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Prenatal care

  • Prenatal care is the care you get while you’re pregnant.
  • Regular prenatal care helps keep you and baby healthy.
  • A doctor, midwife or other health provider gives this care.
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Vaccinations during pregnancy

Some infections can harm you and your baby during pregnancy. This is why vaccinations are so important. They help protect your body from infection. You pass this protection to your baby during pregnancy. This helps keep your baby safe during the first few months of life until he gets his own vaccinations.

Vaccinations also protect you from getting a serious disease that could affect future pregnancies. Talk to your health care provider to make sure all your vaccinations are up to date. You probably got vaccinations as a child. But they don’t all protect you for your whole life. Or there may be new vaccinations that weren’t available when you were young. Over time, some childhood vaccinations stop working, so you may need what’s called a booster shot as an adult.

Not all vaccinations are safe to get during pregnancy. Here’s a chart to help you know when you can get certain vaccinations if you need them. Talk to your health care provider about vaccinations you need before, during or after pregnancy.



What vaccinations are recommended before pregnancy?
The U.S. Department of Health and Human Services (DHHS) recommends that you be up to date on all routine adult vaccinations before you get pregnant.

If you’re planning pregnancy, get a preconception checkup. This is a medical checkup you get before pregnancy.

At your checkup, ask your health care provider if you need any vaccinations or boosters. If you have a copy of your vaccinations record, bring it to your preconception checkup. If you don’t have a copy, your provider can do a simple blood test to find out what you need. If you do need any vaccinations, wait 1 month after you get any shot before trying to get pregnant.

Here are some vaccines that are recommended before pregnancy:

  • Flu. Get the flu shot once a year during the flu season (October through May). It protects you and your baby against both seasonal flu and H1N1, a kind of flu that spread around the world in 2009. If you come down with the flu during pregnancy, you’re more likely than other adults to have serious complications, such as pneumonia.
  • HPV. This vaccine protects against the infection that causes genital warts. The infection also may lead to cervical cancer. The CDC recommends that women up to age 26 get the HPV vaccine.
  • MMR. This vaccine protects you against the measles, mumps and rubella. Measles can be harmful to pregnant women and cause miscarriage.
  • Tdap. This vaccine is recommended for caregivers, close friends and relatives who spend time with your baby. It prevents pertussis (also called whooping cough). Pertussis is easily spread and very dangerous for a baby. If you're thinking about getting pregnant, ask your provider about getting the Tdap vaccine. It protects you from getting pertussis so you don't give it to your baby. 
  • Varicella. Chickenpox is an infection that causes itchy skin, rash and fever. It’s easily spread and can cause birth defects if you get it during pregnancy. It’s also very dangerous to a baby. If you’re thinking about getting pregnant and you never had the chickenpox or the vaccine, tell your provider.

What vaccinations are recommended during pregnancy?
The Centers for Disease Control and Prevention (CDC) recommends two vaccinations during pregnancy:

  1. Flu vaccine if you weren't vaccinated before pregnancy
  2. Tdap vaccine during each pregnancy at 27 to 36 weeks

If you come in contact with certain illnesses or if you’re at high risk for infection, your provider may recommend other vaccinations during pregnancy. These include:

  • Anthrax
  • Japanese encephalitis
  • Polio
  • Rabies
  • Vaccinia (smallpox)
  • Yellow fever

What vaccinations are not recommended during pregnancy?
Don’t get these vaccines during pregnancy:

  • BCG (tuberculosis)
  • Memingococcal
  • MMR
  • Nasal spray flu vaccine (called LAIV) (Pregnant women can get the flu shot, which is made with killed viruses.)
  • Typhoid
  • Varicella

Wait at least 1 month after getting any of these vaccinations before you try to get pregnant.

What vaccinations are recommended after pregnancy?
If you didn’t catch up on vaccinations before or during pregnancy, do it after your baby’s born. This can help protect you from diseases in future pregnancies.

If you didn’t get the Tdap vaccine before or during pregnancy, you can get it right after you give birth. Getting the Tdap vaccine soon after giving birth prevents you from getting pertussis and passing it on to your baby. Your baby should get his first pertussis vaccine at 2 months old. Babies may not be fully protected until they’ve had three doses.

