Baseline labs, first prenatal visit
CBC (complete blood count). Baseline hemoglobin and hematocrit — the number your second and third trimester anemia checks get compared against.
Blood type and Rh factor. If you're Rh-negative and your baby is Rh-positive, you'll need a RhoGAM shot around 28 weeks and after delivery to prevent complications in future pregnancies.
Rubella immunity. You can't get the MMR vaccine while pregnant — if you're not immune, this flags it for after delivery, before your next pregnancy.
Hepatitis B and C, HIV, syphilis screening. Standard opt-out screening — you can decline, but early detection changes management significantly for all of these.
Urine culture. Checks for a UTI, which is often symptomless in pregnancy but raises preterm labor risk if untreated.
Thyroid function (TSH). Untreated thyroid disorders affect fetal brain development. Ask for this even if it's not automatically included.
Genetic screening options
All of these are optional
NIPT (cell-free DNA screening). A blood test, as early as 9–10 weeks. Screens for chromosomal conditions like Down syndrome with high accuracy. Can also reveal sex, if you want to know.
First trimester combined screening. Blood test plus a nuchal translucency ultrasound, weeks 11–13. An older, less precise alternative to NIPT, sometimes used alongside it.
Carrier screening. For you and your partner — checks whether you carry genes for conditions like cystic fibrosis, sickle cell disease, or Tay-Sachs. Worth doing regardless of family history.
CVS (chorionic villus sampling). Diagnostic, not a screen — done 10–13 weeks, only if screening results raise concern or you specifically request it. Carries a small miscarriage risk your provider should quantify for you.
Screening results are probabilities, not diagnoses. A "high risk" result on NIPT or combined screening means a follow-up diagnostic test (CVS or amniocentesis) is offered, not that anything is confirmed. You are never required to act on a screening result you don't want.