Prenatal care, commonly referred to as antenatal care, is a sort of preventative medicine. Prenatal care is given in the form of medical checkups, which include advice on how to live a healthy lifestyle and medical information such as maternal physiological changes during pregnancy, biological changes, and prenatal nutrition, including prenatal vitamins, all of which help to prevent potential health problems and promote the health of both the mother and the child.
Maternal death, miscarriages, birth abnormalities, low birth weight, newborn infections, and other preventable health problems have all decreased as a result of the availability of routine prenatal care, including prenatal screening and diagnosis.
In high-income countries, traditional prenatal care usually comprises of monthly visits during the first two trimesters (from the 1st week to the 28th week).
From the 28th to the 36th week of pregnancy, weekly visits
Weekly visits to the delivery after the 36th week (from the 38th to the 42nd week)
Parental needs and family dynamics are assessed.
The traditional type of antenatal care dates back to the early 1900s, and there is little evidence that it is the optimal way to provide antenatal care. Antenatal care is expensive and requires a large number of people. The next paragraphs outline studies on alternative kinds of antenatal care that may help to alleviate the strain on maternity facilities in all nations.
Prenatal Care: Talk to your doctor before pregnancy.
Before you get pregnant, talk to your doctor about what you can do to prepare your body. Before beginning sexual activity, women should prepare for pregnancy. Before becoming pregnant, ladies should give themselves at least three months to prepare.
The following are the top five things you should do before getting pregnant:
- Take 400-800 micrograms (400-800 mcg or 0.4-0.8 mg) of folic acid every day for at least 3 months before becoming pregnant to reduce your risk of brain and spinal birth abnormalities. Folic acid is found in a variety of foods. It is, however, difficult to obtain all of the folic acid you require through diet alone.The best and simplest way to ensure you’re receiving enough folic acid is to take a vitamin with it.
- Quit smoking and abstain from alcoholic beverages. Consult your doctor for assistance.
- Make sure any medical conditions you have are under control. Asthma, diabetes, depression, high blood pressure, obesity, thyroid illness, or epilepsy are some of the conditions. Make sure you’re up to date on your vaccines.
- Discuss any over-the-counter or prescription medications you’re taking with your doctor. Dietary and herbal supplements are examples of these. Some medications are not safe to take while pregnant. At the same time, stopping medications that you require can be dangerous.
- Stay away from potentially dangerous toxic substances or materials at work and at home. Chemicals and cat or rodent feces should be avoided.
I’m expecting a child. What should I do—and what should I avoid doing—to protect myself and my unborn child?
To take care of yourself and the precious life growing inside you, follow these dos and don’ts:
Do’s and don’ts in health care
- Seek prenatal care early and often. Whether this is your first or third pregnancy, health care is crucial. At each visit, your doctor will check to see if you and the baby are in good health. If there are any issues, taking action as soon as possible would benefit both you and the baby.
- Every day, take a multivitamin or prenatal vitamin with 400 to 800 micrograms (400–800 mcg or 0.4–0.8 mg) of folic acid. Although folic acid is most vital during the first trimester of pregnancy, you should continue to take it throughout your pregnancy.
- Consult your doctor before discontinuing or starting any medication. Some medications are not safe to take while pregnant. Keep in mind that even over-the-counter drugs and herbal supplements can have negative side effects or trigger additional issues. However, not taking the medications that you require could be dangerous.
- Stay away from x-rays. If you need dental work or diagnostic tests, let your dentist or doctor know you’re expecting so they can take extra precautions.
- Get vaccinated against the flu. The flu can make pregnant women quite unwell and necessitate hospitalization.
Do’s and don’ts in the kitchen
- Consume a wide range of nutritious foods. Fruits, vegetables, whole grains, calcium-rich diets, and low-saturated-fat foods are all good choices. Also, make sure you’re getting lots of fluids, particularly water.
- Every day, make sure you get all of the nutrients you require, including iron. Anemia, which is associated with preterm birth and low birth weight, can be avoided by consuming adequate iron. You can help your infant obtain the nutrients he or she needs by eating a variety of healthy foods. However, check with your doctor to see whether you need to take a daily prenatal vitamin or iron supplement to ensure you receive enough.
