What to do after a positive pregnancy test?

What do I need to do after a positive pregnancy test? Pregnancy is an exciting period full of changes in a woman's life. During this time, it is crucial to make sure that both you and your baby are in good health. For this reason, it will be essential to have a follow-up with your midwife and gynaecologist after a positive pregnancy test, in order to detect any problem that may arise and guarantee a healthy pregnancy.

In this post created by our team of midwives, we will talk to you about the positive pregnancy test, as well as the importance of check-ups during pregnancy, when you should have them and what to expect during each visit of the first trimester. From Happymami we will provide you with information based on scientific evidence and help you understand why these check-ups are so important for you and your baby after a positive pregnancy test.

What is the first thing I should do if I am pregnant?

Now that you are pregnant, the first thing you should do is to take into account certain aspects that you most probably already had in mind while you were trying to get pregnant.

As far as vitamins are concerned, we need to take the vitamins specific to pregnancy. Any brand will be suitable, and it will depend on your preference or on your gynaecologist's recommendation, and you are most probably already taking them, as they are recommended before the conception of the embryo.

The second thing will be to adapt your diet to the new pregnancy situation we are in, and to create a healthy lifestyle that favours the correct development of your pregnancy. You can download our guide on eating during pregnancy, completely free of charge, with what you can and cannot eat during this period.

And the third thing will be to have your pregnancy monitored by health professionals. Make an appointment with your midwife at the health centre, to start the support that, as professionals, we will give you throughout your pregnancy, birth and postnatal period. The first visit for a pregnant woman should take place as soon as possible once the pregnancy is confirmed, and the follow-up will continue until the postnatal period.

How do you realise that you are pregnant?

There are many symptoms and signs that can make you suspect that you are pregnant, the most recurring being the absence of your period (amenorrhoea). That is why, if you have doubts about how to know if you are pregnant, the best thing to do is to take a pregnancy test to confirm it.

Positive pregnancy test

Receiving a positive pregnancy test is a moment of great impact and emotion for many women. This result indicates the presence of the hCG hormone in the body, a sign that the pregnancy has begun. After a positive pregnancy test, it is important to confirm the result with a visit to the doctor. This step is crucial in order to start the appropriate prenatal follow-up, thus ensuring the health of both the mother and the baby. Recognising the symptoms of pregnancy and confirming the pregnancy with a positive test allows future mothers to prepare themselves and to receive the necessary support from the very first moment.

Remember that the pregnancy test measures a hormone specific to pregnancy known as hCG, which will be present in urine at around week 6 of gestation, and in blood at week 4.

As health professionals, when we care for women who do not know whether they are pregnant, we suspect pregnancy in any woman of childbearing age with amenorrhoea (absence of periods). In these cases we will carry out the confirmation of pregnancy by means of an immunological hCG test in urine, which becomes positive one week after the first missed period in 95% of cases. If the pregnancy test is negative, the amenorrhoea persists and it is a woman with regular cycles, we will repeat the pregnancy test 7 days after the first one. If the doubt persists, free ß-hCG in blood should be determined.

Evolution of a positive pregnancy test

When you take a pregnancy test and the result is positive, you experience a series of physical and emotional changes as the weeks go by. Initially, the test detects the hCG hormone in your urine, confirming the pregnancy. In the first weeks, this hormone continues to rise, which can cause early symptoms such as fatigue, nausea and breast tenderness. As the pregnancy progresses, these symptoms may intensify and you may notice an increase in emotional sensitivity. It is common to schedule your first prenatal appointment around week six, where a doctor can perform an ultrasound scan to check the development of the pregnancy.

Towards the end of the first trimester, hCG production reaches its peak and your body begins to adapt to the hormonal changes, which can make some symptoms lessen. During this crucial time, at Happymami we are here to support you with products that make your transition to motherhood easier. Our bottles, designed to imitate breastfeeding, ensure a comfortable and pleasant experience for both you and your baby, helping you prepare for the arrival of your little one with confidence and peace of mind.

