diet and exercise, vitamins to take, birthing options, etc.  Most visits after this will simply consist of taking your weight, a urine analysis, listening to the heartbeat, and an opportunity to ask any questions you may have.

During the first appointment, the doctor will be able to determine a due date, perform an exam and will more than likely perform a pap test.  The government also requires that all women get tested for HIV.

During the subsequent appointments, the doctor will ask about how you’re feeling and if you have any concerns.  The goal of each appointment is to see how the pregnancy is proceeding and to provide you with information along the way.  Each appointment will often include checking your weight, blood pressure and taking urine samples.   As the baby grows, the OB/GYN will check the position of the baby, along with the heartbeat.

At around 20 weeks, an ultrasound will be scheduled in order to better assess the health of the baby and to find out the sex of the baby if the mother so desires.

Most appointments will include a urine sample to screen the sugar, a weight recording, the baby’s heartbeat (if applicable), the OB/GYN will check the position and your blood pressure will be checked.

You should expect to see the doctor about 12 to 15 times.

Prenatal screenings

Most of the screenings will be done throughout the pregnancy; however, some may be optional and will only be recommended if your doctor recommends it.

• Bacteriuria urinary tract
• Rh incompatibility
• Hepatitis B
• Gestational diabetes

What are the extra costs?

If there are any complications resulting in extra testing, the total cost will increase.

If you would like additional ultrasounds, such as a 4d ultrasound, this will more than likely not be covered by insurance because it is not a necessity.  A 4d ultrasound can cost anywhere from $100 to $300 depending on what features are included in the experience.

Most doctors suggest that pregnant women take some sort of multi-vitamin.  This is usually covered by insurance except for a small copay.

The baby delivery will be considered an additional cost outside of the care.

Complications during a pregnancy can sometimes lead to extensive tests or prolonged hospital stays.  If this is the case, the cost can greatly vary depending on what has been done.

Tips to know:

During the first appointment, be sure to bring items such as your medical records, a list of medications you’re currently on, questions you may have (write these down) and a friend or husband to help support you during this process.

Before the process even begins, it’s essential to know what’s going to be covered under your health insurance policy.  Since many health insurance policies are different, one policy may cover one procedure, while another may deny it.

Consult with the hospital before the labor begins.  If paying out of pocket, the hospital will be more than happy to give a discount to those that are paying up front with cash.

If purchasing prenatal vitamins on your own, talk with your OB/GYN.  Many OB/GYNs are more than happy to give out samples for free throughout the duration of the pregnancy.  This is a great way to avoid paying the full retail price.

While a hospital delivery can be rather expensive, consider other alternatives that are cheaper such as a doula and/or midwife.  An insurance company may not cover a procedure such as this one, but many soon-to-be moms prefer this route because of the home-based setting.   See: “ How much does a doula cost? ”

How can I save money?

Planning pregnancy ahead of time can help save confusion with the insurance company.  If you sign up for health insurance when you are already pregnant, some companies consider it a “pre-existing condition” and it will not be covered.   Keep in mind that if you sign up with a group insurance plan, they will have to cover you by law.

If you have no insurance, many doctors offices and hospitals will give discounts if you pay in cash.  These discounts are not openly offered, however;  you must inquire and bargain with them.

Uninsured women who meet certain financial guidelines will find that there are many programs that can help with the cost of the care.

Most OB/GYNs are more than happy to provide you with prenatal vitamins for free.  If you can’t afford the vitamins, let them know.

Prenatal care low-income options:

Local Health Department

Your local health department should be able to provide you with some programs that they run at a lower cost or even for free.  To connect with a local health department in your area, call 1-800-311-BABY.

Medical Schools

Many bigger medical schools will run clinics for the public.  Working with medical students that are supervised, you can get care at a fraction of the cost.

Planned Parenthood

Like the health department, planned parenthood can provide care based on your salary.

This is a program sponsored by the government for those who meet certain income guidelines.  If accepted to this program, you will get a list of doctors that you can see for care.

How to choose a prenatal care provider:

Similar to a midwife, a doula is more like a coach.  They will help with physical and emotional support during the labor.  A doula will often work with a midwife during the labor process.  If using a doula, make sure that you check with your insurance company to see if you’re covered.

