When you find out you are pregnant…
… it’s very common to feel a bit lost at the beginning. There are suddenly appointments, blood tests, and scans—and no clear map of what comes first and why.
This page is here to help you understand the most common pregnancy tests and screenings in Israel, and to give you a way to think about what actually feels right for you.
While I make every effort to keep this information accurate and up to date, this guide is for educational purposes only and does not replace individualized care, medical advice, or discussions with your healthcare providers.
So what happens now?
In Israel, prenatal care is typically provided by an OB/GYN (רופא נשים or רופאת נשים). You’ll have regular appointments with your doctor every 4-8 weeks for check-ups and to receive referrals for necessary tests and screenings. However, it’s important to know that your OB/GYN won’t be present at the birth itself.
In addition to these appointments, a nurse will check your blood pressure, weight, and urine once a month. Some Kupot Cholim offer a personal “pregnancy nurse,” giving you the opportunity to receive consistent care from the same nurse throughout your pregnancy. Some of the nurses are also helpful in guiding you through the tests, screenings, and other options available.
The best way to contact your OB/GYN can vary depending on your Kupah, branch, and city. You may be able to reach out through the app, call the branch secretary, schedule a phone consultation, or visit the branch in person.
If you’re considering a home birth with a private midwife, it’s recommended to start looking during your first or second trimester. In some areas, demand can be high, and securing a midwife by week 15-20 is necessary. Private midwives often offer additional prenatal care and continuous support during pregnancy, birth, and postpartum.
You can consult with your OB/GYN about genetic testing and receive a referral to a genetic nurse for you and your husband. There are genetic tests available for free in Israel, while some additional tests come at a cost.
It is recommended to start taking folate or folic acid at least 1-3 months before trying to conceive and continue until the 12th week of pregnancy. Folic acid can help prevent birth defects known as neural tube defects, including spina bifida. Typically, a dose of 400 micrograms (0.4 milligrams) is recommended, although some women may require a higher dose. If you have any questions about this, you can ask your nurse or OB/GYN. All prenatal vitamins in Israel contain folic acid. If you request a prescription for “prenatal” from your OB/GYN or family doctor, you can receive it at a discounted rate at the pharmacy of your Kupat Cholim.
Bshaa tova! You can request a blood test from your OB/GYN or family doctor to confirm the results, or just wait for the first OB/GYN appointment you need to schedule now for week 6-12
This appointment should be scheduled between weeks 6-11 of pregnancy. During this appointment, the doctor will perform a vaginal ultrasound to check for a heartbeat and to ensure the embryo is properly implanted in the uterus. If your OB-GYN does not perform this ultrasound themselves, they will give you a referral to an ultrasound technician.
It’s important to note that a heartbeat is typically not visible before weeks 6-8. If you want to prevent emotional stress because of maybe not yet seeing the heartbeat, schedule the appointment for week 7 or later. Additionally, the size of the embryo will be measured to estimate the age of the pregnancy. Some doctors perform these measurements themselves, while others refer patients to an ultrasound technician. The doctor will also provide referrals for blood and urine tests, as well as future ultrasound scans.
Understanding your rights in Israel can help you feel more confident and empowered. According to section 13 of the Patients’ Rights Law, any medical intervention requires your informed consent. This means that your healthcare provider should explain the proposed treatment or test, its expected outcomes, and any potential risks or benefits. They should also outline alternative options and their risks and benefits, so that you can make an informed decision.
In maternity care, time pressures and cultural norms sometimes mean that this process does not happen as it should. However, knowing your rights can help you feel more comfortable asking all the questions you need to make informed decisions.
These are the key rights you have during your pregnancy and birth:
The right to receive treatment.
The right to respectful care.
The right to patient confidentiality.
The right to privacy.
The right to have a companion of your choice during care and birth.
The right to request a different doctor or midwife if needed.
The right to make decisions about your care and to receive enough information to make an informed choice.
Blood tests are conducted at the beginning and throughout pregnancy. These tests include a Complete Blood Count (CBC), which checks for anemia, infections, and other blood disorders. Another test is done to determine the mother’s blood type and whether she is Rh-negative or Rh-positive. If the mother is Rh-negative, she will be recommended to receive a medication called RhoGAM (Anti-D) to prevent Rh incompatibility issues in future pregnancies. Additionally, a test is conducted to determine if the mother is immune to sicknesses such as CMV and Rubella. Often, blood tests also include checks for Hepatitis B and C, HIV, Syphilis, and other illnesses.
Urine tests and urine cultures are done during several points of pregnancy to screen for markers of urinary tract infections, preeclampsia, and gestational diabetes.
TIP: Schedule all the screening tests at the very beginning of pregnancy; otherwise, there may be no appointments available close to where you live.
