No Gestational Age Restriction

USCIS guidelines do not restrict the immigration medical exam based on gestational age. Whether you are in your first, second, or third trimester, the exam can be performed. The civil surgeon applies the same pregnancy-related modifications at any stage of pregnancy.

If your green card interview is approaching and you are in your third trimester, you do not need to wait until after delivery to have the exam. The civil surgeon is experienced in evaluating pregnant applicants and will ensure the exam is conducted safely and comfortably.

What Is Modified in the Third Trimester

The same components that are modified during any stage of pregnancy are modified in the third trimester:

• Live vaccines (MMR, varicella, live attenuated influenza) are deferred — these will be administered after delivery
• Chest X-ray is typically deferred unless there is a clinical indication for immediate TB evaluation
• Inactivated vaccines (Td/Tdap, hepatitis A, hepatitis B, inactivated influenza, etc.) are safe and can be administered
• Blood draw for syphilis testing is safe and performed as usual
• TB skin test or IGRA blood test is safe and performed as usual
• Physical examination is performed with appropriate accommodations for comfort

Physical Comfort During the Exam

The physical examination in the third trimester is straightforward. The civil surgeon will conduct the exam with your comfort in mind. Let the clinic staff know you are in your third trimester when you schedule your appointment so they can make any necessary accommodations.

The exam typically takes 45 to 60 minutes. You will be asked to sit, stand, and lie down briefly during the physical examination. If you have any mobility limitations or discomfort, inform the civil surgeon at the start of the appointment.

Planning Around Your Due Date

If your due date is close to your green card interview, discuss the timing with your immigration attorney. There are two main scenarios:

If the interview is before your due date, completing the exam in the third trimester allows you to have Form I-693 ready for the interview, with deferred components documented. You will need a follow-up appointment after delivery to complete the deferred vaccines and chest X-ray.

If the interview can be rescheduled or is after your due date, waiting until after delivery allows you to complete all components in a single visit. Your attorney can advise on whether rescheduling is feasible.

After the Third-Trimester Exam

If you complete the exam in your third trimester, the civil surgeon will seal Form I-693 with the deferred components documented. After delivery, you will return to complete the deferred vaccines and, if applicable, the chest X-ray. The civil surgeon will update and re-seal the form. Make sure to schedule the follow-up promptly after delivery to avoid delays in your application.