A certified midwife is great for women who are considered to be at low-risk.  Educated in nursing, a midwife can practice at hospitals and a birthing center.  Many prefer to deliver babies in the patient’s home.

Family Practice

Family doctors can provide care during a pregnancy but it may not be as detailed as an OB.  They can do just about everything, except for cesarean deliveries.

Obstetricians

Medical doctors who specialize in delivering babies.  They will also have special training with surgeries such as a cesarean section.  Women who think that they are at the highest risk during a pregnancy should consider this specialty.

How can I compare prices?

Because we are talking about the health of you and your baby, you should choose a doctor and hospital according to their credentials and your comfort level, not according to price.

When choosing a provider, research their reputation, their bedside manner, office location, where you deliver and how they handle off-hour calls.

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Pregnancy Checklist

Be prepared for the big day with this pregnancy to-do list by trimester and month.

This article is based on reporting that features expert sources.

With all the logistics that arise with planning for conception and pregnancy, it’s no surprise that the 40-week-long endeavor brings out many challenges.

Whether you’re hoping for a positive pregnancy test in the near future or already have a baby on the way, here’s a list of useful tips to help with how to prepare for pregnancy.

First Trimester Pregnancy Checklist 

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During the first trimester, you’ll experience hormonal changes as your body demonstrates the earliest signs of pregnancy.

You may not know you’re pregnant during the first month of pregnancy. The first probable signs of pregnancy may appear around 12 to 15 days after ovulation at the earliest. This is when levels of human chorionic gonadotropin (hCG), a hormone produced by the placenta, are high enough to become detectable on a pregnancy test .

At this time, you may experience other presumptive signs of pregnancy, such as:

• Sore breasts
• A missed period
• Nausea and vomiting

During the first month, check a few early pregnancy tasks off your list, including:

• Choose your pregnancy and birth provider, like an OB-GYN, midwife or family medicine OB provider
• Select which hospital you plan to give birth at, if your provider has delivery privileges at multiple locations
• Schedule your initial prenatal appointment
• Treat any comorbid conditions and review your current medications, as some may need to be changed during pregnancy

Dr. Kecia Gaither, a double board-certified OB-GYN and maternal-fetal medicine provider, suggests treating conditions like:

• Thyroid disease
• Hypertension

“Comorbid conditions, especially uncontrolled diabetes, can significantly increase the risk of congenital abnormalities,” explains Gaither, who also serves as director of perinatal services and maternal-fetal medicine at New York City Health + Hospitals, Lincoln in the Bronx.

Congratulations! Month two is when most women discover their pregnancies.

As soon as you learn you're pregnant, it’s important to stop smoking , drinking or using drugs. Talk with your medical provider about which prescription medications you may need to start, stop or change at this time.

You will also likely begin taking supplements under the direction of your medical provider. Gaither emphasizes the importance of optimizing your pregnancy meal plan and maintaining healthy iron and folate levels for optimal fetal development.

This is because key fetal development occurs during month two, such as:

• Development of the neural tube, which will later become organs in the nervous system, like the brain and spinal cord
• Digestive tract development
• Bone formation

Month three

Month three is often an exciting time in pregnancy, when most people have the first chance to hear the baby’s heart rate. The heart rate may be detectable as early as six weeks, but most initial prenatal appointments occur between eight and 12 weeks.

By this point, you may already be experiencing morning sickness, which is nausea or vomiting, most commonly during the first three months of pregnancy.

To combat these symptoms, try:

• Eating small, frequent meals
• Staying hydrated
• Eating a small snack, like a few crackers, before getting out of bed

While morning sickness is common, reach out to your provider if you experience the following:

• Nausea or vomiting that is preventing you from your daily activities
• Inability to stay hydrated
• Feeling faint, dizzy or confused due to your symptoms
• Vomiting multiple times a day, unrelieved by home care

You may need a hydration infusion to keep you hydrated, or your provider may prescribe medications to combat your symptoms.

Second Trimester Checklist 

By the second trimester, the reality of preparing for a baby will start to set in. During this trimester, the early stages of nesting – a drive to prepare your home and lifestyle to accommodate your new addition – may begin.

