How to manage anxiety about pain during common pregnancy tests

First trimester (less than 14 weeks)

Blood testing

You’ll discover there’s a lot of blood testing done during pregnancy – blood counts to detect anemia, determining your blood type, and screening for certain infections, especially at an early visit. Some testing will be repeated later in pregnancy.

If you can't stand the sight of needles or blood, you’re not alone. A study from the University of Michigan found that 20 to 30 percent of young adults have a fear of needles. Passing out at the sight of blood can be an automatic nervous system response.

Please tell the person taking your blood if you get lightheaded or faint during blood draws. We can recline you or ask you to lie down during the draw to prevent injury from falling. The provider can also use a topical anesthetic to numb your skin.

You might want to look away during the draw and take slow, deep breaths to relax. If it helps, distract yourself with music or a video on your phone. No need to feel embarrassed – we understand!

Pap smear

Many women only need this routine well-woman exam every three to five years, compared with the annual exam of the past. Pap smear exams are safe during pregnancy.

If you need a Pap smear, your health care provider will insert a speculum into your vagina and use a small brush to wipe the surface of your cervix. We collect cervical cells to analyze them and check for precancerous cells.

Women often describe the feeling of a small pinch or cramping, but everyone’s pain threshold is different. Ask your doctor if you can take an over-the-counter pain medication such as Tylenol an hour before the exam to reduce discomfort. Deep breathing can help you stay calm and relax your pelvic muscles. If you feel pain, tell your doctor.

Frequently testing for infections like chlamydia and gonorrhea will take place at the same time your pap test is done. If you've recently had a Pap smear, ask if that testing can be done with a urine sample instead.

Ultrasound

Ultrasound uses high-frequency sound waves to create an image of the baby, which helps us check for normal fetal growth. Ultrasounds can be done transabdominally (the ultrasound wand is passed over the stomach) or transvaginally (the wand is inserted into the vagina).

A transvaginal ultrasound often can provide a clearer view, especially early in the pregnancy. It gets us closer to the uterus without the barrier of abdominal tissue. Your doctor may recommend this method to check for early fetal heart activity, identify the source of abnormal bleeding, or diagnose an ectopic pregnancy.

The lubricant gel we use may be cold against the skin. That's the most uncomfortable part, patients report, so many Ob/Gyn offices keep the gel in a warmer. You may feel pressure from the wand, but most patients with no underlying health concerns do not find the exam painful. If you feel uncomfortable or need a break, tell your provider.

Nuchal translucency screening

This screening involves two tests that help determine whether the baby might have a genetic condition such as trisomy 21 (Down syndrome) or trisomy 18 (Edward’s syndrome):

• An ultrasound to check the back of the baby's neck for extra fluid or thickening
• Blood work to measure the amount of two substances found in the blood of all pregnant women: pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin

During these tests, use your self-soothing methods and communicate with your doctor. Based on the findings, your provider may recommend additional tests to verify the diagnosis. Generally, this involves more imaging and blood work, neither of which should be any more physically uncomfortable.

Chorionic villus sampling (CVS)

If your baby might be at increased risk of a genetic condition, you may choose to get diagnostic testing in the first trimester. CVS involves testing cells taken from the placenta. It can be performed using either a small catheter inserted through the cervix or with a needle through the abdomen. When done transabdominally, the doctor will usually numb up the skin prior to insertion.