Pre-Natal Care

Why is prenatal care important?
Prenatal care is important for all women, even if they have been pregnant before and feel fine. Women who receive prenatal care have fewer problems with pregnancy, labor, delivery and the postpartum period than women who don't receive prenatal care.

Some women will develop medical problems in pregnancy; prenatal care allows early detection and treatment of these problems, which can prevent the problems from becoming more serious for the woman and her baby.

Where should I receive my prenatal care?
You need to find a health care provider with whom you feel comfortable. You may want to start by checking with your current health insurance plan to determine what services are covered and any rules about where prenatal service can be obtained. Most women receive prenatal care from a physician (who sometimes works with a nurse practitioner or physician assistant) or a nurse-midwife. It may be helpful to talk to friends, coworkers, neighbors and relatives about their experiences with health care providers and hospitals.

Women who do not have health insurance coverage for pregnancy can contact their local health department or family planning clinic or call their toll-free state prenatal care hotline to find information about available programs.

What can I expect during my first prenatal visit?
During your first prenatal visit, your care provider will ask you about past illnesses, surgeries, family illnesses and genetic diseases. She or he will discuss any current illnesses and medications that you may be taking.

Generally, during the first or second prenatal visit, you will have a complete physical exam. Your health care provider may want to confirm your pregnancy with a pregnancy test, ultrasound or by listening to the fetal heart beat. Your health care provider will prescribe a daily prenatal vitamin/mineral supplement at this time.

How often will I have prenatal visits and what will happen at these visits?
Follow-up visits will usually be once a month early in pregnancy, increasing to weekly as you approach your due date.

During these visits, the following items will usually be checked, although each one may not be done every visit:

• your weight
• blood pressure
• size of the uterus
• fetal heart beat
• urine

You may be asked about vaginal discharge or bleeding, changes in fetal movement, headaches and swelling of feet hands or face. It is important to discuss any concerns you have with your health care provider.

You should receive information about how to take good care of yourself and your baby, warning signs of any problems and emergency numbers to call if you encounter problems or questions before your next visit.

What kinds of tests will I have during pregnancy?
Prenatal testing may include:

• blood tests for anemia, blood type, RH factor, diabetes, infections including hepatitis B and syphilis, and immunity to rubella
• urine tests to detect infection, diabetes or kidney problems
• pap smear
• test for vaginal infections
• ultrasound

Optional test (to detect genetic or other problems with the fetus) include:

• amniocentesis
• MSAFP (maternal-serum alpha-fetoprotein)
• CVS (chorionic villus sampling)
• HIV testing is offered as an optional test and is recommended during pregnancy.

What type of childbirth classes should I attend?
Most prenatal care providers will give you information about childbirth preparation classes, usually associated with the hospital or birthing center where you plan to deliver.

In most communities many other classes are offered, including exercises for pregnant and postpartum women, breastfeeding and postpartum care. Before signing up for childbirth preparation classes, you should first read about the different methods in books and talk to different childbirth instructors to determine which method you want to pursue. Take advantage of classes that are available. This is a great time to learn about your body and developing baby as well as an opportunity to get to know other families preparing for parenthood.

What can I do to increase my chances of having a healthy baby?
Have a preconception visit before becoming pregnant. Make sure you consume 400 micrograms of folic acid every day. See a qualified practitioner for prenatal care as soon as you suspect you are pregnant. Get regular exercise, maintain health eating habits and gain a sensible amount of weight (25-35 pounds for normal weight women).

If you smoke, get help with quitting and avoid being around persons who are smoking. Avoid alcohol and drugs. Get plenty of rest and drink several glasses of water every day.

Be informed about your pregnancy and your health. Read about pregnancy and take classes for childbirth preparation. Call your health care provider to report warning signs (bleeding, headache, swelling, decreased fetal movement) and check before taking any medication, even over-the-counter medicines and vitamin or mineral supplements.

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