Around week 10, you’ll have an opportunity to perform noninvasive prenatal genetic testing (NIPT), which uses the mother's blood to screen for chromosome balance and genetic conditions, such as Down syndrome.

By this time your pregnancy may also start to show. If you haven’t already, make sure to add some maternity and loose-fitting clothing to your wardrobe.

Dr. Andrea Braden, a board-certified OB-GYN and lactation consultant, suggests not to wait on purchasing new bras.

“Your breast size starts to increase during pregnancy and for preparation for nursing after," she explains. "Typically, you'll need to buy a new bra as it is, so I would say go ahead and buy bras that have the dual function of being a pregnancy bra in a nursing bra.”

Make sure that by month five, you have a stable exercise routine or movement plan to ensure a healthy pregnancy.

According to the American College of Obstetrics and Gynecology, exercise during pregnancy is essential to:

• Reduce aches and pains
• Relieve constipation
• Decrease the risk of pregnancy complications

Month five is also when you may feel some of the first signs of fetal movement.

Month six is a great opportunity to start the first stages of nesting.

Consider the following nesting activities:

• Planning baby purchases or creating a baby registry
• Planning for potential projects around the house or in the nursery
• If you are working, start to consider how you will handle medical leave and time off to recover after birth and bond with your baby

Third Trimester Checklist 

You’re in the final stretch! The third trimester is a great time to finalize your plans and preferences for labor and delivery.

Month seven

Taking a hospital birth class? Best to take it in the third trimester so your memory is fresh, explains Kristin Revere, the owner and founder of Gold Coast Doulas in Grand Rapids, Michigan. If you’re opting for a birth without an epidural, she explains you may consider taking birth classes like hypnobirthing or Lamaze as early as six weeks into pregnancy if you want to get a head start. This will help you mentally prepare to cope with labor pain.

Since you're starting your third trimester, it's a good idea to start preparing for your baby to enter the world.

• Choose your baby's pediatrician .
• Purchase a car seat and have it inspected and properly installed.
• Build a crib or bassinet for the nursery.

Month eight

By month eight, you may be experiencing significant pregnancy-related aches and pains or having trouble sleeping. Ashley Mareko, surrogate program director at Surrogate First, says she used acupuncture and chiropractic services throughout her pregnancy but began going once a week in her third trimester.

Many pregnant women, like Mareko, share anecdotal evidence of acupuncture and chiropractic services helping with reducing pregnancy and labor pain or assisting with labor induction. Researchers acknowledge that the body of evidence supporting acupuncture is limited, but ACOG does not discourage acupuncture or acupressure use in pregnancy. The American Pregnancy Association shares that there are no major concerns with chiropractic care during pregnancy.

At the beginning of month nine, it’s helpful to start planning for birth and the postpartum period.

Here are a few tips:

• Cook some make-ahead freezer meals for nutritious, easy meals after birth.
• Start packing your hospital bag for delivery , just in case the baby comes a few weeks early.
• Finalize your birth plan, and ask the hospital about any pertinent birth or visitation policies. 

Bottom Line

The course of your pregnancy will bring new challenges and learning experiences, and no two pregnancies are exactly the same. Consult with your pregnancy provider to get pregnancy advice tailored to your health and wellness.

Antidepressants During Pregnancy

Payton Sy June 1, 2023

The U.S. News Health team delivers accurate information about health, nutrition and fitness, as well as in-depth medical condition guides. All of our stories rely on multiple, independent sources and experts in the field, such as medical doctors and licensed nutritionists. To learn more about how we keep our content accurate and trustworthy, read our  editorial guidelines .

Braden is a board-certified OB-GYN based in Atlanta and a breastfeeding medicine specialist at Lybbie, a lactation innovation company.

Gaither is a double board-certified OB-GYN and maternal fetal medicine provider. She is also the director of perinatal services and maternal-fetal medicine at New York City Health and Hospitals, Lincoln in the Bronx.

Mareko is the surrogate program director at SurrogateFirst, a surrogacy matching service. She is based in Los Angeles.

Revere is the founder of Gold Coast Doulas in Grand Rapids, Michigan.