Genetic Scans, Screenings & Tests
The nuchal translucency scan is an ultrasound scan performed between weeks 11-13+6 of pregnancy to assess the risk of several chromosomal abnormalities, especially Down syndrome. The Ministry of Health recommends this test for all women in Israel, which may come as a surprise to women from other countries. The test costs 0-52 NIS.
It is a non-invasive screening, not a diagnostic test, that is meant to detect Down syndrome and some other genetic disorders. The neck of the baby is measured. More fluid than normal in the back of the neck means there is a higher risk for Down syndrome, trisomy 18, trisomy 13, Turner syndrome, or congenital heart disease. When combined with a blood test (serum screening סקר ביוכמי) you can detect 90% of Down Syndrome cases. The seker biochemi is a blood test that checks for levels of pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin (HCG).
Assuming 100,000 women do the nuchal fold scan in combination with the blood test, statistically, around 170 of them will have a baby with Down syndrome. Of these women, 153 will be correctly informed that they have a high chance of having a baby with Down syndrome (true positive), while 17 will be incorrectly informed that their baby is unlikely to have Down syndrome even though it does (false negative). The remaining 99,830 women will have babies without Down syndrome. Most of them will be correctly informed that they do not have a high chance of having a baby with Down syndrome (true negative), but up to 5% of pregnant women will receive a high-risk test result even though their baby is not affected (false positive). These are 4,991 women.
When the second trimester serum screening, an additional blood test between weeks 16-18, is added, 90-95% of down syndrome cases can be detected, with a false positive rate 1-3%. Costs are 0-73 NIS.
NIPT is a non-diagnostical blood test that can be done as early as 10 weeks pregnant to screen for chromosomal abnormalities, such as Down syndrome. NIPT is considered more accurate than other screening tests, detecting 99% of down syndrome cases. Data is still missing about the false positive rate, but it seems to be more common than previously advertised. NIPT is not covered by the health fund and costs several thousand shekels. You might be eligible for a partial refund through the supplementary insurance.
The early scan, which takes place between weeks 14 and 17, is not recommended by the Health Ministry and not common in most countries, but almost all Israeli obstetricians recommend it. As it is not part of the official recommendations, it is a private service. Women with supplementary insurance are eligible to receive the scan for around 50-200NIS (check with your health insurance).
During the examination, various aspects of the fetus are assessed, including its presentation and movements, the position of the placenta, the number of blood vessels in the umbilical cord, the amount of amniotic fluid, fetal heart rate, and movements. Additionally, several measurements are taken, such as the biparietal diameter (BPD) of the skull, head circumference (HC), abdominal circumference (AC), and femur length (FL). Besides these measurements, organs like the skull and brain, face, chest, abdomen, and spine are examined in detail. As the fetus is still very small, many things are not developed yet, but many major problems can be detected by this early pregnancy age.
An amniocentesis, or amniotic fluid test, is a diagnostic test between weeks 16-22 of pregnancy for diagnosing genetic abnormalities. The health ministry recommends it to all women from the age of 32, and some OB/GYNs recommend it to all women. The purpose of the test is to check the chromosomal count of the fetus, including whether there are any missing or extra bits of chromosomes. In Israel, the amniocentesis is covered by the kuppah in certain cases, including women who are 32 or older (as mutations increase with age), when the nuchal translucency (NT) measurement is above 3mm, or when there is a risk of trisomy 13, 18, or 21 above 1:350. The test might also be covered if you have supplementary insurance from your health fund, even if there is no indication.
The genetic chip test (CMA) that is usually part of the amniocentesis in Israel identifies small genetic abnormalities, such as deletions or duplications in DNA, that traditional karyotyping cannot detect. These abnormalities can lead to developmental, physical, or cognitive disorders. There is a 1:100 chance of finding a significant chromosomal issue, rising to 1:40 when abnormalities are detected in ultrasounds. 1:200 of the results may have unclear significance.
The risk of miscarriage in Israel due to amniocentesis is estimated to be between 1:1000 and 1:1500. There are also other rare risks, such as rupturing of the amniotic sac (water breaking), infection, or injury to the fetus.
The late anatomy scan, which takes place between week 20-23 (or 19-25), is recommended by the Health Ministry and fully covered by health insurance. As in the early anatomy scan, the examination assesses various aspects of the fetus, including presentation and movements, placenta position, umbilical cord blood vessels, amniotic fluid volume, fetal heart rate, and movements. Measurements taken include biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL). In addition to these measurements, the scan examines organs such as the skull and brain, face, chest, abdomen, and spine in detail, allowing for the detection of developments not visible in the early scan.
In Israel, the health ministry, as in many other countries, recommends one ultrasound during the third trimester of pregnancy, even though the World Health Organization (WHO) does not recommend routine ultrasounds after week 24 in low-risk pregnancies. The purpose of the third-trimester ultrasound is to assess fetal growth, placental function, amniotic fluid volume, and the baby’s position, as well as to detect potential concerns such as growth restriction or unusually high birth weight. However, there is ongoing debate about the benefits and risks of routine third-trimester ultrasounds, including the possibility of overdiagnosis and overtreatment without a clear improvement in outcomes.