- Avoid food-borne infections like toxoplasmosis (TOK-soh-plaz-MOH-suhss) and listeria for yourself and your baby (lih-STEER-ee-uh). Before consuming fruits and veggies, make sure they’re clean. Avoid eating raw or undercooked meats and fish. We handle, clean, cook, eat, and preserve foods correctly at all times.
- Avoid eating mercury-rich fish such as swordfish, king mackerel, sharks, and tilefish.
Do’s and don’ts in terms of living a healthy lifestyle
- Put on some weight in a healthy way. Your doctor can advise you on how much weight gain to expect throughout pregnancy.
- Don’t smoke, drink alcohol, or use illegal substances. These can injure or kill your baby in the long run. Consult your doctor for assistance in stopping smoking.
- At least 2 hours and 30 minutes of moderate-intensity aerobic activity each week, unless your doctor advises otherwise. It’s preferable to spread your workouts out over the course of the week. If you worked out regularly before becoming pregnant, you can continue to do so as long as your health does not deteriorate and you consult your doctor about your activity level during your pregnancy. Find out how to have a healthy pregnancy.
- Avoid taking excessively hot baths, hot tubs, or saunas.
- Get lots of rest and learn to manage your stress.
- Educate yourself. Read books, watch videos, attend childbirth classes, and talk to other moms.
- Inquire with your doctor about childbirth classes for you and your spouse. Classes can assist you in preparing for your baby’s delivery.
- Avoid chemicals such as pesticides, solvents (such as certain cleaners or paint thinners), lead, mercury, and paint (including paint fumes). Pregnancy warnings are not always included on product labels. If you’re not sure if a product is safe, see your doctor. If you are concerned that chemicals used at work may be dangerous, speak with your doctor.
- If you have a cat, inquire about toxoplasmosis with your doctor. A parasite that can be detected in cat feces causes this sickness. Toxoplasmosis can cause birth abnormalities if not treated. By avoiding cat litter and using gloves when gardening, you can reduce your risk of
- Stay away from rodents, especially pet rodents, as well as their urine, droppings, and nesting material. Rodents can transmit a virus to your unborn child, which can be damaging or even fatal.
- Take precautions to avoid disease, such as frequent hand washing.
- Avoid inhaling secondhand smoke.
Right now, I don’t want to get pregnant. Should I continue to take folic acid on a daily basis?
Yes! Birth malformations of the brain and spine occur early in pregnancy, frequently before a woman realizes she is pregnant. It’s possible that by the time she discovers she’s pregnant, it’ll be too late to prevent such birth problems. Furthermore, in the United States, half of all pregnancies are unintended. As a result, all women who are capable of becoming pregnant require 400 to 800 micrograms of folic acid every day.
During my pregnancy, how often should I see my doctor?
Your doctor will give you a list of all the doctor’s appointments you should make while you’re pregnant. The majority of professionals advise that you see your doctor.
- Weeks 36 to birth: once a week.
- Once a month, for weeks 4 through 28,
- Twice a month for weeks 28 through 36.
You’ll probably see your doctor more frequently if you’re over 35 or if your pregnancy is high-risk.
During prenatal appointments, what happens?
- Do a complete physical exam, including a pelvic exam and a Pap test.
- Take your blood and urine for lab work.
- Check your blood pressure, height, and weight.
- Calculate your due date.
- Answer your questions. During your first prenatal visit, your doctor will:
- Ask about your health history, including diseases, operations, or prior pregnancies.
- Ask about your family’s health history.
- Do a complete physical exam, including a pelvic exam and a Pap test.
- Take your blood and urine for lab work.
During your initial visit, you should ask questions and express any concerns you have about your pregnancy. Learn everything you can about staying healthy.
Prenatal visits in the future will most likely be shorter. Your doctor will examine your health and ensure that the baby is developing normally. The majority of prenatal appointments will include the following:
- Keeping track of your weight gain
- Checking your blood pressure
- Measuring your abdomen to check your baby’s growth (once you start to show) Keeping an eye on the baby’s heart rate
You’ll get several routine tests when you’re pregnant. Some tests, such as blood work to check for anemia, blood type, HIV, and other variables, are recommended for all women. Other tests may be recommended based on your age, personal or family health history, ethnicity, or the findings of previous regular tests.