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What to Expect When You're Expecting , 5th edition, Heidi Murkoff. WhatToExpect.com, How Much Does Pregnancy Cost? December 2020. Health Care Cost Institute, Understanding Variation in Spending on Childbirth Among the Commercially Insured , May 2020. Healthcare.gov, Health Coverage if You’re Pregnant, Plan to Get Pregnant, or Recently Gave Birth, 2021. Department of Labor Employee Benefits Security Administration, FAQs on COBRA Continuation Health Coverage , November 2015. Kaiser Family Foundation, Medicaid/CHIP Eligibility Limits , 2019.

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Their first baby came with medical debt. These Illinois parents won't have another.

Medical debt is as much a hallmark of having children as long nights and dirty diapers. The Crivilare family, Andrew, Heather and Rita, 2, are pictured at their kitchen table in Jacksonville, Ill. Neeta Satam for KFF Health News hide caption

Medical debt is as much a hallmark of having children as long nights and dirty diapers. The Crivilare family, Andrew, Heather and Rita, 2, are pictured at their kitchen table in Jacksonville, Ill.

JACKSONVILLE, Ill. — Heather Crivilare was a month from her due date when she was rushed to an operating room for an emergency cesarean section.

The first-time mother, a high school teacher in rural Illinois, had developed high blood pressure, a sometimes life-threatening condition in pregnancy that prompted doctors to hospitalize her. Then Crivilare's blood pressure spiked, and the baby's heart rate dropped. "It was terrifying," Crivilare said.

She gave birth to a healthy daughter. What followed, though, was another ordeal: thousands of dollars in medical debt that sent Crivilare and her husband scrambling for nearly a year to keep collectors at bay.

The Crivilares would eventually get on nine payment plans as they juggled close to $5,000 in bills.

"It really felt like a full-time job some days," Crivilare recalled. "Getting the baby down to sleep and then getting on the phone. I'd set up one payment plan, and then a new bill would come that afternoon. And I'd have to set up another one."

Crivilare's pregnancy may have been more dramatic than most. But for millions of new parents, medical debt is now as much a hallmark of having children as long nights and dirty diapers.

About 12% of the 100 million U.S. adults with health care debt attribute at least some of it to pregnancy or childbirth, according to a KFF poll .

These people are more likely to report they've had to take on extra work, change their living situation, or make other sacrifices.

Heather Crivilare says she wishes there were a grace period for medical debt after the birth of a child, as there is for student loan debt after graduation. Neeta Satam for KFF Health News hide caption

Heather Crivilare says she wishes there were a grace period for medical debt after the birth of a child, as there is for student loan debt after graduation.

Overall, women between 18 and 35 who have had a baby in the past year and a half are twice as likely to have medical debt as women of the same age who haven't given birth recently, other KFF research conducted for this project found.

"You feel bad for the patient because you know that they want the best for their pregnancy," said Eilean Attwood, a Rhode Island OB-GYN who said she routinely sees pregnant women anxious about going into debt.

"So often, they may be coming to the office or the hospital with preexisting debt from school, from other financial pressures of starting adult life," Attwood said. "They are having to make real choices, and what those real choices may entail can include the choice to not get certain services or medications or what may be needed for the care of themselves or their fetus."

Best-laid plans

Crivilare and her husband, Andrew, also a teacher, anticipated some of the costs.

The young couple settled in Jacksonville, in part because the farming community less than two hours north of St. Louis was the kind of place two public school teachers could afford a house. They saved aggressively. They bought life insurance.

And before Crivilare got pregnant in 2021, they enrolled in the most robust health insurance plan they could, paying higher premiums to minimize their deductible and out-of-pocket costs.

Then, two months before their baby was due, Crivilare learned she had developed preeclampsia. Her pregnancy would no longer be routine. Crivilare was put on blood pressure medication, and doctors at the local hospital recommended bed rest at a larger medical center in Springfield, about 35 miles away.

"I remember thinking when they insisted that I ride an ambulance from Jacksonville to Springfield ... 'I'm never going to financially recover from this,'" she said. "'But I want my baby to be OK.'"

For weeks, Crivilare remained in the hospital alone as covid protocols limited visitors. Meanwhile, doctors steadily upped her medications while monitoring the fetus. It was, she said, "the scariest month of my life."

