What is Prenatal Care?

Prenatal care is very important during your pregnancy. Ideally, prenatal care should start when you plan your pregnancy – if you are healthy before your pregnancy, you are most likely to be a guaranteed a healthy baby. During this transitional period, the mother-to-be experiences many physical, emotional and spiritual changes and it is essential that extra attention be given to her physical health and emotional health.

The primary objectives of prenatal care include:

• Early and regular prenatal care to monitor both mother and baby throughout the pregnancy. Keep regular appointments with your physician or obstetrician so that any health complications will be spotted early.
• Follow dietary and nutritional requirements throughout the pregnancy period
• Follow physicians advice and ask questions that may bother or confuse you
• Learn to connect emotionally with the unborn baby
• Educate yourself by reading books on conception, pregnancy, birth, nutrition, baby care and women’s care

Pregnant women will need to choose a healthcare provider that will be able to provide prenatal care, delivery and postpartum services. These healthcare providers include obstetricians/gynecologists, family physician, or certified midwives who are all specialists in pregnancy and childbirth.

Your first prenatal visit is usually to confirm pregnancy – when your menstrual period is between two and four weeks late. Consulting your physician during the first six to eight weeks of pregnancy is generally advised. The physician will enquire about the symptoms that you are experiencing, your medical history (operations, diseases or previous pregnancies) and family’s health history. A complete physical exam including pelvic exam with pap test is performed.

Blood tests are ordered to check for a complete blood cell count (CBC), blood typing and screening for Rh antibodies, for sexually transmitted diseases (STDs) such as syphilis, hepatitis gonorrhea, and chlamydia as well HIV (human immunodeficiency virus). Blood samples are also taken to check whether you have been immunized for chickenpox (varicella), measles (rubeola), mumps or German measles (rubella). Urine tests will also be ordered as well as your blood pressure, height and weight checked. Your physician will also be able to figure out the baby’s due date. During this visit, you will also be informed about the importance of nutrition and diet as well as other pregnancy do’s and don’ts. Ask your physician as many questions as possible.

Follow-up prenatal visits usually occur:

• Every four weeks until 28th week of pregnancy
• Every two weeks until 36 weeks
• Every week until the baby is born

These visits will include checking the baby’s heart rate, your blood pressure, urine samples for symptoms of diabetes and measuring your weight. Certain tests may also be performed and these include:

• Amniocentesis (amnio) to check for any fetal abnormalities such as Down syndrome or spina bifida. This test is usually performed during 15 and 20 weeks of pregnancy and is recommended if you are 35 years and older, have a family history of these conditions or an abnormal AFP.
• Chorionic villus sampling (CVS) is performed for the same reasons as the amniocentesis – to check for abnormalities of the fetus during the first trimester. Women can choose to have either this test or the amnio performed.
• Ultrasound (sonogram, sonograph, echogram or ultrasonogram) to check whether the pregnancy is progressing normally and confirm the delivery date. This examination is usually performed at 18 to 20 weeks.

If you are over 35 years or experiencing preexisting health problems such as high blood pressure or diabetes, your health may need to be monitored more frequently by your physician.

Help for Prenatal Care

Natural remedies

Natural remedies can also help you to maintain a balanced emotional state throughout your pregnancy, especially when you may be feeling apprehensive, overwhelmed or fearful. Flower essences are gentle and safe to use during pregnancy without any harmful side effects. Flower essences such as Maidenhair Fern, Peach, Bell Gardenia and Chestnut helps to quiet the mind, promote mental clarity and restore zest and energy.

A new landmark study suggests that pregnant women should ask for a prenatal vitamin supplement that contains natural vitamin E. According to this new research, the human placenta can deliver natural vitamin E to the fetus in much greater concentration (3.5 to one) than the synthetic supplement. Vitamin E helps protect the newborn from oxidative stress. Premature babies are usually low in vitamin E.

Natural and synthetic vitamin E are not the same. Previous research has shown that natural vitamin E is better retained and more biologically active than synthetic. To identify the kind of vitamin E in a supplement, it is necessary to read the ingredients listed on the label. Natural vitamin E begins with “d,” as in “d-alpha-tocopherol.” The synthetic version begins with “dl” as in “dl-alpha-tocopherol.”