Prenatal Care: Visits numbers
Pregnant women should have at least eight antenatal appointments to detect and address issues as well as obtain vaccines, according to the WHO. Despite the fact that prenatal care is critical for both mother and baby’s health, many women do not receive eight sessions. There is minimal evidence to support the notion that numbies were more likely to be admitted to neonatal critical care and stay there for longer periods of time (though this could be down to chance results).
In reality, the findings of Digswell et alCochrane’s Review back up this claim, showing that in low-resource settings where the number of visits is already low, ANC programs with fewer visits are linked to an increase in perinatal deaths. As a result, even in low-income countries (LICs), where pregnant women already have fewer checkups, the reduced visit approach is unlikely to be optimum.
Not only is it strongly encouraged to see prenatal care early, but it is also a more flexible pathway that allows for more visits from the time a pregnant woman books for prenatal care, as it may provide for greater attention to those women who arrive late. In addition, compared to women who had the typical number of antenatal appointments, those who had fewer visits were less happy with the care they received. Telemedicine is a novel option for some of the normal prenatal care sessions.
New health policies, health worker education, and health service reorganization are just a few examples of how to change health systems to help women get antenatal care. Interventions in the community to assist parents in changing their children can also be beneficial. Media campaigns that reach a large number of people, enabling communities to take control of their own health, informative-education-communication efforts, and financial incentives are all examples of interventions.
According to an evaluation of these programs, one of them helps increase the number of women who receive antenatal care. However, combining measures may reduce pregnancy and early life infant fatalities, lower the number of low birth weight babies delivered, and increase the number of women receiving antenatal care.
According to the World Health Organization (WHO), over 830 women died every day in 2015 due to complications during pregnancy and childbirth. Only five of them reside in high-income nations. The rest of the world’s population resides in low-income countries.
A study looked at the differences in early and low-weight birth deliveries between local and immigrant women, and found that prenatal care received made a difference. The study looked at two women who gave birth in a region of Spain between 1997 and 2008. According to the findings, immigrants had a substantially higher rate of very preterm birth (VPTB) and very low birth weight (VLBW) than natives. The study demonstrated the necessity of prenatal care and how universal prenatal care will enable people of all backgrounds to receive optimal care prior to pregnancy and delivery.
Prenatal Care: Group versus individual care.
Group prenatal care has a few apparent advantages: it is less expensive than one-on-one appointments, and the women receive more hours of care as a group than they would if they were on their own. Only a few short studies on group care have been undertaken, but they have indicated that moms in the group environment knew more about pregnancy, birth, and parenting. According to the review, the women liked the group treatment, and there was no difference in how the pregnancies progressed in the group and individual settings.
Prenatal Care: Midwife-led care
Midwife-led care for low-risk women means a midwife team (and, if necessary, a GP) oversees a woman’s care, and she rarely sees a specialist doctor during her pregnancy. Women who have their pregnancies managed by a midwife are more likely to give birth naturally rather than be induced. They are, however, less likely to have their waters ruptured, have an instrumental delivery, have an episiotomy, or give birth prematurely. A caesarean section was performed on roughly the same number of women in each group.
Prenatal Care: diagnosis
Pregnant women are categorised as normal-risk or high-risk after their initial antenatal care appointment, using a particular booking checklist.
Many countries provide women with a summary of their case notes, which includes vital background information regarding their pregnancy, such as their medical history, growth charts, and any scan reports. The midwives and doctors can utilize the summary of the mother’s case notes until her hospital notes arrive if she goes to a different hospital for care or to give birth.
According to a study, women who keep their own case notes are more likely to have a caesarean section. However, the women stated that having their notes gave them more control and that they would prefer to have them again in future pregnancies. Although none of the women neglected to bring their own notes to any appointments, 25% of the women stated that their hospital notes were lost in the hospital.