Fear turned to relief after her daughter, Rita, was born. The baby was small and had to spend nearly two weeks in the neonatal intensive care unit. But there were no complications. "We were incredibly lucky," Crivilare said.

When she and Rita finally came home, a stack of medical bills awaited. One was already past due.

Crivilare rushed to set up payment plans with the hospitals in Jacksonville and Springfield, as well as the anesthesiologist, the surgeon, and the labs. Some providers demanded hundreds of dollars a month. Some settled for monthly payments of $20 or $25. Some pushed Crivilare to apply for new credit cards to pay the bills.

"It was a blur of just being on the phone constantly with all the different people collecting money," she recalled. "That was a nightmare."

Big bills, big consequences

The Crivilares' bills weren't unusual. Parents with private health coverage now face on average more than $3,000 in medical bills related to a pregnancy and childbirth that aren't covered by insurance, researchers at the University of Michigan found.

Out-of-pocket costs are even higher for families with a newborn who needs to stay in a neonatal ICU, averaging $5,000. And for 1 in 11 of these families, medical bills related to pregnancy and childbirth exceed $10,000, the researchers found.

"This forces very difficult trade-offs for families," said Michelle Moniz, a University of Michigan OB-GYN who worked on the study. "Even though they have insurance, they still have these very high bills."

Nationwide polls suggest millions of these families end up in debt, with sometimes devastating consequences.

About three-quarters of U.S. adults with debt related to pregnancy or childbirth have cut spending on food, clothing, or other essentials, KFF polling found.

About half have put off buying a home or delayed their own or their children's education.

These burdens have spurred calls to limit what families must pay out-of-pocket for medical care related to pregnancy and childbirth.

In Massachusetts, state Sen. Cindy Friedman has proposed legislation to exempt all these bills from copays, deductibles, and other cost sharing. This would parallel federal rules that require health plans to cover recommended preventive services like annual physicals without cost sharing for patients. "We want ... healthy children, and that starts with healthy mothers," Friedman said. Massachusetts health insurers have warned the proposal will raise costs, but an independent state analysis estimated the bill would add only $1.24 to monthly insurance premiums.

Tough lessons

For her part, Crivilare said she wishes new parents could catch their breath before paying down medical debt.

"No one is in the right frame of mind to deal with that when they have a new baby," she said, noting that college graduates get such a break. "When I graduated with my college degree, it was like: 'Hey, new adult, it's going to take you six months to kind of figure out your life, so we'll give you this six-month grace period before your student loans kick in and you can get a job.'"

Rita is now 2. The family scraped by on their payment plans, retiring the medical debt within a year, with help from Crivilare's side job selling resources for teachers online.

The Crivilares paid off the medical debt for Rita's birth, but they are shouldering some more since Rita needed surgery for recurrent ear infections. Neeta Satam for KFF Health News hide caption

The Crivilares paid off the medical debt for Rita's birth, but they are shouldering some more since Rita needed surgery for recurrent ear infections.

But they are now back in debt, after Rita's recurrent ear infections required surgery last year, leaving the family with thousands of dollars in new medical bills.

Crivilare said the stress has made her think twice about seeing a doctor, even for Rita. And, she added, she and her husband have decided their family is complete.

"It's not for us to have another child," she said. "I just hope that we can put some of these big bills behind us and give [Rita] the life that we want to give her."

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

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Screening for Cervical Cancer

The HPV test and the Pap test can help prevent cervical cancer or find it early.

• You should start getting Pap tests at age 21. If you are 30 years old or older, talk to your doctor about testing options.

Screening tests

• The HPV test looks for the virus ( human papillomavirus ) that can cause cell changes on the cervix.
• The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately.

Both tests can be done in a doctor's office or clinic. During the Pap test, the doctor will use a plastic or metal instrument, called a speculum, to look inside your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it. The cells are sent to a laboratory.

• If you are getting a Pap test, the cells will be checked to see if they look normal.
• If you are getting an HPV test, the cells will be tested for HPV.

What is cervical precancer? When there are cervical cells that look abnormal but are not yet cancerous, it is called cervical precancer. These abnormal cells may be the first sign of cancer that develops years later. Cervical precancer usually doesn't cause pain or other symptoms. It is found with a Pap test.