Many OB/GYNs in Israel recommend performing ultrasound scans not only once during the third trimester, but during nearly every prenatal visit, which are typically scheduled every 4–6 weeks and often more frequently toward the end of pregnancy.
Some OB/GYNs may also recommend an additional detailed anatomy scan during the third trimester. This is usually only recommended when there is a medical indication, such as concerns about fetal growth, placental issues, abnormalities seen on previous scans, or specific maternal or fetal risk factors.
Tip: Making Decisions About Screenings and Tests
During pregnancy, you will be offered many different tests and screenings. Before deciding which ones feel right for you, it can be helpful to think not only about the medical aspects of a test, but also about what role the information would play for you emotionally, practically, and ethically.
Some women want as much information as possible throughout pregnancy, while others prefer to avoid tests that would not change their decisions or care. There is no single “right” approach, only the approach that feels right for you and your family.
• Would the results of this test change my medical care, birth planning, or decisions during pregnancy?
• Would knowing certain information help me prepare emotionally, practically, or medically?
• How do I usually cope with uncertainty or stressful information?
• Would a high-risk screening result reassure me, or increase anxiety?
• How would I feel about further testing, including invasive tests such as amniocentesis?
• Are there conditions for which I would consider termination, and others for which I would not?
• How important is it for me to avoid unnecessary medical interventions or procedures?
• How do my personal, cultural, religious, or family values influence my decisions?
If a screening test suggests a higher likelihood of Down syndrome or another chromosomal condition, how would you want to proceed? Some families choose further testing, such as NIPT or amniocentesis, while others decide not to pursue additional testing.
If your baby is diagnosed with Down syndrome, would you choose a termination? Would your decision change depending on whether the baby has Down syndrome with no apparent organic disorders or with significant issues? Would knowing this information help you emotionally prepare for parenting a child with Down syndrome or explore treatments to support the baby?
If your baby is diagnosed with a condition that is likely fatal, such as trisomy 18, what would feel right for you? Would you choose a palliative approach, or would you decide on termination?
These are deeply personal and complex decisions, and there’s no single right answer. Take the time to make choices that align with your values, preferecnes, and circumstances.
More Common Tests & Screenings
According to statistics, approximately 4-10% of pregnant women are affected by gestational diabetes. The glucose screening test is recommended by the health ministry to identify this condition early on. If left untreated, gestational diabetes can lead to complications during pregnancy and birth, such as premature birth, stillbirth, and macrosomia (big baby).
The benefits of the glucose screening test are clear – early identification and management of gestational diabetes can help reduce the risk of complications for both the mother and baby. When gestational diabetes is well-managed, the associated risks are similar to those of a healthy pregnancy. As a result, the practice of universally recommending induction at 39 weeks for women with gestational diabetes is no longer standard, though it may still depend on specific hospital protocols.
There is an ongoing discussion about the most accurate way to conduct this test. In Israel, the initial test involves drinking a 50-gram sugar solution and taking a blood sample after one hour (screening). If the test result is positive, a 100-gram diagnostic test is recommended, during which blood sugar is tested hourly for three hours (diagnosis). Some women may experience discomfort or side effects from drinking the sugary solution, such as nausea, vomiting, or dizziness.
Another point of discussion is how to diagnose gestational diabetes, as the blood sugar levels considered normal were adjusted several years ago, which has increased the number of women who are diagnosed with gestational diabetes. Some argue that the new definitions do not necessarily improve outcomes as seen in some studies, while others believe that the higher rates of gestational diabetes can be explained by the declining health of women.
Some women choose to opt out of the glucose screening test and instead perform a glucometer test over the course of several days. If you are considering this option, consult with your doctor or midwife.
GBS testing screens pregnant women for Group B Streptococcus (GBS) bacteria. GBS is a common type of bacteria that can cause serious infections in newborns, and even death. The test involves collecting a swab from the vagina and rectum. In Israel, GBS testing is universally recommended for all pregnant women.
If a woman tests positive for GBS, this may have implications for her birth options and care plan. The standard approach is to administer antibiotics intravenously every four hours during labor to reduce the risk of transmitting the bacteria to the baby. Without antibiotic treatment, approximately 50% of babies born to GBS-positive mothers become colonized (carriers), while about 1–2% of all babies born to colonized mothers develop early-onset GBS disease. When a mother with GBS receives antibiotics during labor, the risk of early-onset GBS disease in the infant is reduced by approximately 80%.
One last thing about all these tests
You don’t have to decide everything at once.
You’re allowed to take it step by step, ask questions, change your mind, or choose differently than what others around you are doing.
This is your pregnancy, and it’s okay for your choices to reflect you.
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