Date of Next Appointment

Date of Next Appointment

Ingredients:
21 M Y S E L F
12 weeks

Directions:
n If you are tired or sick to
your stomach, these
feelings should end soon.
n Always wear your seat
belt when you are in a
car, van, or truck. The
shoulder harness should
go between your breasts
and the lap belt under
your stomach.
n Most women can safely
have sex while they are
pregnant. Ask your health
care giver if you have
discomfort or have other
concerns.
Questions I want to ask:
1. Will my taking hot baths hurt my baby?
2. What should I do if certain healthful foods, like milk, make me feel sick?
3.
4.
Advice and answers to my questions:
M Y S E L F 22
My
prenatal care
appointment
Date of Visit:
Name of Health Care Provider Seen:
Weeks of Pregnancy:
Due Date:
Weight:
Tests (Check each one you had):
n Blood Pressure (Reading: )
n Urine n Heard my baby’s heart beat
List any other tests you had:
(Turn to pages 8 and 9 for more information about tests.)
Date of Next Appointment:
Other visits or problems since my appointment:
Problem Date Advice/Treatment