Where should you make an appointment when you become pregnant?

In Spain, pregnancy care is established universally and begins at the health centre. Call your health centre and make an appointment with your midwife, telling her that you have become pregnant.

How many appointments are there in pregnancy?

The number of appointments during pregnancy depends on the level of risk attributed to you at the first appointment, so we will find that a follow-up programme of between 6 and 9 visits in women with a low risk of developing complications during pregnancy or birth will be the appropriate one.

The recommendation is based on the absence of statistically significant differences between prenatal care programmes with reduced visits (4-9 visits) and standard prenatal care (13-14 visits) as regards the outcomes for the mother and the newborn. Although there is a higher risk of perinatal mortality, it is not statistically significant. Furthermore, the evidence comes from studies carried out in high- and low-income countries, which makes it indirect evidence.

It is true that women are less satisfied with the reduced-visit scheme and the cost of the programme is lower, but the costs related to the length of hospital stay of the newborns increased. Therefore, the recommendation is based on this analysis. In the section on Diagnostic and therapeutic strategies, the contents of each proposed visit are detailed.

The consultation plan established for a pregnant woman is as follows:

• Initial examination: as soon as possible, before 8 weeks
• Every 4 weeks between week 8 and week 32 of pregnancy
• Every 2 weeks between week 32 and week 36 of pregnancy
• Every week until the end of the pregnancy
• Postnatal visit 7-10 days after the birth (postnatal period)

What happens if I do not attend the prenatal check-ups?

Pregnancy appointments are justified because they are an essential service that seeks to favour the correct development of the pregnancy through a continuous assessment of both the mother's and the baby's condition. These appointments allow a detailed monitoring of maternal and foetal health, which is crucial in order to detect any anomaly or complication early. Thanks to these periodic assessments, we can anticipate possible problems that may arise during the pregnancy.

This allows us to intervene in a timely manner and, if possible, to implement preventive measures to minimise the risk of serious complications or mortality for both the mother and the baby. In addition, these consultations provide an opportunity for future mothers to receive education and support, contributing to a safer and healthier pregnancy experience.

When do the weekly appointments in pregnancy begin?

The first pregnancy appointment should preferably be made before 10 weeks of gestation, although there are also sources that refer to before 8 weeks of gestation.

At this appointment your midwife will open a pregnancy medical record, with a complete medical history of your own, a physical examination, and requests for the necessary blood tests and ultrasound scans. It will also be the best occasion to ask any questions you may have and to receive the first advice for your pregnancy.

What is done at the first pregnancy check-up?

At the first appointment for a pregnant woman with your midwife at the health centre, as we have seen, it is the longest one, as your medical record will be opened, in which she will enter a complete anamnesis with your personal, family and obstetric history and toxic habits, as well as your vaccination status. The information is complemented with a physical examination: height, weight, BMI and blood pressure.

You will also be asked for complementary tests such as the first-trimester blood test (between week 9 and 10 of gestation). A complete blood test that includes a fasting glucose, full blood count, blood group and Rh, irregular antibodies (indirect Coombs), and serologies, such as syphilis, rubella, HIV, Hepatitis B and Hepatitis C. There are cases in which the mother is considered at risk and tests for Chagas, toxoplasma, Zika, among others, will be requested.

In addition, she will request the combined first-trimester screening, in order to rule out the risk of Down's syndrome, Patau syndrome and Edwards syndrome, which will be complemented by the first ultrasound scan, called the first-trimester scan, performed between week 11 plus 2 days and week 13 plus 6 days, preferably around week 12 of gestation.

What will the midwife inform me about at the first pregnancy visit?

