depends on what kinda practitioner you see. I'm using a midwife. At the first appointment I believe they do the doppler to hear the heartbeat, and pee in a cup and that's about it. Maybe a breast exam? No pap for me though. I'm going to decline if they ask. My practice doesn't do ultrasounds until 20 weeks for an anatomy check and if you want to know the sex, you can find out then. So, it all depends on who you're seeing! Also, my first appointment isn't until 12 weeks!