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Prenatal Care

Prenatal care refers to the medical visits, screenings, and care you receive during pregnancy. It includes your health care provider’s involvement and your own efforts, including supplements, diet, and exercise.

When you’re pregnant, prenatal care is of the utmost importance. Seeing your health care provider regularly, eating a balanced diet, and ensuring you’re up to date on your immunizations are routine facets of prenatal care.

Understanding what to expect in prenatal care can ensure a safe pregnancy and healthy birth.

Pre-Pregnancy Planning

Delivering a healthy baby starts before you even get pregnant with pre-pregnancy behaviors that promote a healthy life. If you anticipate or intend to get pregnant, certain lifestyle changes and habits can help contribute to a healthier pregnancy.

Supplements

One of the easiest additions to your lifestyle is good prenatal vitamins, which often include vitamin D and C, choline, iron, calcium and a host of B vitamins. Depending on the amount of folic acid in your prenatal vitamin, you might want to supplement more, ideally totaling around 400mg per day. Consider taking an omega-3 supplement such as fish oil or borage/algae oil if you’re vegan or vegetarian.

Avoid Toxic Substances

If you smoke, you should quit. Smoking is one of several risk factors in pregnancy that can be easily avoided and removed during the preconception period. If you’re in a situation where you’re around smokers, find a way to avoid them; and if you can’t avoid them, ask them to quit or smoke somewhere else.

Avoid alcohol if you’re trying to conceive. It’s a well-known fact that alcohol can cause severe pregnancy complications. Alcohol misuse during pregnancy is linked with low birth weight, birth defects, cognitive delays, and many other complications.

Any other environmental problems, such as lead paint, should be removed as well. Though it’s not good for anyone to be around lead, it’s particularly dangerous for pregnant women and their babies.

Get Control of Preexisting Medical Conditions

Metabolic conditions such as high blood pressure or diabetes can cause serious damage to your body and make pregnancy difficult. If you have any chronic health problems, the preconception period is the time to get them under control.

For type 2 diabetes or high blood pressure, losing weight can improve both. Regular exercise can increase insulin sensitivity, which combats diabetes and also improves blood pressure. If you want to conceive, you need to focus on your overall health to ensure the best outcomes for you and your baby.

Hormonal imbalances, such as PCOS, thyroid disorders, and estrogen dominance, can affect your ability to safely carry a child to term. Many high-risk pregnancies are made more dangerous by uncontrolled conditions. Now is the time to take them seriously, as they directly impact your reproductive health.

Why is prenatal care important?

When you are trying to conceive or determine if you’re pregnant, you will want to speak with a doctor of obstetrics to set up your prenatal care schedule. Each trimester has specific prenatal tests and milestones, and the best way to ensure a healthy pregnancy is to stick to your appointment schedule.

Medical care during your pregnancy will be primarily done through your gynecologist since any ailment you have will need to be evaluated with the baby in mind. OB/GYNs better understand how various illnesses and treatments need to be considered to avoid hurting your developing baby.

Your doctor will likely request one prenatal care visit per month from weeks 4 to 28. From weeks 28 to 36, you’ll have a visit every two weeks; and from week 36 until birth, you’ll visit each week.

First Trimester

Prior to getting pregnant or soon after, you will undergo blood tests to check for certain diseases and conditions, including:

  • STIs such as HIV and hepatitis
  • Preeclampsia
  • Vitamin deficiencies
  • Blood typing and Rh status
  • Anemia
  • Diabetes
  • Hormonal imbalances

These tests give your doctor a baseline of your health, allowing them to instruct further testing or treatment from there if needed.
Your doctor will also check your urine for:

  • Bladder or kidney infection
  • Protein and sugar levels
  • Kidney disease

Your weight, blood pressure, and other vital signs will be recorded as well on your first visit. This is the time to discuss any health topics you wish, including family history or potential birth abnormalities you’re worried about. Currently, you can also expect to be screened for coronavirus throughout your pregnancy, as COVID-19 infection can affect unborn children.

Prenatal care visits are positively correlated with healthy births, so starting off on the right foot during the first trimester is critical.

Prior to getting pregnant or soon after, you will undergo blood tests to check for certain diseases and conditions, including:

  • STIs such as HIV and hepatitis
  • Anemia
  • Preeclampsia
  • Diabetes
  • Vitamin deficiencies
  • Hormonal imbalances
  • Blood typing and Rh status

These tests give your doctor a baseline of your health, allowing them to instruct further testing or treatment from there if needed.
Your doctor will also check your urine for:

  • Bladder or kidney infection
  • Protein and sugar levels
  • Kidney disease

Your weight, blood pressure, and other vital signs will be recorded as well on your first visit. This is the time to discuss any health topics you wish, including family history or potential birth abnormalities you’re worried about. Currently, you can also expect to be screened for coronavirus throughout your pregnancy, as COVID-19 infection can affect unborn children.