Cindy's Story: Preventing Cervical Cancer

"If I didn't go to that appointment, I might not be around for my kids," says Cindy. Her cervical cancer screening test found precancerous cells. She shares her story in this video.

When to get screened

If you are 21 to 29 years old.

You should start getting Pap tests at age 21. If your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test.

If you are 30 to 65 years old

Talk to your doctor about which testing option is right for you:

• An HPV test only. This is called primary HPV testing. If your result is normal, your doctor may tell you that you can wait five years until your next screening test.
• An HPV test along with a Pap test. This is called co-testing. If both of your results are normal, your doctor may tell you that you can wait five years until your next screening test.
• A Pap test only. If your result is normal, your doctor may tell you that you can wait three years until your next Pap test.

If you are older than 65

Your doctor may tell you that you don't need to be screened anymore if:

• You have had at least three Pap tests or two HPV tests in the past 10 years, and the test results were normal or negative, and
• You have not had a cervical precancer in the past, or
• You have had your cervix removed as part of a total hysterectomy for non-cancerous conditions, like fibroids.

Are you worried about the cost?‎‎‎

How to prepare for your test.

No special preparation is needed before you have an HPV test.

If you are getting a Pap test, you can take steps to make sure the test results are accurate. Avoid intercourse, douching, and using vaginal medicines or spermicidal foam for 2 days before the test. If you had sex before the test, go to the appointment as planned and let the doctor know.

If you have your period, don't worry. Both tests can still be done at this time.

Test results

It can take as long as three weeks to receive your test results. If your test shows that something might not be normal, your doctor will contact you and figure out how best to follow up. There are many reasons why test results might not be normal. It usually does not mean you have cancer.

If your test results show cells that are not normal and may become cancer, your doctor will let you know if you need to be treated. In most cases, treatment prevents cervical cancer from developing. It is important to follow up with your doctor right away to learn more about your test results and receive any treatment that may be needed.

If your test results are normal, your chance of getting cervical cancer in the next few years is very low. Your doctor may tell you that you can wait several years for your next cervical cancer screening test. But you should still go to the doctor regularly for a checkup.

Pap test result

A Pap test result can be normal, unclear, abnormal, or unsatisfactory.

• A normal (or "negative") result means that no cell changes were found on your cervix. This is good news. But you still need to get Pap tests in the future. New cell changes can still form on your cervix. Your doctor may tell you that you can wait three years for your next screening test if you received a Pap test only. If you also received an HPV test, and the result is negative, your doctor may tell you that you can wait five years for your next screening test.
• It is common for test results to come back unclear. Your doctor may use other words to describe this result, like equivocal, inconclusive, or ASC-US. These all mean the same thing—that your cervical cells look like they could be abnormal. It is not clear if it's related to HPV. It could be related to life changes like pregnancy, menopause, or an infection. The HPV test can help find out if your cell changes are related to HPV. Ask your doctor what to do next.
• An abnormal result means that cell changes were found on your cervix. This usually does not mean that you have cervical cancer. Abnormal changes on your cervix are likely caused by HPV. The changes may be minor (low-grade) or serious (high-grade). Most of the time, minor changes go back to normal on their own. But more serious changes can turn into cancer if they are not removed. The more serious changes are often called "precancer" because they are not yet cancer, but they can turn into cancer over time. In rare cases, an abnormal Pap test can show that you may have cancer. You will need other tests to be sure. The earlier you find cervical cancer, the easier it is to treat.
• If there are not enough cells in the sample or the cells are clumped together, this is considered unsatisfactory. Your doctor may ask you to come back for another Pap test in a few months.

HPV test result

An HPV test result can be positive or negative.

• A negative HPV test means you do not have an HPV type that is linked to cervical cancer. Your doctor may tell you that you can wait five years for your next screening test.
• A positive HPV test means you do have an HPV type that may be linked to cervical cancer. This does not mean you have cervical cancer now. But it could be a warning. The specific HPV type may be identified to determine the next step.
• Cervical Cancer Screening Recommendation Statement (US Preventive Services Task Force)
• Next Steps after an Abnormal Cervical Cancer Screening Test: Understanding HPV and Pap Test Results (National Cancer Institute)

Cervical Cancer

Screening tests and the HPV vaccine can help prevent cervical cancer.