50. Routine Tests in Pregnancy Including Labs and Blood Draws

Are you wondering what routine blood tests in pregnancy are usually done, why they are standardized, and what choices you have around these routine tests? 

Tune in to explore the significance of these tests as a snapshot of your health in pregnancy, helping to detect any issues early on and be sure you and your baby are healthy!

In this episode the pregnancy labs we will talk about include:

• Complete Blood Count (CBC): Understanding its role in checking for anemia, infection, or clotting issues twice during pregnancy…
• Blood Typing and Rh Factor: Significance for pregnancy and potential implications…
• Urine Sample Analysis: Screening for urinary tract infections, often asymptomatic during pregnancy…
• Screening for Diseases: Including Rubella, Varicella, Hepatitis, HIV, and STIs, with further discussions on treatment if conditions are positive…
• Additional Tests: TSH for thyroid check, Pap smear for cervical cancer screening, gestational diabetes screening, and genetic screening options.

Understanding routine tests help you to actively engage in your prenatal care, ensuring the best outcomes for both you and your baby. Don’t forget to check out our free resource on hospital birth choices at bethconnors.com/choices!

Your Birth Bestie Episodes Referenced:

• #17 Group Beta Strep During Pregnancy: Risks to Consider Before Labor and Birth
• #19Gestational Diabetes: Pregnancy Risks, Testing Options, and Alternatives to Glucola Drink
• #45 Prenatal Genetic Screening Tests: Testing Options and Important Details

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👋 WHO AM I?

Welcome, friends! I am Beth, a certified nurse midwife, doula, and childbirth educator. My philosophy is rooted in autonomy, informed decision making, and positive mindset to help expecting parents plan for a beautiful, stress-free birth. I am here to provide value to YOU through tips and practical advice, either to guide you through pregnancy or to help you prepare for childbirth, postpartum and beyond. There’s no fluff here - only info that adds to your positive experience and saves you stress and uncertainty.

Transcript

Hello and welcome back to episode 50 of Your Birth Bestie podcast! Today, we are going to be talking about routine tests during pregnancy, where you go to the lab, they draw your blood and run tests on the things your provider orders. And the reason why I love talking about prenatal care and giving you this information, is because you have the right to know exactly what kinds of tests are being ordered and decide for yourself if you even want to consent. If you have questions, you can definitely use this information too as a conversation started with your provider to be sure your concerns are understood and you get all your follow-up questions answered! 

Generally, there are two times where your blood is drawn in pregnancy, it could be less, or it could be more, depending on your medical history and what’s recommended by your provider. But it also depends on what you want and values too and it’s important you are part of these conversations rather than just going along with whatever it is that your doctor wants. Not that anything they are doing is wrong or malicious, just that you are aware of what is happening each step of the way and knowing you deserve to know that I think is a good reminder for a lot of us.

There are actually a lot of choices, especially when you’re receiving prenatal care within a hospital system, that aren’t openly discussed with you up front. You usually have to know what questions to ask and prepare for your visits and your labor and delivery. And I want to help you navigate your experience to be the best it can be, so if you’re interested you can click on the link in the show notes or head over to bethconnors.com/choices and download my free guide to 15 hidden hospital birth choices every pregnant mom should know, from their first appointment to their last.

Let’s first talk about why we do prenatal testing in general anyways? And that’s because they are little snapshots of how your pregnancy is progressing and helps us keep an eye on things to potentially catch any issues early on, before they become a problem. It’s all about keeping you and your baby healthy and predicting any change in the plan of care, to increase the chance of you having the best outcome and best experience. 

So the first standardized set of labs we’ll chunk together as the first-trimester lab tests. Usually these are drawn at your first prenatal appointment, sometimes the second visit, it just depends on your clinic. But the breakdown of what’s usually included in the first-trimester labs are: a complete blood count or CBC which gives us values about your red blood cells, white blood cells, and platelets and the results help check for any signs of anemia, infection, or clotting issues; there is also blood typing and Rh factor which is really important and this refers to if you have for example type A or B blood and the Rh factor is the positive or negative piece. Your blood type and Rh factor can play an important role in your pregnancy because if you’re Rh negative and your baby is Rh positive, there is a chance your immune system could see the baby as a “threat” if your blood is mixed during pregnancy or at delivery. This is where tools like the injection Rhogam come in, which we can talk about another time.

