Mandatory and Optional Examinations During Pregnancy

Pregnancy is not an illness; it is simply a “different” state in which a woman spends the whole nine months preparing for the new role of mother, which brings with it many physical and psychological changes. After the second line appears on a pregnancy test, she visits her gynecologist and starts going for regular checkups. What examinations do pregnant women undergo, and which of them are mandatory?

Mandatory examinations during pregnancy

All examinations performed during pregnancy are voluntary, so you do not have to undergo anything by force. If you decide on a home birth, then your arranged midwife will most likely be happy if you undergo these examinations:

ultrasound in the first trimester, where the pregnancy is confirmed and its length is determined, and ectopic pregnancy is ruled out, which is dangerous for the mother and needs to be ended as soon as possible;
screening in the second trimester, where any possible abnormalities in the baby are detected, fetal viability is assessed, the due date is уточнено, and the mother’s blood count is checked;
check of the heart sounds and placental viability, if the mother is past the due date.

Non-mandatory examinations during pregnancy

All examinations are optional during pregnancy, and it is entirely up to the expectant mother which ones she undergoes and which ones she does not. In addition to the examinations described below, the woman attends regular checkups usually once every 4-6 weeks (after 37 weeks of pregnancy, once a week) with her gynecologist, who monitors the mother’s weight gain, blood pressure, any swelling of the limbs, and checks the urine for the presence of protein and sugar. Some doctors also perform an ultrasound examination, measuring the baby and checking its heart sounds. Here is a list of all possible examinations divided by trimester.

Examinations in the 1st trimester of pregnancy

From 6 weeks of pregnancy (approximately 2-3 weeks after a missed period) - confirmation of pregnancy, exclusion of ectopic pregnancy;
8th-10th week (no later than the 14th week) - initial examination, issuing of the pregnancy card, blood tests to determine fasting blood sugar, HIV, syphilis, hepatitis B, blood type and Rh factor, thyroid hormone levels, and cytological and colposcopic examination of the cervix;
12th-14th week - combined screening in the 1st trimester (first-trimester screening) - possible congenital developmental defects in the baby are detected (e.g. Down syndrome), and today it also includes a test for the risk of preeclampsia; most insurance companies cover the screening, it costs 1500 CZK, and in addition to the report from the examination you will also take home a nice ultrasound photo and you can ask about the baby’s sex, fathers are welcome at this screening.

Examinations in the 2nd trimester of pregnancy

20th-22nd week - screening in the 2nd trimester - performed by a gynecologist and fully covered by insurance, the placement of the placenta, amount of amniotic fluid, organ development, and the baby’s heart activity are checked;
20th-22nd week - detailed assessment of fetal morphology in the 2nd trimester of pregnancy - the examination aims to detect congenital developmental defects, heart defects, various genetic changes, etc.; this examination is no longer covered by insurance (usually costs 1500 CZK), but it can be claimed from the insurance company within the pregnancy program; you will usually also take home an ultrasound photo, possibly even 3D and 4D photos of the baby on a flash drive, and the doctor will confirm the baby’s sex, fathers are welcome again;
20th-24th week - cervicometry - the doctor measures the length of the cervix and thereby detects the risk of premature birth, the minimum should be 2.5 cm;
24th-28th week - oGTT - test for gestational diabetes (blood draw on an empty stomach, then after 60 minutes and 120 minutes after drinking the glucose solution), the values are up to 5.1 mmol/l (first draw), up to 10.0 mmol/l (second draw), and up to 8.5 mmol/l (third draw). If the fasting value is higher, the test is repeated another day; if the repeated one is also higher, the woman attends a clinic where she and the doctors address gestational diabetes through diet (milder cases) or medication and injections (higher values). It can happen that the woman’s fasting value is fine, but the other two values are not within the limit; in that case, she also attends the clinic.

Examinations in the 3rd trimester of pregnancy

28th-34th week - blood count check, determination of iron levels in the blood;
30th-32nd week - screening in the third trimester - baby’s viability, its position (head down or breech - this can change at any time until birth, so it is not the final position), estimated baby weight, placement of the placenta, amount of amniotic fluid, checking the baby’s organs and limbs;
35th-37th week - vaginal and rectal swab to detect the presence of group B streptococcus (GBS);
36th-37th week - ultrasound screening for fetal growth restriction - the baby’s growth is checked here and the mother pays for it herself, then she can request reimbursement from the insurance company if she has not already used up the entire package (the price varies by facility, usually it is 500-1500 CZK);
36th-37th week - check-in at the selected maternity hospital (initial examination, registration of the pregnant woman for delivery in the maternity hospital, cardiotocography - checking the baby’s heart rate, which takes approximately 30 minutes);
from the 37th week - some doctors perform cardiotocography at every visit (once a week), but today it is no longer standard and is usually done only after the 40th week in the maternity hospital;
from the 41st week - handover of the woman to the care of the maternity hospital - this means that the woman no longer attends checkups with her gynecologist, but at the chosen maternity hospital, once every 3-4 days, as needed.

Other examinations during pregnancy

In addition to examinations primarily related to pregnancy, the woman should also undergo an examination by:

dentist - in addition to the 2 standard checkups per year, the woman may visit her dentist one more time, and any dental repairs are usually covered by insurance;
pediatrician - preventive checkup and ECG recording.

If a woman decides to undergo all the recommended examinations during pregnancy, there will be quite a few of them; however, in today’s world of technological development, it is possible to detect any baby abnormalities very early and thus prevent possible complications.

It is entirely up to you which examinations you undergo and which you skip; always trust your feelings, and if anything feels uncomfortable, refuse it, you are entitled to do so. Having worries during pregnancy is natural, all expectant mothers have them.

We wish you a smooth pregnancy and a beautiful start with your baby.