Medical Care During Pregnancy

The Importance Of Prenatal Care

According to the Centers for Disease Control and Prevention (CDC), almost 4 million American women give birth every year. Nearly one third of them will have some kind of pregnancy-related complication. Those who don't get adequate prenatal care run the risk that such complications will go undetected or won't be dealt with soon enough. That, in turn, can lead to potentially serious consequences for both the mother and her baby.

These statistics aren't meant to alarm you, but rather to convey the importance of starting prenatal care as early as possible — ideally, before you even become pregnant. Of course, this isn't always possible or practical. But the sooner in your pregnancy you begin, the better your chances of ensuring your own health and that of your baby.
Prenatal Care Before Becoming Pregnant

Ideally, prenatal care should start before you get pregnant. If you're planning a pregnancy, see your health care provider for a complete checkup. He or she can do routine testing to make sure you're in good health and that you don't have any illnesses or other conditions that could affect your pregnancy. If you've been experiencing any unusual symptoms, this is a good time to report them.

If you're already being treated for a chronic condition, such as diabetes, asthma, hypertension (high blood pressure), a heart problem, allergies, lupus (an inflammatory disorder that can affect several body systems), depression, or some other condition, you should talk to your doctor about how it could affect your pregnancy. In some cases, you may need to change or eliminate medications — especially during the first trimester (12 weeks) — to reduce risk to the fetus. Or, you may need to be even more vigilant about managing your condition.

For example, women with diabetes must be especially careful about keeping their blood glucose levels under control, both before they begin trying to conceive and during their pregnancy. Abnormal levels increase the risk of birth defects and other complications.

This is also a good time to talk with your health care provider about other habits that can pose a risk to your baby, such as drinking alcohol or smoking. Ask about starting a prenatal vitamin that contains folic acid, calcium, and iron.

It's especially important for women who are planning to become pregnant to take vitamins with folic acid beforehand, because neural tube defects (problems with the normal development of the spine and nervous system) happen in the first 28 days of pregnancy, often before a woman even knows she's pregnant.

If you have or your partner has a family history of a significant genetic disorder and you suspect either of you may be a carrier, then genetic testing may be advisable. Talk this over with your health care provider, who can refer you to a genetic counselor if necessary.

If you find out that you're pregnant before you do any of this, don't worry. It's not too late to get the care that will help to ensure your health and that of your baby.
Now that you're pregnant, taking care of yourself has never been more important. Of course, you'll probably get advice from everyone — your doctor, family members, friends, co-workers, and even complete strangers — about what you should and shouldn't be doing.

But staying healthy during pregnancy depends on you, so it's crucial to arm yourself with information about the many ways to keep you and your baby as healthy as possible.
Prenatal Health Care
Key to protecting the health of your child is to get regular prenatal care. If you think you're pregnant, call your health care provider to schedule an appointment. You should schedule your first examination as soon as you think that you are pregnant.

At this first visit, your health care provider likely do a pregnancy test, and will figure out how many weeks pregnant you are based on a physical examination and the date of your last period. He or she will also use this information to predict your delivery date (however, an ultrasound performed sometime during your pregnancy will help to verify that date).

If you're healthy and there are no complicating risk factors, most health care providers will want to see you:

* every 4 weeks until the 28th week of pregnancy
* then every 2 weeks until 36 weeks
* then once a week until delivery

Throughout your pregnancy, your health care provider will check your weight and blood pressure while also checking the growth and development of your baby (by doing things like feeling your abdomen, listening for the fetal heartbeat starting during the second trimester, and measuring your belly). During the span of your pregnancy, you'll also have prenatal tests, including blood, urine, and cervical tests, and probably at least one ultrasound.

If you still need to choose a health care provider to counsel and treat you during your pregnancy, there are several options:

* obstetricians/gynecologists (also known as OB/GYNs — doctors who specialize in pregnancy and childbirth, as well as women's health care)
* family practitioners (doctors who provide a range of services for patients of all ages — in some cases, this includes obstetrical care)
* certified nurse-midwives (advanced practice nurses specializing in women's health care needs, including prenatal care, labor and delivery, and postpartum care for uncomplicated pregnancies; there are also other kinds of midwives, but you should look for one with formal training who's been certified in the field)

Any of these is a good choice if you're healthy and there's no reason to anticipate complications with your pregnancy and delivery. However, nurse-midwives do need to have a doctor available for the delivery in case an unexpected problem arises or a cesarean section has to be performed.