Good Prenatal Care Includes:
- Good nutrition and health habits before and during pregnancy
- Frequent prenatal examinations to detect early problems
- Routine ultrasounds to detect fetal abnormalities and problems
- Routine screening for:
- Sexually transmitted diseases
- Rubella immunity
- Blood type problems (Rh and ABO)
- Genetic disorders – if a family history or the age of the mother presents a high risk
- Blood pressure abnormalities
- Urine protein
Women who choose to have an abortion usually do so in the very early stages of the pregnancy (usually before 10 or 12 weeks gestation). Abortion is legal through the 24th week of pregnancy in the cases of medical indications. The abortion procedure, however, becomes more difficult with advancing gestational age, and many providers do not perform pregnancy terminations in the second trimester.
Women who plan to continue a pregnancy-to-term need to choose a health care provider who will provide prenatal care, delivery, and postpartum services. Provider choices in most communities include:
- Physicians specializing in obstetrics and gynaecology (OB/GYN)
- Certified nurse midwives (CNMs)
- Certain family practice physicians
The goals of prenatal care are to:
- Monitor both the mother and baby throughout the pregnancy
- Look for changes that may lead to a high-risk pregnancy
- Explain nutritional requirements throughout the pregnancy and postpartum period
- Explain activity recommendations or restrictions
- Address common complaints that may arise during pregnancy (for example, backache, joint pain, nausea, heartburn, headaches, urinary frequency, leg cramps, and constipation) and how to manage them, preferably without medications
Women who are considering becoming pregnant, or who are pregnant, should eat a balanced diet and take a vitamin and mineral supplement that includes at least 0.4 milligrams (400 micrograms) of folic acid. Folic acid is needed to decrease the risk of certain birth defects (such as spina bifida).
Pregnant women are advised to avoid all medications, unless the medications are necessary and recommended by a prenatal health care provider. Women should discuss all medication use with their providers.
Pregnant women should avoid all alcohol and drug use. They should not smoke. They should avoid herbal preparations and common over-the-counter medications that may interfere with normal development of the fetus.
Prenatal visits might be typically scheduled (although there are differences in different countries):
- Every 4 weeks during the first 32 weeks of gestation
- Every 2 weeks from 32 to 36 weeks gestation
- Weekly from 36 weeks to delivery
Weight gain, blood pressure, fundal height, and fetal heart beats (as appropriate) are usually measured and recorded at each visit, and routine urine screening tests are performed.
When to Call the Doctor:
- Call for an appointment if you suspect you are pregnant, are currently pregnant and are not receiving prenatal care, or if you are unable to manage common complaints without medication.
- Call your health care provider if you suspect you are pregnant and are on medications for diabetes, thyroid disease, seizures, or high blood pressure.
- Notify your health care provider if you are currently pregnant and have been exposed to a sexually transmitted disease, chemicals, radiation, or unusual pollutants.
- Call your health care provider if you are currently pregnant and you develop fever, chills, or painful urination.
- It is urgent that you call your health care provider if you are currently pregnant and notice any amount of vaginal bleeding, the membranes rupture (water breaks), or you experience physical or severe emotional trauma.