Prenatal Care

WHAT IS PRENATAL CARE?

Prenatal care means health care during your pregnancy, before your baby is born. Take care of yourself and your baby by:

  • Getting early prenatal care. If you know you are pregnant, or think you might be pregnant, call your caregiver as soon as possible. Schedule a visit for a general/prenatal examination.

  • Getting regular prenatal care. Follow your caregiver's schedule for blood and other necessary tests. Do not miss appointments.

  • Do everything you can to keep yourself and your baby healthy during your pregnancy.

  • Prenatal care should include evaluation of medical, dietary, educational, psychological, and social needs for the couple and the medical, surgical, and genetic history of the family of the mother and father.

  • Discuss with your caregiver:

  • Your medicines, prescription, over-the-counter, and herbal medicines.

  • Substance abuse, alcohol, smoking, and illegal drugs.

  • Domestic abuse and violence, if present.

  • Your immunizations.

  • Nutrition and diet.

  • Exercising.

  • Environment and occupational hazards, at home and at work.

  • History of sexually transmitted disease, both you and your partner.

  • Previous pregnancies.

WHY IS PRENATAL CARE SO IMPORTANT?

By seeing you regularly, your caregiver has the chance to find problems early, so that they can be treated as soon as possible. Other problems might be prevented. Many studies have shown that early and regular prenatal care is important for the health of both mothers and their babies.

I AM THINKING ABOUT GETTING PREGNANT. HOW CAN I TAKE CARE OF MYSELF?

Taking care of yourself before you get pregnant helps you to have a healthy pregnancy. It also lowers your chances of having a baby born with a birth defect. Here are ways to take care of yourself before you get pregnant:

  • Eat healthy foods, exercise regularly (30 minutes per day for most days of the week is best), and get enough rest and sleep. Talk to your caregiver about what kinds of foods and exercises are best for you.

  • Take 400 micrograms (mcg) of folic acid (one of the B vitamins) every day. The best way to do this is to take a daily multivitamin pill that contains this amount of folic acid. Getting enough of the synthetic (manufactured) form of folic acid every day before you get pregnant and during early pregnancy can help prevent certain birth defects. Many breakfast cereals and other grain products have folic acid added to them, but only certain cereals contain 400 mcg of folic acid per serving. Check the label on your multivitamin or cereal to find the amount of folic acid in the food.

  • See your caregiver for a complete check up before getting pregnant. Make sure that you have had all your immunization shots, especially for rubella (German measles). Rubella can cause serious birth defects. Chickenpox is another illness you want to avoid during pregnancy. If you have had chickenpox and rubella in the past, you should be immune to them.

  • Tell your caregiver about any prescription or non-prescription medicines (including herbal remedies) you are taking. Some medicines are not safe to take during pregnancy.

  • Stop smoking cigarettes, drinking alcohol, or taking illegal drugs. Ask your caregiver for help, if you need it. You can also get help with alcohol and drugs by talking with a member of your faith community, a counselor, or a trusted friend.

  • Discuss and treat any medical, social, or psychological problems before getting pregnant.

  • Discuss any history of genetic problems in the mother, father, and their families. Do genetic testing before getting pregnant, when possible.

  • Discuss any physical or emotional abuse with your caregiver.

  • Discuss with your caregiver if you might be exposed to harmful chemicals on your job or where you live.

  • Discuss with your caregiver if you think your job or the hours you work may be harmful and should be changed.

  • The father should be involved with the decision making and with all aspects of the pregnancy, labor, and delivery.

  • If you have medical insurance, make sure you are covered for pregnancy.

I JUST FOUND OUT THAT I AM PREGNANT. HOW CAN I TAKE CARE OF MYSELF?

Here are ways to take care of yourself and the precious new life growing inside you:

  • Continue taking your multivitamin with 400 micrograms (mcg) of folic acid every day.

  • Get early and regular prenatal care. It does not matter if this is your first pregnancy or if you already have children. It is very important to see a caregiver during your pregnancy. Your caregiver will check at each visit to make sure that you and the baby are healthy. If there are any problems, action can be taken right away to help you and the baby.

  • Eat a healthy diet that includes:

  • Fruits.

  • Vegetables.

  • Foods low in saturated fat.

  • Grains.

  • Calcium-rich foods.

  • Drink 6 to 8 glasses of liquids a day.

  • Unless your caregiver tells you not to, try to be physically active for 30 minutes, most days of the week. If you are pressed for time, you can get your activity in through 10 minute segments, three times a day.

  • If you smoke, drink alcohol, or use drugs, STOP. These can cause long-term damage to your baby. Talk with your caregiver about steps to take to stop smoking. Talk with a member of your faith community, a counselor, a trusted friend, or your caregiver if you are concerned about your alcohol or drug use.

  • Ask your caregiver before taking any medicine, even over-the-counter medicines. Some medicines are not safe to take during pregnancy.

  • Get plenty of rest and sleep.

  • Avoid hot tubs and saunas during pregnancy.

  • Do not have X-rays taken, unless absolutely necessary and with the recommendation of your caregiver. A lead shield can be placed on your abdomen, to protect the baby when X-rays are taken in other parts of the body.

  • Do not empty the cat litter when you are pregnant. It may contain a parasite that causes an infection called toxoplasmosis, which can cause birth defects. Also, use gloves when working in garden areas used by cats.