At this first pregnancy visit after the positive pregnancy test we will give you a lot of information, but do not worry, we usually accompany this information with leaflets, and we are also very accessible so that you can contact us with any doubt. Among the information we will give you will be:

• Information about the visits during pregnancy care, usual frequency.
• Information about examinations and complementary tests to be carried out.
• Information on the reasons for alarm and for consultation during the first trimester.
• Recommendations on how to act in the face of the usual discomforts during pregnancy.
• Recommendations on diet and healthy habits, informing you of the hygiene rules against infections
• We will ask you about your dietary habits: if you have an adequate diet of dairy products and iodised salt 2g, there will be no need to supplement. On the other hand, we will supplement with folic acid if you were not already taking it, until 12 weeks of gestation. If you are vegan or an ovo-lacto-vegetarian or vegetarian, we will supplement with Vitamin B12.
• Advice on sexual activity.
• Information on appropriate regular physical activity.
• Recommendations on medicines during pregnancy, avoiding self-medication, exposure to radiation or occupational or environmental toxins.
• Oral health advice: recommendation of a visit to the dentist at the health centre (CAP).
• Recommendation of the inactivated flu vaccine during the flu season.

First-trimester ultrasound in pregnancy

Although it has not been proven that early, late or serial ultrasound in a normal pregnancy improves perinatal mortality or morbidity, due to its easy handling and accessibility it is a highly widespread test in pregnancy care in our country.

The objectives of this ultrasound in low-risk pregnant women are to determine the embryonic activity, the gestational age, the existence of a multiple pregnancy, an ectopic pregnancy and the detection of foetal malformations.

First-trimester screening

It is the first visit you will have with gynaecology, also known as the first ultrasound scan, and it will be carried out between week 12 and week 13 plus 6 days of gestation. During this visit, population screening is carried out with the aim of detecting the risk that our baby may have some syndrome, such as Down's syndrome or other chromosomal abnormalities. This screening consists of a combination of tests, including ultrasound and blood tests, to assess the risk of genetic problems.

This population screening programme is offered to the entire population systematically and according to protocol, guaranteeing that all pregnant women have access to this crucial assessment. The first-trimester ultrasound allows health professionals to measure the nuchal translucency of the foetus, as well as to verify the correct formation and development of the baby. In addition, the heartbeat and other important vital signs can be observed.

Taking part in this screening is an important decision for future parents, since the results provide valuable information about the baby's health and can help to plan additional medical care if necessary. This first ultrasound scan is also a special moment for parents, as it is the first opportunity to see the developing baby and to hear its heartbeat, creating an emotional connection and a sense of reality in the pregnancy.

How can you find out whether my baby is at risk of Down's syndrome?

This first pregnancy screening detects 3 types of syndromes, and it is achieved by taking into account ultrasound parameters such as the measurement of the nuchal translucency (NT) and biochemical parameters analysed in maternal serum, such as the measurement of the free ß fraction of human chorionic gonadotrophin (ß-hCG) and pregnancy-associated plasma protein A (PAPP-A); presenting a detection rate (DR) of 90% for trisomy 21 (Down's syndrome) and 95% for trisomies 18 (Edwards syndrome) and 13 (Patau syndrome) with an overall false-positive rate (FPR) of 5% under optimal test conditions.

At this visit you will not be given the final result; it will be at the next visit with your midwife that we will know the result.

Second visit with the midwife 16-18 weeks of gestation

This is a routine pregnancy follow-up visit, in which your midwife will take the opportunity to update your medical record, reassess the gestational risk and hand over the results. Once again a physical examination will be carried out: weight, blood pressure and health education. In addition, complementary tests will be requested again, as well as the 2nd-trimester ultrasound scan, which will be performed between week 20 and 22 of gestation, with week 21 of pregnancy being preferable, and which we will address in the next post, pregnancy follow-up in the second trimester.

Conclusion What to do after a positive pregnancy test?

Prenatal follow-up during pregnancy is essential to guarantee the health and well-being of the mother and the baby. It is important to follow the recommendations of health professionals, such as midwives and gynaecologists, and to attend all the scheduled appointments, bearing in mind that each community may have its own protocol of action. If you have doubts about your pregnancy and motherhood, do not hesitate to contact a health professional in order to receive the necessary care.

Bibliography What to do after a positive pregnancy test?

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