Congratulations, You're Expecting!
Every parent wants to give their baby the healthiest start possible in life. Whether this is your first pregnancy or you're expanding your family, screenings can provide important insights into a baby's health before and after birth, helping families prepare and ensure timely care when needed.
Below, you will find information on Newborn Screening and Prenatal/Carrier Screening and how the screenings can work together to provide a complete picture of your baby's health.
What is Newborn Screening?
Newborn screening is done when your baby is 24-48 hours old and is the first step towards a healthy start for your baby as it helps find treatable conditions early, often before anyone notices something is wrong. The screening has three parts: blood spot, hearing and heart screening. Early detection and treatment can help babies live healthier lives.
Newborn Screening Components
Blood Spot Screen
A small blood sample is taken from your baby’s heel, placed on a filter card and sent to a special laboratory for testing. This testing helps find health conditions that can affect a baby’s hormones, blood, nervous system, or how they process foods. Finding these conditions early can help prevent serious health problems, disability and even death.
Hearing Screen
Small earphones or ear buds are placed on or in your baby’s ear to see if they can hear or respond to sounds. Finding a hearing loss or deafness early helps babies stay on track with speech, language and communication skills.
Heart Screen
A small sensor placed on your baby’s hand and foot is used to check the amount of oxygen in your baby’s blood. Low levels of oxygen in the blood may be caused by a serious heart problem known as critical congenital heart disease (CCHD). If found early, babies with CCHD can often get help through medical treatments or surgery.
Why is Newborn Screening Important?
A baby can have a condition even if they seem healthy at birth. These conditions may not run in families. Every condition tested for by newborn screening has a treatment. So, finding these conditions early helps babies get the care they need to prevent serious health problems, disability, and even death.
What is Prenatal Screening?
Prenatal screenings are simple tests that help check if your baby might be at risk for certain health conditions or birth differences. These tests are usually done on you, and sometimes your partner if needed.
These screenings don’t give a diagnosis, but they can help show if more testing may be needed. Having this information early can help you feel more prepared and give your baby the healthiest start possible.
Why is Prenatal Screening Important?
Prenatal screening gives you information about your baby’s health. It can find problems early and help you get the right care needed for your baby.
Parent Quote
“I never imagined one of my children would receive a life changing diagnosis. At 27 weeks, we received the diagnosis that our daughter Etta, had a critical congenital heart disease (CCHD). This news was shocking and devastating, and we had to relocate our family to Minnesota while we anxiously prepared for her birth and lengthy hospital stay. Our faith, family and friends carried us through such uncertain times. Today, Etta is closely monitored by her cardiology team and continues to do well. You’d never know that our miracle girl has a CCHD – early diagnosis made all the difference!”
- Mother of a Child with Critical Congenital Heart Disease Diagnosed Prenatally
If you would like more information or have specific questions, a genetic counselor can help explain what testing may be beneficial for you and your baby. Ask your provider for a referral to genetic counseling.
Does My Baby Still Need Newborn Screening if I had Prenatal Screening?
Yes, prenatal screening and newborn screening are different tests done at different times. The screenings work together to find health problems early, so babies can get the care they need as soon as possible.
Are Prenatal & Newborn Screening Required?
Prenatal screening is optional. Both blood spot and heart screening are required, and hearing screening is highly recommended.
A home birth involves the participation of trained midwives or nurse-midwives in cases of low-risk, healthy pregnancies. As interest in home birth increases, the number of studies will continue to grow to provide us with a greater understanding of the related risks and benefits.
The American Pregnancy Association has information designed to help women make informed decisions on whether a home birth is safe for them.
If you are planning an out-of-hospital birth, talk to your midwife about newborn screening before your baby is born. If your midwife cannot perform newborn screening, make other arrangements. Your baby’s health care provider can help arrange screening by another midwife, a hospital, clinic, or local health department. It is important that you make a plan so your baby completes screening near the recommended age.
What to Expect: Health Screenings for Mom & Baby
Understanding what screenings and tests will be done during pregnancy and after birth - and when they occur - can make the journey less overwhelming. Knowing the timing and purpose of the each screening helps families make informed choices and support a healthy start for their baby. Click on each timeline below to find which screenings or tests are offered during that specific timeframe.
First Trimester (Weeks 1-13)
- Non-Invasive Prenatal Screening
A blood test that checks for certain genetic conditions - Routine Blood Work
Tests your blood type, iron, sugar and checks for infections
Second Trimester (Weeks 14-27)
- Triple or Quad Screen
A blood test that can find certain birth conditions - Ultrasound
A scan to check your baby’s growth and development, including the heart, spine and face - Glucose Screening
A test to check for diabetes during pregnancy
Third Trimester (Weeks 28-40)
- Group B Strep Test (Weeks 35-37):
A swab test to check for a common bacteria that could harm your baby during birth
After Birth (First 48 hours)
- Newborn Screenings are done at 24 hours
Includes a blood spot, hearing and heart screening to check for conditions that can harm your baby - Results from the hearing and heart screening are available right away. The results from the blood spot screening are sent to a special lab for processing and will take a few days to be available.
Well Baby Visit (2 days - 1 week after birth)
- The doctor will check your baby’s health and growth and make sure they're doing well.
- Ask your doctor about your baby’s newborn screening results, especially if you haven't heard back by the time your baby is one week old. Results should be available by then.
- Normal Results: If your baby's screening results are normal (also called negative), it means the screening did not show signs of a condition and no follow-up is needed.
- Out-of-range (also called abnormal) Results: If a result falls outside the expected range, your baby's provider will contact you as soon as possible to talk about next steps. Needing more testing done does not mean your baby has a condition. It is really important to follow your provider's instructions so your baby can get the best care.
Fourth Trimester (First weeks after birth)
• Watch your baby to make sure they are healthy and growing.
• Go to your own doctor visits after your baby is born and take care of yourself because you are important too!
Prenatal Diagnosis Resources
Finding out about a prenatal diagnosis can feel overwhelming and it's normal to have a lot of questions and mixed emotions. North Dakota has a resource called Project Carson that offers support to families who have received a prenatal or at birth diagnosis.
Find answers to the most common questions about blood spot, hearing or heart screening.