PRENATAL CARE
The health care that a pregnant woman receives prior to the birth of her child is called prenatal care. Prenatal care monitors the health of both the baby and the mother. Care should be started as early as possible. Under ideal conditions, a woman should consider preconception health care for up to one year before becoming pregnant. What follows is an overview description of the course of prenatal care. Your specific visits and their content will be determined by your doctor.
How often will I see the doctor or midwife?
Most pregnancies are uncomplicated and the course of prenatal care is summarized as follows:
Gestational Age Frequency of visits -
Up to 28 weeks once monthly
Up to 36 weeks every two weeks
Up to delivery every week until delivery
If a woman has medical conditions or factors that put her pregnancy at a risk of complications, her frequency of visits will be different than those listed above. Her doctor will determine visits based upon her specific situation.
WHAT TO EXPECT DURING PRENATAL VISITS
First Prenatal Visit
- Compete medical and family history.
In general, your doctor will gather information regarding your menstrual history, past and present medical history, medication use, contraception use, previous pregnancy history as well as surgical and social history. Other pertinent information will be collected to get an overall picture of your health.
- Physical examination including a pelvic exam. You will receive an examination to gather baseline information on various major organ systems, blood pressure, and weight. Although you will receive a general physical examination, special attention will be given to the abdomen and pelvis. The pelvic examination will include:
- An evaluation of the internal pelvic area to estimate whether its size can allow for a vaginal delivery
- An evaluation of the fundal height to estimate the size of the uterus and approximate gestational age.
- An evaluation of the cervix including a PAP smear; also, cells and secretions will be gathered to screen for sexually transmitted diseases and other infections.
- An evaluation of fetal heart beat, depending upon gestational age.
- Laboratory Tests
You will give blood samples to check for:
- Anemia
- Rh and antibody screen
- Screening for diabetes
- Check for antibodies against German measles (rubella)
- Screening for hepatitis and syphilis
Depending upon your risk factors, you may be screened for genetic disorders, HIV, tuberculosis, and other conditions that may affect you and your baby.
You will give other specimen samples to check for:
- Urinary tract infection
- Sexually transmitted diseases such as chlamydia, gonorrhea, group B streptococcal disease, herpes, and HVP
Depending upon your risk factors, additional tests may be taken. Also, your prenatal care physician will determine when to schedule a sonogram.
Remaining Prenatal Visits
After your first prenatal visit, the doctor or midwife will collect additional information:
- Ask about your health and well being since the last visit
- Check your blood pressure and weight
- Check your urine
- Measure your abdomen to determine the growth of your baby (through the fundal height).
- Listen for the baby's heartbeat (depending on gestational age)
- Discuss your health questions and concerns
- Follow-up on any laboratory tests
- Schedule additional tests, as needed, and make next prenatal appointment.
Common Concerns During Pregnancy
Some issues specific to pregnancy may impact your daily life and habits. Discuss these issues and others with your doctor.
- Proper nutrition and maternal weight gain
- Exercise
- Risky habits to avoid
Links to health services and prenatal care in Montgomery County, Maryland
Montgomery County Public Health Services
www.co.mo.md.us./services/hhs/phs
The Maternity Center/Midwives, Bethesda. & Germantown
www.maternitycenter.com
Provides maternity, adoption, and foster care
Christian Homes
www.christianhomes.com
National Association of Christian Child & Family Agencies
www.naccfa.org/dire_level/crisis.html
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