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  • Bring your insurance or ministry card with you. 

  • If you have children, keep in mind that the appointment could take up to 1.5 hours.

  • A deposit is required at this visit.


We are looking forward to your first visit with Birth Wellness! When you start care, we will discuss both routine and non-routine labs and ultrasounds. By reading information about the following screening, you will be much better prepared in understanding the labs that Birth Wellness routinely offers and those that require you to make an informed decision.

Routine Screening

If you have had prior care and labs with another midwife or physician, we will have you sign a records release form. This form is faxed to the provider who will send Birth Wellness your records. Please be prepared with the following:

  • Name of practice

  • Name of doctor

  • Address

  • Phone number


If you have not had prior care or labs, we will order all of the initial laboratory testing at your first visit. The following prenatal labs are routinely ordered by midwives.

  • CBC- A blood test (complete blood count) that screens for anemia, infection and other general conditions. Anemia decreases the amount of oxygen available to you and your baby and can be corrected with supplementation and dietary changes.

  • ABO/Rh- A blood test that determines blood type and Rh factor.

  • Antibody Screen- A blood test that screens for possible incompatibility between maternal and fetal blood. Women who are Rh negative may develop antibodies against their baby’s Rh positive blood. RhoGam will be offered to prevent this condition.

  • Rubella Titer- A blood test that checks immunity to rubella. Although most women have been immunized against rubella, protection may decrease over time. The disease can be devastating to a fetus if the mother contracts rubella during pregnancy.

  • RPR- A blood test that detects exposure to syphilis.

  • Hepatitis B  - A blood test that detects exposure to hepatitis B. Hepatitis B is a liver infection that presents a risk to infants, midwives and anyone else exposed to your blood during the birth.

  • HIV - The state of Tennessee requires that their health care providers offer HIV screening twice during pregnancy: once at the initial visit and again at 28 weeks. We prefer that you have HIV screening with your initial laboratory work to determine your risks and your eligibility for out of hospital birthing.  The test is not a test for AIDS. It tests for antibodies to the HIV virus,

Non-Routine Screening

The following tests are not part of routine screening. This means we do not include them in our standard lab tests, but we do offer these options. Please read over the following screening options so that you are better prepared to make a decision regarding your options.

First Trimester Ultrasound

If your cycles are very irregular or if you are unsure of your date of conception, we can discuss ordering an early pregnancy ultrasound. They provide the best estimate under these circumstances.

Genetic Screen

If you start care early, you need to make a decision on genetic screening for birth defects. Please learn about these screens at the following links:

  1. Maternal Serum Screen, 1st and 2nd Trimester. This screen is an appropriate choice for women at low risk of having a baby with a chromosome disorder.

  2. InformaSeq.  This test is recommended for women at increased risk of having a baby with a chromosome disorder.


Insurance companies often require physician referral for these tests. Additionally, insurance may not cover genetic screening unless there are risk factors. Other barriers to getting genetic screening include:

  • Inability for midwives to order nuchal translucency ultrasound

  • Inability of midwives to refer to perinatologist

If you do decide to have genetic screening, keep in mind we are only able to order the bloodwork portion of the screen. If genetic screening is really important to you, it may be advisable to see a physician for this portion of your care with us.

Early Gestational Diabetes Screen

When pregnant, your blood sugars (glucose) are consistently higher than pre-pregnancy. That’s because the hormone (insulin) that regulates your blood sugar gradually becomes suppressed. By the end of your second trimester, insulin may decline to about fifty percent of normal expected values. This normal decrease is very beneficial, as insulin resistance enables a mother to deliver nutrients to her growing baby. If insulin production becomes too deficient, however, a mother may develop gestational diabetes, occurring in about 6% of all women. Gestational diabetes means that your blood sugar isn’t properly regulated.

The standard timeframe for testing Gestational Diabetes Mellitus (GDM) is between 24-28 weeks. ACOG, however, recommends first trimester screening  for women who have an increased risk for developing GDM, including:

  • Prior GDM  

  • African American, Asian, American Indian, Hispanic, Pacific Islander, or Latina

  • Type 2 diabetes in a parent or sibling

  • PCOS

  • Marked obesity

  • Physical inactivity  

If you test negative for GDM in early pregnancy, you may be tested again between 24-28 weeks. If you test positive, your midwife will talk to you about follow-up with a nutritionist.

Chlamydia / Gonorrhea Screen

Chlamydia and gonorrhea are sexually transmitted infections (STIs) caused by bacteria. Anyone who is sexually active can contract these infections. If a mother is at risk, she can be screened for sexually transmitted infections in early pregnancy and receive antibiotic treatment if needed. To screen, a vaginal swab or urine specimen is collected. 

Risks of chlamydia and gonorrhea to baby

A baby can contract a severe type of conjunctivitis (pink eye) caused by gonorrhea or chlamydia infection in the mother’s body. Pinkeye that is caused by gonorrhea or chlamydia is called ophthalmia neonatorum (ON). Without treatment, it can potentially lead to permanent eye damage or blindness. Because of this potential damage, the state of Tennessee requires that their health care providers administer newborn antibiotic eye ointment. This can be declined due to religious beliefs.


In most cases, parents can safely decline this procedure. The only way for a newborn to contract ON is if the mother is infected with chlamydia or gonorrhea. If the mother does not have chlamydia or gonorrhea, then the newborn cannot catch it.

Urine Culture

We may recommend a urine culture at your initial prenatal visit or as indicated to check for the presence of bacteria associated with a urinary tract infection (UTI). A UTI is when bacteria enters your urethra, which can spread to your urinary tract  - including your bladder and kidneys.

While most women will have symptoms of a UTI, others will have no symptoms – so doing a urine culture will help identify any problems early on. And guess what – pregnant women are more prone to UTIs. Part of the reason for doing a culture, as well, is that the screening method of using a dipstick may not always catch a UT

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