Understanding OB Care

What Happens During Pregnancy: The Four Trimesters 

Pregnancy is divided into four stages: three trimesters and a fourth stage called postpartum. Each one brings different changes and different things your provider will watch for. 

First Trimester: Weeks 1–13 (through 13 weeks, 6 days) 

The first trimester is when most of your baby's body systems begin to form. This is also when your baby is most vulnerable.  

Your OB provider will focus on: 

• Making sure you are getting the right nutrients and vitamins 

• Guiding you on what to avoid, like certain foods, medications, and substances 

• Checking your overall health and any pre-existing conditions 

• Helping you manage early pregnancy symptoms like nausea 

• Confirming your due date often with an early ultrasound 

• Ordering bloodwork and STI screenings to check for infections that can affect your baby 

If you have a health condition like diabetes or high blood pressure, managing it early in pregnancy is especially important.  

Second Trimester: Weeks 14–27 

Many people feel better in the second trimester. Your baby is growing fast, and your provider will start tracking that growth more closely.  

During this stage, your provider will: 

• Check your baby's heartbeat at every visit 

• Measure your belly to track your baby's growth 

• Do a detailed ultrasound at around 18–20 weeks to check on your baby's development 

• Test for gestational diabetes and anemia between weeks 24–28 

• Offer optional genetic screening tests 

• Talk with you about signs of preterm labor to watch for 

Visits happen every four weeks until you reach 24-26 weeks gestational age; then they happen every two weeks. You may be able to find out your baby's sex at the 20-week ultrasound. Let your provider know if you would rather wait!  

Third Trimester: Weeks 28–Birth 

In the third trimester, visits become more frequent. Your provider is closely monitoring you and your baby to make sure both of you are ready for delivery. 

During this stage, your provider will: 

• Check your baby's position. Most babies move head-down before birth. If yours is in a different position (called breech), your provider will talk with you about your options. 

• Screen for group B strep bacteria around weeks 35–37. If you test positive, antibiotics during labor can protect your baby. 

• Discuss signs of labor and when to go to the hospital 

• Talk about your birth preferences, things like pain management or who you want in the room 

• Give you a Tdap vaccine (whooping cough) to protect you and your newborn 

What About Labor and Delivery? 

When it is time to have your baby, you will be in good hands, even though your NHC provider will not be in the delivery room with you. At NHC, we work closely with trusted community partners who will care for you during labor and delivery. 

Where you deliver depends on which NHC clinic you receive care at: 

• Tanasbourne patients deliver with OHSU Family Medicine at Hillsboro Medical Center 

• Oregon City patients deliver with Women's Healthcare Associates at Providence Willamette Falls Medical Center 

Your NHC care team will help you understand what to expect, connect you with your delivery team, and make sure you feel prepared and supported before that day comes. After delivery, your NHC provider will continue to care for you through postpartum. 

Fourth Trimester: Postpartum (Birth through 12 Weeks)

The postpartum period (sometimes called the fourth trimester) begins right after your baby is born and lasts about 12 weeks. This stage is just as important as the three that came before it. Your body is healing, your hormones are shifting, and you are adjusting to life with a new baby.

What Your Body Is Going Through

According to the Mayo Clinic, after delivery, it is normal to experience:

• Vaginal soreness or pain, especially if you had a tear or an episiotomy (a small cut made during delivery to help the baby out). This can take a few weeks to heal.
• Vaginal discharge, called lochia. It starts bright red and heavy, then gradually becomes lighter in color and slows over 4 to 6 weeks. Contact your provider if you are soaking a pad every hour for two hours in a row.
• Cramping or afterpains as your uterus returns to its normal size. This is common, especially during breastfeeding.
• Breast soreness or engorgement. Your breasts may feel full, firm, and tender as your milk comes in. Breastfeeding, often on both sides, can help.
• Bladder leaking when you sneeze, laugh, or cough. This is common after delivery. Kegel exercises can help strengthen your pelvic floor muscles over time.
• Hair loss and skin changes. These are normal and will improve over time.

Your Mental and Emotional Health

Many new parents feel a mix of joy, exhaustion, and sadness after birth. Feeling tearful, anxious, or moody in the first week or two is common (sometimes called the baby blues). These feelings usually go away on their own within two weeks.

But if feelings of sadness, worry, or hopelessness last longer than two weeks — or if you are having trouble caring for yourself or your baby — that is a sign to reach out for help. Postpartum depression is a real medical condition, and it is treatable. You do not have to push through it alone.

Your Postpartum Checkups

OB care does not stop when your baby arrives. ACOG now recommends that postpartum care be an ongoing process. Here is what that looks like:

• Within 3 weeks of birth: Check in with your provider by phone or in person
• Throughout the postpartum period: Additional visits as needed
• By 12 weeks after birth: A complete postpartum checkup

At NHC, your provider will follow up with you to make sure you are healing and doing well. Postpartum care typically includes checking on your physical recovery, talking about any bleeding or healing concerns, screening for postpartum depression and anxiety, discussing birth control options, and answering questions about breastfeeding, sleep, and caring for yourself and your baby.

Almost 40% of new mothers miss their postpartum checkup. Even if you feel fine, please go. How you feel after birth matters just as much as how you felt during pregnancy.