Prenatal care visits are positively correlated with healthy births, so starting off on the right foot during the first trimester is critical.

Second Trimester

In your second trimester checkups, your doctor will measure your baby’s growth and assess fetal movement. Your doctor will speak with you about your diet, exercise, and general lifestyle habits, giving you tips on how to improve in any of these areas. You’ll also be able to listen to your baby’s heartbeat for the first time during these visits.

The second trimester is also the time to administer any genetic testing you might want. One such method of testing is amniocentesis, in which some of the amniotic fluid is drawn to test for genetic markers. The cellular material in the amniotic fluid can indicate if your child will have certain conditions, such as:

  • Spina bifida
  • Down syndrome
  • Open neural tube defects
  • Certain genetically inherited conditions
  • Metabolic disorders

In your second trimester checkups, your doctor will measure your baby’s growth and assess fetal movement. Your doctor will speak with you about your diet, exercise, and general lifestyle habits, giving you tips on how to improve in any of these areas. You’ll also be able to listen to your baby’s heartbeat for the first time during these visits.

The second trimester is also the time to administer any genetic testing you might want. One such method of testing is amniocentesis, in which some of the amniotic fluid is drawn to test for genetic markers. The cellular material in the amniotic fluid can indicate if your child will have certain conditions, such as:

  • Spina bifida
  • Certain genetically inherited conditions
  • Down syndrome
  • Metabolic disorders
  • Open neural tube defects

Why would I need amniocentesis?

If there is a concern of inherited genetic conditions, your doctor might suggest amniocentesis to rule them out or to prepare for treatment. Amniocentesis is also recommended for high-risk pregnancies, such as:

  • Being over the age of 35 upon delivery of the child
  • Having a family history of certain medical conditions
  • Prior pregnancies with birth defects
  • Abnormal maternal screenings prior to the second trimester

Risks of Amniocentesis

There are risks with amniocentesis, though they are minor. The most common side effects of amniocentesis are:

  • Bleeding
  • Cramping
  • Leaking of amniotic fluid from the puncture site or vagina

More serious complications, though rare, do occur in around 1% of patients:

  • Preterm labor
  • Infection
  • Miscarriage

It should be noted that the incidence of miscarriage from amniocentesis is only slightly higher than the general chance of miscarriage. Genetic testing can be extremely helpful in preparing a family for unique conditions and corresponding treatments their child might need. Speak with your doctor to determine any potential birth outcomes as a result of genetic testing.

Third Trimester

The third trimester is the home stretch, and your visits will become more frequent but also more routine. Your doctor will continue to monitor your blood pressure, weight gain, and health habits, such as diet and exercise.

As the due date approaches, your doctor will also ensure the baby is in a good position for delivery. Your general health will continue to be monitored, and you should ask any questions you have, especially in regard to sensations or physical pain.

Now is the time to determine postpartum care, such as considering nurse-midwives for delivery and help at home during the first few weeks after birth. Your doctor will discuss breastfeeding and what medications and foods you should still avoid if you choose to breastfeed. Even some over-the-counter medications aren’t safe and can transfer to your child in breast milk, so it’s important to speak to your doctor.

Postpartum and Beyond

You will need to continue seeing your doctor after delivery to make sure your body is recovering correctly. Additionally, you will want to set up your baby with a doctor of pediatrics so they can get on the path to regular checkups and good health.

Child health is taken very seriously in the United States and all states have a federal human services office that can provide help in a variety of ways.

  • Help with doctors visits
  • Insurance coverage for low-income families and children
  • Nutritional supplementation (WIC and SNAP benefits)
  • Screening for routine women’s health concerns

Prenatal care is accessible and extremely important for the health of you and your baby. If you’re planning on having a baby, you should begin to become conscious of your habits immediately. Cut out unhealthy habits such as smoking or drinking and improve your diet. Exercise and quality sleep are important to improve your overall health and make carrying a child easier.

Your doctor will guide you through the tests you need during pregnancy, starting with routine blood and vitals screenings during the first trimester.

In the second trimester, your baby’s development, movement, and heart rate will be measured. This is the time for genetic testing through amniocentesis as well.

The third trimester is about ensuring everything is progressing smoothly up until the delivery date. This is the time to speak to your doctor about postpartum recovery and continued care.

Make the effort to attend all prenatal visits and follow your doctor’s advice to ensure a healthy, happy baby.