Until your baby gets his first pertussis shot, the best way to protect him is to get the vaccine yourself and avoid people who may have the illness. Caregivers, close friends and relatives who spend time with your baby should get vaccinated, too.

Getting vaccinated soon after giving birth can help prevent your newborn baby from getting other illnesses, too. This is because most babies don’t begin their regular vaccination schedule until 2 months of age. By you getting vaccinated, you can avoid getting sick and, in turn, passing an illness to your baby.

If you’re breastfeeding, it’s safe for you to get routine adult vaccines. Ask your provider if you have questions.

Do vaccinations cause autism?
No. Vaccinations do not cause autism.

Some people are concerned that thimerosal, a chemical that has mercury in it and is used in some vaccines, causes autism. This concern came from a study done many years ago. The research in that study was flawed.

Since then, much careful research shows that thimerosal in vaccines did not cause autism. Thimerosal is no longer used in vaccines, except in tiny amounts in some flu shots. You can get a thimerosal-free flu vaccine if you want. Talk to your provider if you’re concerned about thimerosal in vaccines.

Last reviewed February 2013

See also: Your baby’s vaccinations, Later prenatal care checkup

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Frequently Asked Questions

What is transabdominal ultrasound?

When you hear about ultrasound during pregnancy, it’s most likely a transabdominal ultrasound. This is a prenatal test that uses sound waves to show a picture of your baby in the uterus (womb). Your health care provider uses it to check your baby’s health. Most women get an ultrasound at 18 to 20 weeks of pregnancy.

During an ultrasound, your provider moves a plastic tool, called a transducer, across your belly. The transducer sends sound waves into your uterus. The waves bounce around to create a picture of your baby on a monitor. To get a better picture, your provider covers your belly with a thin layer of gel. This helps the sound waves move more easily.

Your provider measures your baby’s body throughout the test. Depending on your baby’s position, your provider may point out his hands, legs and other body parts. You should be able to tell if your baby’s a boy or a girl, so be sure to tell your provider if you don’t want to know!

You may need to have a full bladder during the test. This prevents pockets of air in your bladder from affecting the picture. Ultrasound is painless, but having a full bladder may be uncomfortable.

What is first trimester ultrasound?

First-trimester ultrasound (also called early ultrasound) is a prenatal test that uses sound waves to show a picture of your baby in the uterus (womb). Some providers may use this kind of ultrasound to make sure your baby’s organs are growing and developing normally.

Your health care provider uses it to check your baby’s health. A first-trimester ultrasound takes place before 14 weeks of pregnancy.

The kind of first-trimester ultrasound you have depends on the type of information your provider needs. Your provider usually does ultrasound by moving a plastic tool, called a transducer, across your belly. This is called transabdominal ultrasound. You also can have a transvaginal ultrasound, which means it’s done in the vagina (birth canal). Both kinds usually take about 15 to 20 minutes.

Your provider can use first-trimester ultrasound to:

See also: Ultrasound

What is 4-D ultrasound?

4-D ultrasound is a prenatal test that uses sound waves to show a three-dimensional picture of your baby in the uterus (womb) and shows your baby’s movement. 3-D images are almost as clear as a photograph, and 4-D is a moving-picture version or video. Some providers may use this kind of ultrasound to make sure your baby’s organs are growing and developing normally.

You may know of some places, like stores in a mall, that aren’t run by doctors or other medical professionals that offer “keepsake” 3-D or 4-D ultrasound pictures or videos for parents. The American College of Obstetricians and Gynecologists, the Food and Drug Administration and the American Institute of Ultrasound in Medicine do not recommend these non-medical ultrasounds. The people doing them may not have medical training and may give you wrong or even harmful information.

What is 3-D ultrasound?

3-D ultrasound is a prenatal test that uses sound waves to show a three-dimensional picture of your baby in the uterus (womb). Some providers may use this kind of ultrasound to make sure your baby’s organs are growing and developing normally.

The 3-D ultrasound is almost as clear as a photograph. A moving-picture version is called 4-D ultrasound.

You may know of some places, like stores in a mall, that aren’t run by doctors or other medical professionals that offer “keepsake” 3-D or 4-D ultrasound pictures or videos for parents. The American College of Obstetricians and Gynecologists, the Food and Drug Administration and the American Institute of Ultrasound in Medicine do not recommend these non-medical ultrasounds. The people doing them may not have medical training and may give you wrong or even harmful information.

