It is very important for women to have and maintain proper health practices before pregnancy. Preconception counseling, such as premarital and family planning, can be provided as part of routine health examinations. Health promotion involves a healthy diet, maintaining an optimal weight, exercise, rest, safe sex practices, and avoiding substance abuse of tobacco, alcohol, and any recreational drugs. Before becoming pregnant, a routine health examination should be made with a health care provider. At this time a health history, routine physical examination, pelvic exam, Papanicolaou (Pap) test, blood type, Rh factor, and hemoglobin level can be evaluated.

The first visit includes a detailed health history, a complete physical examination (including a pelvic exam), and manual pelvic measurements to determine pelvic adequacy and laboratory tests. The laboratory tests on the initial visit are as follows: blood type and Rh factor, antibody screen, complete blood count, urine analysis and culture, Rubella antibody screen, hepatitis B antigen, human immunodeficiency virus antibody screen, serological test for syphilis, tests for gonorrhea and chlamydia, Pap test, and tuberculosis skin test. Also, a 1-hour glucose tolerance test is done at the initial visit if a woman is at risk for gestational diabetes. However, this test is done routinely at 24 to 28 weeks’ gestation for all pregnant women.

Early diagnosis of pregnancy can be done by pregnancy tests. The commonly used laboratory tests for pregnancy are based on detecting the presence of human chorionic gonadotropin (hCG), a hormone secreted by the chorionic villi of the placenta, found in urine or blood serum of the pregnant woman. Because all pregnancy tests are only 95% accurate in diagnosing pregnancy, these tests are considered probable signs of pregnancy rather than positive signs of pregnancy. In the nonpregnant woman, there are no units that are detectable because there are no trophoblast cells producing hCG. In the pregnant woman trace amounts of hCG appear in the serum as early as 24 to 48 hours after implantation. They reach a measurable level (50 mIU/ml) in 7 to 9 days after conception.

Urine tests are rarely used in the health care setting because blood serum tests give earlier results. Home pregnancy tests based on urine samples are still used by the consumer. The home pregnancy tests are convenient. A woman dips a reagent strip into her stream of urine. A color change on the strip denotes pregnancy.