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Prenatal Care

Arrange to have prenatal care as soon as you know you are pregnant. It is vital for a healthy pregnancy. Your prenatal care clinician can help you reduce the risk of having a low-birth-weight baby by 300 percent.

Women who are considering becoming pregnant in the next several months should begin taking a prenatal vitamin with at least 400 mcg of folic acid daily. Folic acid has proven to be vital in preventing birth defects of the brain and spinal cord.

See your Clinician Regularly

How many times will you need to see your clinician? It all depends.
If you are age 18 to 35 and healthy you will probably have a
"low-risk" pregnancy. If so, plan on seeing your clinician about

  • once a month for the first 28 weeks (seven months)
  • every two or three weeks from the 28th to the 36th week (eighth month)
  • weekly from the 36th week until delivery (ninth month)

If you have a "high-risk" pregnancy, you will need to see your clinician more often.

The First Visit

The first visit is usually the longest. The examination is very thorough. You will be asked questions about your medical history. You will also be asked about your partner's and your family's medical history. You will have a complete physical exam. Your clinician will measure your height, weight, blood pressure, breathing, and pulse.

You will be given a gynecological exam that will include

  • a breast exam
  • a Pap test
  • tests for chlamydia and gonorrhea

You may be given blood or skin tests to check for

  • anemia
  • blood type
  • cystic fibrosis
  • Gauchers
  • hepatitis
  • rubella
  • sickle cell anemia
  • syphilis
  • Tay-Sachs
  • thalassemias
  • tuberculosis

Urine tests will check for

  • diabetes
  • infection

Follow-Up

Serious health problems can occur during pregnancy. That's why it is very important that you visit your clinician for regular checkups. Your clinician will

  • test your urine
  • check your blood pressure
  • examine you for fluid retention (swollen face, hands, or feet)
  • measure the growth of your uterus
  • examine your abdomen to check the position of the fetus
  • listen for the sounds of the fetal heartbeat

Be sure you have the tests and treatments you need.

Special tests for birth defects are done at certain times. Some defects may be corrected during pregnancy if they are detected early enough.

Ultrasound

Ultrasound scans allow the clinician to take pictures of the fetus as it develops. Ultrasound is also called a sonogram. It may

  • show the position and size of the fetus
  • show the position of the placenta
  • confirm your due date
  • detect multiple pregnancies
  • detect severe abnormalities

An ultrasound scan builds a picture of the fetus on a screen by bouncing sound waves into your uterus. It is a very safe procedure — no X-rays are involved. It may be combined with blood tests to screen for Down Syndrome in the first trimester.

CVS — Chorionic Villus Sampling

CVS is a test that examines the tissue that attaches the fetus to the wall of the uterus. CVS detects certain birth defects. It is usually performed between 10 and 12 weeks after your last menstrual period.

You may consider CVS if:

  • you are over age 35
  • you or your partner have a family history that reveals risk of certain birth defects or other disorders
  • you have had a child with a major birth defect

CVS can be performed in two ways. The tissue sample can be taken by inserting a thin tube through the vagina and cervix. Or it can be taken by inserting a needle through the abdomen. Ultrasound is used to guide the needle in both methods.

CVS is generally painless. However, women may feel cramping or have bleeding or spotting after CVS. Symptoms usually stop within a few days, but you should always tell your health care provider if you have any discomfort or bleeding.

CVS is generally safe. There is a slight chance of infection, injury to the fetus, or having labor too early after CVS.

Multiple Marker Screening (Triple Test)

At 16 weeks you may be offered a blood test called a triple test. Triple tests screen for Down Syndrome, brain and spine defects, as well as other defects. Further tests will be offered if the triple test reveals an increased risk of birth defects.

Amniocentesis

Amniocentesis is a test that examines fluid that surrounds and protects the fetus. Amniocentesis detects certain birth defects. It is usually performed between 15 and 18 weeks after your last menstrual period.

You may consider amniocentesis if:

  • you are over age 35
  • your triple test shows a need for more testing
  • you or your partner have a family history that reveals risk of certain birth defects or other disorders
  • you may have the baby too early — premature delivery
  • you have had a child with a major birth defect

First, the clinician applies a painkiller. Then, a long, thin needle is used to take out a small amount of the fluid. Ultrasound is used to guide the needle.

Amniocentesis is generally painless — many women report having no pain at all, but some women report mild discomfort. Amniocentesis is also generally safe. However, there is a slight chance of infection, injury to the fetus, or having labor too early.

BPP — Biophysical Profile

The BPP uses ultrasound combined with a fetal monitor to observe fetal heart beat and movement. BPP allows a clinician to evaluate the well-being of the fetus. It is usually performed during the third trimester.

Learn how to deal with the discomforts of pregnancy.