See also: Ultrasound

What is Doppler ultrasound

Doppler ultrasound is a kind of prenatal test that can be used to check a baby’s health in high-risk pregnancies. Providers usually use Doppler ultrasound during the last trimester, but it may be done earlier.

During Doppler ultrasound, your provider uses a plastic tool called a transducer to measure the blood flow in the umbilical cord and some of your baby’s blood vessels. This test shows if your baby is getting enough oxygen. Your provider also can listen to your baby’s heartbeat using Doppler ultrasound.

Some providers use Doppler ultrasound to check mothers with Rh disease. This is a condition where a difference between the mother’s blood and baby’s blood can cause a dangerous kind of anemia in the baby. Anemia is when the body doesn’t have enough red blood cells or the red blood cells are too small. When the condition is found early and treated, most affected babies survive.

What is transvaginal ultrasound?

Transvaginal ultrasound is a prenatal test that uses sound waves to show a picture of your baby in the uterus (womb). Your health care provider uses transvaginal ultrasound to check your baby’s health. It’s often used for early ultrasound in the first trimester.

During the test, your provider moves a thin, wand-like transducer into the vagina. You lay on your back with your feet in stirrups during the exam. You may feel some pressure from the transducer, but it shouldn’t cause pain.

Transvaginal ultrasound can be used throughout pregnancy to check for problems with the cervix (opening to the uterus) and lower uterus.

See also: Ultrasound

How is blood pressure measured?

Blood pressure is the force of blood that pushes against the walls of your arteries. Arteries are blood vessels that carry blood away from your heart to other parts of the body. If the pressure in your arteries becomes too high, you have high blood pressure. High blood pressure is also called hypertension.

At each prenantal care visit, your health care provider checks your blood pressure. To do this, she wraps an inflatable cuff around your upper arm. She pumps air into the cuff to measure the pressure in your arteries when the heart contracts (gets tight) and then relaxes.

Your blood pressure reading is given as two numbers: the top (first) number is the pressure when your heart contracts and the bottom (second) number is the pressure when your heart relaxes. A healthy blood pressure is 110/80. High blood pressure happens when the top number is 140 or greater, or when the bottom number is 90 or greater

Your blood pressure can go up or down during the day. Your provider can re-check a high reading to find out if you have high blood pressure during pregnancy.

Last reviewed March 2012

See also: High blood pressure during pregnancy, Preeclampsia, HELLP syndrome

Can a rubella shot hurt my baby during pregnancy?

If you got your rubella shot around the time you got pregnant, it's unlikely that your baby will be harmed by the vaccine. However, it's best to wait to get pregnant for 28 days after vaccination because there is a very small risk of potentially hurting the baby. To date, there hasn't been any birth defects reported that are attributed to the rubella vaccine. In any case, the risk of harming your baby by getting the vaccine at the time you got pregnant is much lower than the risk of harming your baby if you caught rubella during pregnancy.

I couldn't see my baby at my 7 week ultrasound. Why?

At the 7th week of pregnancy, your baby is about ½ an inch long or the size of a blueberry. He's very small. When a transabdominal ultrasound (done on your belly) is done at such an early stage, it's possible that the baby can't be seen. It could be because it's too early in the pregnancy or because you conceived a little later than what you thought. Your health care provider might recommend a transvaginal ultrasound (done inside the vagina) to help see the baby more clearly.

What are choroid plexus cysts?

The choroid plexus is the area of the brain that produces the fluid that surrounds the brain and spinal cord. This is not an area of the brain that involves learning or thinking. Occasionally, one or more cysts can form in the choroid plexus. These cysts are made of blood vessels and tissue. They do not cause intellectual disabilities or learning problems. Using ultrasound, a health care provider can see these cysts in about 1 in 120 pregnancies at 15 to 20 weeks gestation. Most disappear during pregnancy or within several months after birth and are no risk to the baby. They aren't a problem by themselves. But if screening tests show other signs of risk, they may indicate a possible genetic defect. In this case, testing with higher-level ultrasound and/or amniocentesis may be recommended to confirm or rule out serious problems.

Have questions?

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