Prenatal care is the follow up for pregnant mothers during the course of the pregnancy. It refers to the entire process of care right from when the confirmation of pregnancy to the point of labor and delivery. Prenatal care is geared towards ensuring the good health and outcome of the mother and the baby while avoiding all the risks associated with pregnancy and delivery.
It is advisable to begin antenatal care as soon as one discovers that they are pregnant. Usually this happens after missing a period, which is amt about 5 weeks of pregnancy. Though one can start antenatal care at any point during pregnancy, the earlier one starts the better since any risks can be identified early and addressed. In general, a pregnant mother should have at least four (4) antenatal visits during the course of the pregnancy. However, more visits can be scheduled if there are any risks that are identified which may require closer monitoring of both mother and baby.
The first antenatal visit is usually focused on taking a thorough history from the mother as a baseline for the subsequent visits, labor and delivery. The history provides information that is useful for confirming the dates or how far the pregnancy has progressed based on the date of the last period. It also helps to identify any risks that may need to be addressed. Mothers at this point have the opportunity to discuss what to expect during the course of the pregnancy and especially to air any concerns they have. This is particularly useful for first-time mothers.
In the subsequent visits, the progress of the pregnancy is charted and growth of the baby monitored by dates. At each visit, the health care professional will continue screening the mother to ensure that no new risks have developed in the course of the pregnancy e.g. diabetes mellitus, high blood pressure and so on.
In the second trimester, the baby is also screened for any abnormalities of the major organs such as the brain, heart, abdominal organs etc. This allows mothers to prepare themselves incase such an abnormality exists or to determine if the pregnancy is still viable.
In the third trimester, the visits are focused on preparing for labor and delivery. This involves identifying any risk of early/premature labour, or any conditions that may interfere with labour.
During the antenatal visits the health care provider will conduct a full physical examination. This will include taking the basic vital signs like blood pressure, heart rate, temperature, height and weight. This physical examination will then focus on the abdominal exam. This involves feeling the uterus to determine the growth by dates based on the level of the uterus in the abdomen. As the pregnancy progresses, the examination will include feeling the position of the baby in the uterus. It is expected that towards the third trimester, the baby will be lying with the head down, rather than with the head up (breech position). In addition, the heart rate of the baby is also ascertained during the physical examination. The fetal heart rate is a good indicator of the condition of the baby; a reduction or an elevation of the rate suggests distress which needs attention. As labor nears, the physical examination also ascertains the descent of the baby into the pelvis in preparation for delivery. Besides examining the uterus, the physical exam is also useful in picking signs of conditions that occur in pregnancy such as urinary tract infections. This physical examination is conducted at every visit, and is a crucial aspect of antenatal care. There is no pain during this examination and thus mothers need not be anxious.