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Prenatal care - staying healthy during pregnancy

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​One of the most important things you can do for your baby is to seek prenatal care as soon as you learn you are pregnant. Prenatal care is the health care you receive before your baby is born.

Women who have regular prenatal care tend to have fewer problems and deliver healthier babies than women who delay or have no prenatal care.

It is important to see a provider or visit a clinic because your baby’s body develops rapidly, and all the major organs are formed during the first 12 weeks of pregnancy.

Prenatal care includes advice about your pregnancy and a plan of care developed just for you. This plan covers:

  • Health care visits
  • Exercise
  • Diet
  • Work limitations
  • Special things you should do to assure a healthy baby and a comfortable pregnancy

Even if this is not your first baby, remember that every pregnancy is different. Visit your health care provider early in the pregnancy and always return for your scheduled visits. Early care is the best way to prevent, discover, and treat potential problems.

Selecting Your Health Care Providers

Selecting the person or clinic to provide your health care is the first important step. There are many kinds of health professionals who are qualified to care for you during your pregnancy, labor and delivery, and the period after the birth.

Obstetrician-gynecologist (OB-GYN)

​​A doctor who is specially trained to provide medical and surgical care to women. Obstetricians​​ mainly provide pregnancy care, while gynecologists mainly provide female reproductive system care.

Perinatologist

A perinatologist is an obstetrician who specializes in the care of women who may face special problems during pregnancy. These include women:

  • Under 18 years and over 35 years
  • With conditions such as diabetes, hypertension, and sexually transmitted diseases
  • With genetic (inherited) problems
  • Who have a history of problem pregnancies

Family practitioner

A family medicine doctor cares for all family members. Family practitioners are prepared to provide normal obstetric and gynecologic care, but will refer complicated problems to an obstetrician-gynecologist.

Certified nurse-midwife (CNM)

A certified nurse midwife is a registered nurse who has completed advanced education and training. Midwives provide complete obstetrical care for uncomplicated pregnancies (prenatal, labor and delivery, postpartum). They practice in collaboration with doctors. Midwives may also provide well-woman gynecological care.

Nurse practitioner/physician assistant

Health care professional who will work closely with your doctor in providing health care, education, and support services throughout your pregnancy.

Registered dietitian

A health care provider who specializes in nutrition for mothers and infants. The dietitian will work closely with you and your doctor throughout your pregnancy.

Genetic counselor

A genetic counselor is a person specially trained to discuss risk factors of having a baby with a birth defect. These factors include genetic or inherited conditions, exposure during pregnancy to certain drugs or chemicals, and other related concerns of the patient.

Social worker

Professionals who can address special concerns such as finances, insurance, home or family problems, or parenting. Social workers and counselors can make referrals to appropriate agencies when necessary.

In choosing your doctor, nurse midwife, or clinic, you should consider:

  • Their attitudes on issues you feel strongly about, such as prepared childbirth, breastfeeding, single parenthood, the partner’s presence or participation in the delivery, rooming in after the baby is born, and prenatal classes.
  • Their reputation with other patients and health care providers.
  • Their office hours and location of the office and the hospital.
  • Their fees.
  • How comfortable you feel with them.

Your First Visit

Your first visit will probably take more time than later appointments. In addition to a physical examination, you will need to give information about yourself and your pregnancy.

Questions you will likely need to answer:

  • Previous pregnancies, miscarriages, or abortions.
  • Menstrual history – when your periods started, what they are like, and when your last normal period occurred.
  • Medical history – any medical problems you, the baby’s father, or members of either family may have had; particularly such chronic conditions as diabetes, kidney disorders, thyroid problems, heart conditions, and respiratory illnesses; also important are any genetic or congenital disorders.
  • Diet and lifestyle

Your physical exam will include:

  • Measurement of your height, weight, and blood pressure.
  • Examination of your eyes, ears, nose, throat, and teeth.
  • Examination of your heart, lungs, breasts, and abdomen.
  • Internal examination (pelvic examination) of the growth of your uterus.

In addition, several laboratory tests may be performed

If you have any questions about your pregnancy, general health or physical examination, do not be afraid to ask your health care provider.

Tell your provider if you have any physical problems, if you are under stress, or if you have any other special concerns. It is important for your provider to understand how your pregnancy is affecting you and your family.

Follow-up Visits

Your follow-up visits should occur once a month during the first 6 months of your pregnancy.

During these visits, your weight, blood pressure, and possibly your urine will be checked. Your abdomen will be measured to see how the baby is growing and the baby’s heart tones will be checked.

During later pregnancy, you should have more frequent follow-up visits. These examinations help ensure that your pregnancy is progressing normally. Pelvic examinations and blood tests are done when indicated.

If you have questions or concerns between visits, write them down and bring them to your next appointment.

Baby Movement

During your prenatal visits you will be asked if you are feeling the baby move.

Fetal movement is first felt by most mothers sometime after 16 weeks of pregnancy. The time when you first feel fetal movement is dependent upon the number of babies that you have had, as well as the location of the placenta.

Even though you cannot feel the baby’s movements, the baby is known to be very active early in the pregnancy. The movement of the baby increases during the early and middle portions of pregnancy, with most movement occurring in the seventh or eighth month. After that there is a gradual decline in the frequency of the baby’s movement as well as a change in the type of movement that the baby makes. This is primarily because of less space available for vigorous kicking or motion.

Contact your provider if you notice a sudden decrease in the baby’s movements. This may indicate a potential problem and further fetal evaluation may be necessary.