Testing for diseases or problems in a fetus or embryo before it is born is known as prenatal diagnosis or prenatal screening (notice that the terms “prenatal diagnosis” and “prenatal screening” refer to two separate types of tests). During pregnancy, obstetricians and midwives can evaluate the mother’s health and prenatal development through a series of regular check-ups.
Physical examinations often include the following:
(Mother’s) medical history is being compiled.
Taking (mother’s) blood pressure and measuring her height and weight
Blood and urine tests for Doppler fetal heart rate monitoring (Mother’s)
Consultation with the caregiver
From 25 weeks of pregnancy, in some countries, such as the United Kingdom, the symphysial fundal height (SFH) is measured as part of antenatal checkups. The SFH is calculated by measuring the distance between the woman’s pubic bone and the top of her uterus. Only one piece of research was found in a review of this practice, so there isn’t enough information to tell whether monitoring the SFH helps detect tiny or large newborns. The assessment suggests continuing to measure the SFH because it is not expensive and is used in many places.
Small newborns can be identified using growth charts, which measure the SFH. A growth chart can be divided into two types:
A chart based on the population that depicts the average growth and size of each baby.
A customized growth chart based on the mother’s height and weight, as well as the weights of their previous children,
According to an examination of which of these charts better detects small babies, there is no high-quality research to prove which is the best. Because personalized growth charts cost more money and require more time for health care personnel to construct, additional research is needed before they are suggested.
Obstetric ultrasounds are most typically performed around week 20 of the second trimester.
Ultrasounds are believed to be relatively safe and have been used to monitor pregnancy for over 35 years. Ultrasounds are used to, among other things, diagnose pregnancy (uncommon).
Keep an eye out for numerous fetuses.
Evaluate the mother’s potential dangers (e.g., miscarriage, blighted ovum, ectopic pregnancy, or a molar pregnancy condition).
Make sure there are no prenatal malformations (e.g., club foot, spina bifida, cleft palate, clenched fists).
Find out if you have an intrauterine growth retardation condition.
Take note of how the fetal body develops (e.g., heart, brain, liver, stomach, skull, other bones).
Look for issues in the amniotic fluid and the umbilical cord.
Establish a deadline (based on measurements and relative developmental progress)
An ultrasound is usually ordered anytime an anomaly is suspected or on a timetable that looks like this:
Confirm pregnancy at 7 weeks, rule out molar or ectopic pregnancy, and set a due date.
13–14 weeks (in some locations)—assess the likelihood of Down syndrome.
18–20 weeks—read the expanded list above for further information. 34 weeks (in some areas) — determine placenta size and position
According to an assessment of standard ultrasounds performed after 24 weeks, there is no evidence that they help the woman or the infant.
Multiple pregnancies can be diagnosed early in pregnancy, and early scans provide more precise due dates, resulting in fewer women being induced who do not need to be.
The ultrasonic feedback might vary in intensity. When parents can view the screen and are given a clear description of what they can see, they receive high feedback. When the findings are reviewed at the conclusion and the parents are given a picture of the ultrasound, this is considered low feedback. Although there isn’t enough information to draw firm conclusions, different techniques of providing feedback alter how much parents worry and how the mother behaves in terms of her health. A tiny study found that moms who received positive feedback were more likely to quit smoking and drinking alcohol. However, the study’s quality was low, and further research is needed to determine which sort of feedback is best.
A Doppler ultrasound may be used to examine the blood flow to a woman’s unborn baby if she is having a difficult pregnancy. This is done to see if there are any symptoms that the baby isn’t getting enough blood and is hence “at risk.” A study looked at whether all women should have Doppler ultrasounds, even if they were at “low risk” of problems. Standard Doppler ultrasounds may have reduced the incidence of unnecessary baby deaths, according to the analysis, but the data was insufficient to recommend that they be made routine for all pregnant women.
Prenatal care in the United States
Prenatal care is important for all women from all walks of life. While the provision of such services has significant personal health and social benefits, socioeconomic issues in both developing and industrialized countries, such as the United States, preclude widespread use. Although prenatal care can benefit women, different groups in the United States have varying levels of access to health care.