Prenatal care, also referred to as antenatal care, is the care given to a woman when she is pregnant. There is now abundant evidence to show that prenatal care is beneficial to the pregnant woman and the developing fetus. Detection of certain problems that can lead to severe complications is just one of the many benefits of prenatal care.
What is prenatal care?
Prenatal care refers to the regular medical and nursing care recommended for women during pregnancy. Pregnancy is not a disease, but it is important that all pregnant women receive prenatal care so that various medical complications can be prevented or treated at an early stage. Most experts now recommend that there should be some level of continuity of this care. It is important to start prenatal care as early as possible. If you know you are pregnant, or think you might be, call your gynaecologist/obstetrician or doctor to schedule a visit. Regular prenatal care is important. Your doctor or nurse will schedule many checkups over the course of the pregnancy. There is a reason for this.
Why the need for prenatal care?
Prenatal care can help keep the pregnant woman and developing offspring (baby) healthy. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight, and five times more likely to die, than those born to mothers who do get care.
Experienced obstetricians can spot health problems early when they see pregnant women regularly. These scheduled visits allow doctors to treat pregnant women early. Early treatment can cure many problems and prevent others. Also, doctors can talk to pregnant women about things they can do to give their unborn babies a healthy start to life.
How often should the pregnant woman see her doctor during pregnancy?
This might vary from one individual to another and the health status of the pregnant woman. The pregnant woman should follow instructions from her healthcare provider, but most experts suggest the following frequency:
• About once each month for weeks 4 through 28
• Twice a month for weeks 28 through 36
• Weekly for weeks 36 to birth
If the pregnant woman is older than 35 years, or the pregnancy is high risk, she would probably see her doctor more frequently. Some high risk pregnancies, such as multiple gestation, might need to see the doctor much more frequently to detect and prevent complications.
What happens during prenatal visits?
This will obviously vary from one individual to another and also on the stage of pregnancy. The first prenatal visit to the doctor is considered to be one of the most important, although all visits are crucial in the care of the pregnant woman.
During the first prenatal visit, also called the booking visit, a detailed clinical history and physical examination (including a pelvic exam) are carried out. Various office tests are carried out and arrangements are made for more blood tests.
At the first visit, the woman is given the opportunity to ask questions and discuss any issues related to her pregnancy.
Later prenatal visits will probably be shorter. The healthcare provider will check on the health of the pregnant woman and make sure the fetus is growing as expected. Most prenatal visits will include:
• Checking the blood pressure
• Measuring weight gain
• Measuring the size of the uterus to check on the baby’s growth
• Checking the baby’s heart rate.
In Anguilla, all pregnant women are encouraged to have a number of routine tests. Some tests that are suggested for all women include blood work to check for anaemia, and blood type of the pregnant woman. Other tests might be offered based on the woman’s age, personal or family health history. Pregnant women are encouraged to have the HIV test, but this is a voluntary test in Anguilla at this time.
Ultrasound tests
One of the most commonly done investigations during a pregnancy is an obstetric ultrasound scan. It is now recommended that an early ultrasound scan should be done in the first trimester so that the expected date of delivery can be accurately determined. Most healthcare workers still use the first day of the last menstrual period to predict the date of delivery, but this has been shown to be less reliable when compared to the date from an early obstetric ultrasound scan. Ultrasound scans are done at various intervals during the pregnancy and for a number of different reasons. They are considered relatively safe and have been used for over 35 years for monitoring pregnancy. Among other things, ultrasounds are used to:
• Diagnose pregnancy (uncommon)
• Check for multiple fetuses
• Assess possible risks to the mother (e.g. miscarriage and ectopic pregnancy)
• Check for fetal malformation (e.g. club foot, spina bifida, cleft palate)
• Determine if an intrauterine growth retardation condition exists
• Note the development of fetal body parts (e.g. heart, brain, liver, stomach, skull, other bones)
• Check the amniotic fluid and umbilical cord for possible problems.
Counseling
During prenatal visits a significant amount of time is devoted to counseling. A number of areas such as nutrition, use of drugs and alcohol, smoking, breast feeding and type of delivery are discussed.
Conclusion
Prenatal care is an important part of a healthy pregnancy. It has many benefits. As soon as a woman thinks she is pregnant, she should schedule her first prenatal appointment. The woman might want to include her partner in this appointment, as well as in other appointments in the future. The frequency of prenatal visits might vary but it is important to have regular visits as recommended by your healthcare provider.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