  • Do not eat uncooked or undercooked cheese, meats, or fish.

  • Stay away from toxic chemicals like:

  • Insecticides.

  • Solvents (some cleaners or paint thinners).

  • Lead.

  • Mercury.

  • Sexual relations may continue until the end of the pregnancy, unless you have a medical problem or there is a problem with the pregnancy and your caregiver tells you not to.

  • Do not wear high heel shoes, especially during the second half of the pregnancy. You can lose your balance and fall.

  • Do not take long trips, unless absolutely necessary. Be sure to see your caregiver before going on the trip.

  • Do not sit in one position for more than 2 hours, when on a trip.

  • Take a copy of your medical records when going on a trip.

  • Know where there is a hospital in the city you are visiting, in case of an emergency.

  • Most dangerous household products will have pregnancy warnings on their labels. Ask your caregiver about products if you are unsure.

  • Limit or eliminate your caffeine intake from coffee, tea, sodas, medicines, and chocolate.

  • Many women continue working through pregnancy. Staying active might help you stay healthier. If you have a question about the safety or the hours you work at your particular job, talk with your caregiver.

  • Get informed:

  • Read books.

  • Watch videos.

  • Go to childbirth classes for you and the father.

  • Talk with experienced moms.

  • Ask your caregiver about childbirth education classes for you and your partner. Classes can help you and your partner prepare for the birth of your baby.

  • Ask about a pediatrician (baby doctor) and methods and pain medicine for labor, delivery, and possible Cesarean delivery (C-section).

I AM NOT THINKING ABOUT GETTING PREGNANT RIGHT NOW, BUT HEARD THAT ALL WOMEN SHOULD TAKE FOLIC ACID EVERY DAY?

All women of childbearing age, with even a remote chance of getting pregnant, should try to make sure they get enough folic acid. Many pregnancies are not planned. Many women do not know they are actually pregnant early in their pregnancies, and certain birth defects happen in the very early part of pregnancy. Taking 400 micrograms (mcg) of folic acid every day will help prevent certain birth defects that happen in the early part of pregnancy. If a woman begins taking vitamin pills in the second or third month of pregnancy, it may be too late to prevent birth defects. Folic acid may also have other health benefits for women, besides preventing birth defects.

HOW OFTEN SHOULD I SEE MY CAREGIVER DURING PREGNANCY?

Your caregiver will give you a schedule for your prenatal visits. You will have visits more often as you get closer to the end of your pregnancy. An average pregnancy lasts about 40 weeks.

A typical schedule includes visiting your caregiver:

  • About once each month, during your first 6 months of pregnancy.

  • Every 2 weeks, during the next 2 months.

  • Weekly in the last month, until the delivery date.

Your caregiver will probably want to see you more often if:

  • You are over 35.

  • Your pregnancy is high risk, because you have certain health problems or problems with the pregnancy, such as:

  • Diabetes.

  • High blood pressure.

  • The baby is not growing on schedule, according to the dates of the pregnancy.

Your caregiver will do special tests, to make sure you and the baby are not having any serious problems.

WHAT HAPPENS DURING PRENATAL VISITS?

  • At your first prenatal visit, your caregiver will talk to you about you and your partner's health history and your family's health history, and will do a physical exam.

  • On your first visit, a physical exam will include checks of your blood pressure, height and weight, and an exam of your pelvic organs. Your caregiver will do a Pap test if you have not had one recently, and will do cultures of your cervix to make sure there is no infection.

  • At each visit, there will be tests of your blood, urine, blood pressure, weight, and checking the progress of the baby.

  • Your caregiver will be able to tell you when to expect that your baby will be born.

  • Each visit is also a chance for you to learn about staying healthy during pregnancy and for asking questions.

  • Discuss whether you will be breastfeeding.

  • At your later prenatal visits, your caregiver will check how you are doing and how the baby is developing. You may have a number of tests done as your pregnancy progresses.

  • Ultrasound exams are often used to check on the baby's growth and health.

  • You may have more urine and blood tests, as well as special tests, if needed. These may include amniocentesis (examine fluid in the pregnancy sac), stress tests (check how baby responds to contractions), biophysical profile (measures fetus well-being). Your caregiver will explain the tests and why they are necessary.

I AM IN MY LATE THIRTIES, AND I WANT TO HAVE A CHILD NOW. SHOULD I DO ANYTHING SPECIAL?

As you get older, there is more chance of having a medical problem (high blood pressure), pregnancy problem (preeclampsia, problems with the placenta), miscarriage, or a baby born with a birth defect. However, most women in their late thirties and early forties have healthy babies. See your caregiver on a regular basis before you get pregnant and be sure to go for exams throughout your pregnancy. Your caregiver probably will want to do some special tests to check on you and your baby's health when you are pregnant.

Women today are often delaying having children until later in life, when they are in their thirties and forties. While many women in their thirties and forties have no difficulty getting pregnant, fertility does decline with age. For women over 40 who cannot get pregnant after 6 months of trying, it is recommended that they see their caregiver for a fertility evaluation. It is not uncommon to have trouble becoming pregnant or experience infertility (inability to become pregnant after trying for one year). If you think that you or your partner may be infertile, you can discuss this with your caregiver. He or she can recommend treatments such as drugs, surgery, or assisted reproductive technology.