What are your recommendations for standard prenatal care for an otherwise healthy woman who is pregnant for the first time? What should I be eating? What vitamins are good? How often should I see my doctor?

--Marge

With just a few exceptions, I follow the guidelines of the American College of Obstetricians and Gynecologists for care in an uncomplicated pregnancy. I tell my patients to come in for their first prenatal visit shortly after the positive pregnancy test. During this first visit, I'll conduct a physical and take a medical history. Prenatal lab tests for things like blood count, syphilis, hepatitis, HIV and rubella are also conducted at this time.

Generally, a woman with an uncomplicated pregnancy is examined every four weeks for the first 28 weeks, every two to three weeks until 36 weeks and weekly thereafter until delivery. Between 16 and 20 weeks a blood test to rule out certain conditions in the baby like spina bifida or Down's Syndrome is offered. Around 28 weeks, a test for diabetes is done and RhoGam is administered if mom's blood type is RH negative. In my practice, we also do a routine ultrasound at 20 weeks. Obviously, there must be flexibility in these recommendations. If complications arise, visits will be more frequent.

In terms of diet and vitamins, a well-balanced diet with a variety of foods is necessary. These foods should include fruits and vegetables, whole grains, dairy products and protein. Because our diets are not always stellar, and because needs for certain nutrients increase in pregnancy, a prenatal vitamin should be taken -- most of the ones available are perfectly fine. There is some new evidence that too much vitamin can be harmful. Make sure your prenatal vitamin is up to date. During pregnancy, a woman requires an extra 300 calories per day -- that is roughly equivalent to an 8-ounce container of fruit-on-the-bottom lowfat yogurt. "Eating for two" does not mean doubling your food intake; instead, it means ensuring that you get proper nutrition and some added calories.