In the beginning of your pregnancy you might be asked to give a urine sample for analysis to test for any potential urinary tract infections, because in pregnancy the typical symptoms of a UTI you might be familiar with can actually go completely unnoticed.

There are also lab tests to screen for diseases like Rubella, Varicella, Hepatitis, HIV, and sexually transmitted infections. If you aren’t immune to rubella and varicella for example, you have the option to receive those vaccinations postpartum, because they are not to be given during pregnancy for the safety of your baby. If any of these conditions come back positive, you would have a further conversation about treatment.

Other tests that may or may not be ordered depending on your health history and concerns include a TSH to check your thyroid, a pap smear to screen for cervical cancer, and then the last piece is genetic screening.

Genetic screening is something you can decide whether you want or not too, and some families struggle with whether or not they are interested. If you’re undecided, I talk more about genetic screening options in episode 45 of this podcast and how to determine if this would be a good option for your family. These tests can be done as early as 10 weeks with your initial lab draw, or if you decide to add on genetic testing at any point in your pregnancy, that is always an option too.

The next set of routine labs in pregnancy are at the end second-trimester, beginning of the third trimester, between 24-28 weeks. A complete blood count or CBC would be recommended again to follow-up and compare from the baseline values from earlier in pregnancy. At this point in pregnancy, we’re looking for the same things, especially assessing for any signs of anemia or low hemoglobin. Sometimes it is recommended to eat more high-iron foods or supplement with iron tablets to replenish your body and hopefully increase your blood levels before you deliver. Anemia can make you feel tired, weak, pale, short of breath, dizzy, and even crave ice called pica. It’s important to care for our bodies during pregnancy and be mindful of anemia because there can be an increased risk to baby’s growth, possibly lead to preterm delivery, or lengthen the time it takes mom to recover postpartum and make that process more difficult. 

The other test that will be offered around this time is the screening for gestational diabetes. I talk more about gestational diabetes and why we test for it, what the possible risks are if you do have gestational diabetes, but also about the different options you have when it comes to this test. You may have heard of some of the ingredients in the standard hospital offered Glucola drink for this test and feel uneasy about it, so there are alternatives I want you to know about too. I talk all about these in Episode 19 of this podcast, but as a brief note my favorite natural drink is the Fresh Test and you can also monitor your blood sugar with a glucose machine at home if you’d rather not take 50 grams of sugar at one time and get your blood drawn to see how your body reacted to it. Everyone has a preference and you deserve to know all the information to make that decision for yourself.

The last thing, I just want to call out so you’re aware of the timeline around this test to have the chance to make a decision on what you want to do before you’re put on the spot, is the group beta strep vaginorectal swab around 36 weeks. This is a q-tip like swab gently collecting a sample from your vagina and rectum to see if you are positive for this bacteria. It’s a normal flora in the vagina and about 30% of women do test positive. The standard treatment is antibiotics every 4 hours during active labor through an IV line. I talk much more about this as well in another episode, number 17, so for more info you can listen to that episode next. You can choose to test and treat if positive, you can choose to test and not treat if positive, or you can choose to even not test and not treat if you don’t want. Just be sure you are always aware of your options and why each intervention or tool is being recommended to you specifically. You are not just another number, you have unique needs medically and personally, and I hope you have individualized, women-centered care during your pregnancy and birth experience!

That concludes our episode on routine blood tests in pregnancy and I hope what I have shared has helped you feel a little more informed about any remaining tests you may be considering. If you’re maybe nervous about needles, I wanted to reassure you that two blood draws would hopefully be all that recommended for you and then anything else would be on a case-by-case basis. Being mindful of things like the genetic screening tests and if possible combining all the tests into one lab session could be a helpful tip for you too if you’re wanting to limit your pokes and also the trips to the lab out of your busy schedule. On the topic of needles too, you’re not required to have an IV in labor either, these are all choices and I talk about all those different choices in all of my other episodes too, giving you as much information as possible to uncover any hidden information or choices you didn’t even know you had, and then helping you navigate them as well. Don’t forget to download my free resource about choices in the hospital at bethconnors.com/choices if you haven’t already, and thank you so much for tuning in today! I will be back here again next Tuesday and I would love for you to stick around too, bye everyone.