There are many normal discomforts during pregnancy. Your body will go through lots of hormonal changes. Your uterus will grow up to 18 times larger. Your breasts and nipples will become larger, too. And you will gain weight.

You may have increased or decreased sexual desire. You may have changes in hair texture and in body hair. And you may experience discomforts and changes that are new to you. Discuss any of the following normal discomforts with your clinician:

  • abdominal pain, aches
  • backache
  • bloating
  • breast discharge
  • constipation
  • contractions that are painless and irregular (Braxton-Hicks contractions)
  • difficulty sleeping
  • dizziness
  • flatulence (passing gas)
  • fluid retention (swelling)
  • forgetfulness
  • headaches
  • heartburn
  • hemorrhoids
  • increased saliva
  • leg cramps
  • mood changes
  • nasal congestion (stuffiness)
  • nausea, vomiting (morning sickness)
  • nosebleeds
  • rashes
  • sensitive gums
  • shortness of breath
  • skin changes
  • spotting
  • sweating
  • tiredness
  • urinating more often
  • vaginal discharge
  • varicose veins

Tips for avoiding nausea and vomiting:

  • Slowly eat a dry cracker, dry bread, or dry cereal before getting out of bed.
  • Drink small cups of ginger or peppermint tea.
  • Avoid sudden movements when you're getting out of bed — take your time.
  • Have several small meals throughout the day instead of fewer large ones.
  • Drink fluids between meals rather than with your meals.
  • Avoid greasy and fried foods.
  • Drink a little fruit juice or no-caffeine soda when you feel nauseated between meals.
  • Avoid strong spices and odors.

Tips for avoiding heartburn:

  • Have five or six small meals a day. As the fetus grows it pushes against the stomach. There is less and less room for large meals.
  • Chew your food slowly.
  • Don't lie down for at least an hour after eating.
  • Wear clothes that are loose around your waist.
  • Raise your head with several pillows while sleeping.

Tips for avoiding constipation:

  • Increase the amount of liquids and fiber in your diet.
  • Eat more dried or raw fruits and vegetables, including their skins.
  • Use whole-grain bread and cereals, especially oats.
  • Exercise.
  • Have your meals at regular times.
  • Ask your clinician for a safe laxative if these tips don't work for you.

Avoiding constipation can help protect against hemorrhoids, which can be caused by spending lengthy time sitting on the toilet.

Learn the warning signs that something may be wrong.

Report any of these signs to your health care provider. Most pregnancies proceed without any problem. But problems can happen unexpectedly. Contact your clinician immediately if you think you may have been exposed to a sexually transmitted infection or if you have any of these warning signs:

  • sudden weight gain of more than two pounds within one day
  • swelling of the face, ankles, legs, or feet
  • severe or repeated headaches that last more than two or three hours and are not relieved with the medication your clinician has recommended
  • fainting
  • blurred vision, flashes of light, or spots before your eyes
  • pain or burning with urination
  • marked increase in thirst
  • greatly increased or decreased urination
  • unusual smelling vaginal discharge
  • light vaginal bleeding or spotting

Call your clinician and/or go to the hospital immediately if you have any of these very dangerous warning signs:

  • Signs Of Premature Labor  Pregnancy takes about 40 weeks. If contractions cause the cervix to open earlier than normal — between the 20th and 37th week — labor may be premature. This may result in the birth of a premature baby. Babies born before the 37th week may have trouble breathing, eating, and keeping warm. The signs of premature labor include one or more of these:
    • uterine contractions every 10 minutes or faster
    • repeating or constant menstrual-like cramps in the lower abdomen
    • abdominal cramps with or without diarrhea
    • pelvic pressure that feels like the fetus is pushing down
    • increase or change in vaginal discharge
    • sudden gush of watery fluids from the vagina (water breaking)
    • feeling like the fetus is "balling up"
  • Signs Of Other Serious Problems
    • heavy bleeding from the vagina
    • constant severe lower abdominal pain or cramps on one or both sides
    • dimness or blurring of vision that lasts two or three hours
    • dizziness and/or double vision
    • severe or continued vomiting
    • chills and/or fever of 101°F or more
    • fever of 101°F or more with pain or burning during urination
    • sudden severe swelling or puffiness of the face, hands, legs, ankles, or feet, especially if you have a headache or vision change
    • after six months of pregnancy, you notice a significant decrease in the movement of the fetus
    • after six months of pregnancy, you think the fetus hasn't moved in eight hours or more

It takes teamwork to have a healthy pregnancy and a healthy baby.  It is important that you and your clinician communicate well and work together. 

It’s your job to try to stay as healthy as you can and learn what is normal for your pregnancy and what is not.  Watch for changes in your body that may signal problems.

Your clinician’s job is to help you understand your pregnancy, identify problems before they become serious, and to provide care when you need it.

Team up with your clinician for good prenatal care and have a healthy baby.