Once the indicator on that pregnancy test is positive, your life will never be the same. After the initial excitement, you may find that your head is spinning as you think of all you must do to prepare -- everything from scheduling medical tests to signing up for childbirth classes and picking out a car seat. But getting ready doesn't need to be overwhelming. With a little organization and advance planning, you'll be equipped to handle it all -- and able to enjoy this special time.
Month 1: Take your vitamins. As soon as you know you're pregnant, start taking a prenatal supplement with 400mcg of folic acid if you aren't already. This reduces the risk of neural-tube defects, such as spina bifida. It should also contain 27mg of iron and 1,000mg of calcium, says Caren Stalburg, M.D., an ob-gyn at the University of Michigan Health System, in Ann Arbor.
Choose a health-care provider. It's time to pick an ob-gyn or a midwife if you don't have one (or if your doc doesn't do obstetrics). Consider factors like proximity to your home, insurance coverage, and which practice will work best to aim for your ideal birth experience. Once you've chosen, set up an appointment.
Month 3: Start taking tests. Between Weeks 11 and 14 first-trimester screenings are given, including pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin (hCG), blood tests that determine the risk of Down syndrome and trisomy 18. You may also be given a nuchal translucency screening, an ultrasound that measures the back of the fetus's neck (its thickness can indicate chromosomal problems). Results from the screenings will determine if you need further diagnostic tests, such as chorionic villus sampling (CVS) or an amniocentesis. No matter what, women age 35 and over should talk to their doctor about having one of these two genetic tests, which are performed around ten to 12 weeks and 15 to 20 weeks, respectively.
Month 4: Have a second-trimester screening. Also known as multiple marker screening, this blood test typically performed between 15 and 20 weeks looks for hCG, alpha-fetoprotein (AFP), estriol, and inhibin-A. It screens for elevated risk of various defects in the fetus, such as Down syndrome, spina bi-fida, and anencephaly. If your results are abnormal, you'll need additional testing, possibly including an amniocentesis or CVS.
Share the news with your boss. Before you announce everything to your coworkers and office pals, meet with your supervisor to discuss your maternity leave. Go into the appointment with several proposals for how your work might be handled while you are gone, taking both your needs and the company's into account, suggests Ellen Galinsky, president of the Families and Work Institute in New York City.
Month 5: Take a look at your baby. Around 20 weeks, you'll have an ultrasound, so the doctor can assess your baby's growth and make sure all the organs are developing properly. This is likely when you can find out the sex of your little one as well.
Set up your nursery. Furniture delivery can take 12 weeks, so order by Week 20. Get a bassinet, a combination changing table-dresser for clothes, two sets of bed linens, and a baby bathtub. Also buy infant clothing, bibs, receiving blankets, wipes, and at least 50 newborn and 50 size 1 diapers, says Jodie Hughes, an infant-care teacher for Lamaze Family Center Ann Arbor.
Start thinking about a birth plan. Sit down with your partner to outline what you'd ideally like your birth experience to be. You might include whom you'd want to be with you when you deliver, what position you would like to push in, and your preferences about use of pain medications.
Month 6: Get tested for gestational diabetes. Most doctors recommend a glucose challenge screening around Week 26 (unless you're overweight or have a history of diabetes, in which case you should have one earlier). If your test is positive, you'll undergo a glucose tolerance test. If you're diagnosed with gestational diabetes, which can cause overgrowth of the fetus and other complications, you may have to take oral medication or use insulin, though some women manage the condition with nutritional changes and exercise alone.
Tour the hospital. Seeing the labor and delivery rooms and knowing where you'll park and check in can help ease anxieties about the big day.
Line up your support team. Caring for a newborn is exhausting, so you may want someone in addition to your partner -- a friend, relative, or postpartum doula -- on hand to help bathe the baby, do laundry, run errands, or simply fend off visitors so you can rest.
Month 7: Start the search for a pediatrician by 28 weeks, says Parents advisor Jennifer Shu, M.D., coauthor of Heading Home With Your Newborn. Some factors to consider: location, whether you prefer a group or solo practice, and the availability of weekend and evening hours.
Find an infant-care class for tips on changing a diaper, swaddling and bathing a newborn, and more. Also helpful: infant CPR and breastfeeding classes.
Buy a car seat. By law, in order to drive off from the hospital with your infant, you must be able to prove that you've installed a car seat that meets current safety standards. Head to your local police or fire department to learn how to install it correctly.
Month 8: Get screened for Group B strep, bacteria that is harmless to you but can be lethal if passed to the baby. Your doctor will take an external vaginal culture around 35 weeks; if Group B strep bacteria are present, you'll be given medication during labor to prevent transmission to the baby.
Pack your hospital bag. Include items to keep you comfortable (like your iPod or a pair of soft slippers), snacks for you and your partner, a (roomy) change of clothes to go home in, plus an outfit for the baby.
Month 9: Sit back and relax. By now, you should be done with most of your preparation and ready if you go into labor early. As your baby's due date approaches, find a comfy chair, put your hand on your stomach, and enjoy the calm before the storm.
Originally published in the April 2011 issue of Parents magazine.