In this study, published in the March 1998 AMERICAN JOURNAL OF CLINICAL NUTRITION, researchers gave 15 mothers different amounts of vitamin E in a capsule that contained both the natural and synthetic forms of the vitamin five days before giving birth. The dosage given ranged from 15 to 300 international units. At delivery, the researchers found nearly twice the concentration of the natural vitamin E in the mothers’ blood and nearly 3.5 times the amount of natural vitamin E in their placental cords than the synthetic vitamin E, regardless of the amount given. A previous study of men and non-pregnant women showed that natural vitamin E remained in organ tissues much longer than synthetic vitamin E.

“Pregnant women, or women thinking about getting pregnant, should ask their physicians to prescribe a prenatal supplement with the natural form of vitamin E,” the researcher said. “It might be harder to find and the physician might not understand the difference, but based on our study, it’s well worth the extra effort for the well-being of their babies.”

Prenatal Folic Acid

Surely everyone has heard of the importance of folic acid for pregnant women. However, researchers at the University of Maryland have noticed that many commonly prescribed prenatal vitamins do not dissolve well resulting in insufficient absorption of this nutrient. Of the preparations tested, two- thirds released less than 75 percent of the amount listed on the label. Steven Hoag, the author of the study, cautioned that these supplements may provide “inadequate” nutrition.

Breastfeeding

A study published in THE LANCET (July 19, 1997) concludes that breastfeeding may help protect children from developing diabetes later in life. The study was done on 720 Pima Indians, who for some reason are prone to diabetes. The paper indicates that non- insulin-dependant diabetes (Type II) was significantly lower among adults who had been breastfed for at least two months as babies.

A UNICEF report (July 23, 1997) reveals that Thai babies are the least likely in Asia to be breastfed. Only four percent of Thai babies are breastfed, compared to about 44 percent in other developing countries. The report blames this sad state of affairs in Thailand on aggressive marketing by infant formula manufacturers. UNICEF stated that replacing infant formula with mother’s milk could save 1.5 million lives a year.

There are several things that you can do to take care of yourself before and throughout your pregnancy. Making certain lifestyle changes can ensure a healthy pregnancy.

Pre-pregnancy

• Eat a healthy, well balanced diet that contains plenty of fruits, vegetables, whole grains, protein and calcium-rich foods (milk or yoghurt)
• Limit your intake of salty, sugary or fatty foods
• Avoid eating unpasteurized dairy products, soft cheeses (brie or camembert), blue cheeses (roquefort or stilton), raw or soft-cooked eggs, swordfish, marlin or shark and liver
• Maintain a healthy weight, if you or your partner are underweight or overweight with a BMI less than 18.5 or over 25, you may have trouble conceiving
• Exercise regularly for at least 30 minutes per day most days of the week
• Ensure that you take 400 micrograms (0.4mg) of folic acid as part of your daily multivitamin to prevent certain birth defects
• Visit your doctor for a complete medical check up – if you have any existing medical and chronic conditions such as asthma, diabetes or epilepsy, consult your doctor as to how they may affect your ability to conceive. You should also check whether you have been immunized for rubella, chicken pox as well as HIV testing.
• Consult a genetic counselor if you have any inherited conditions such as Down’s syndrome or muscular dystrophy on either side of your families
• Learn to relax, as trying to get pregnant can be quite stressful – practice meditating, yoga or any physical activity, listen to soothing music or write your thoughts in a journal
• Check with your doctor or pharmacy if you taking any prescription or over-the-counter medication about how they may affect fertility
• Both you and your partner should stop smoking, drinking alcohol or taking drugs if you have decided to start a family
• Avoid using hot tubs, saunas, x-rays, chemicals or lead, as they impact fertility

During pregnancy:

• Eat a healthy, well balanced diet that contains plenty of fruits, vegetables, whole grains, protein and calcium-rich foods (milk or yogurt)
• Reduce your caffeine intake to two servings per day
• Do not raw or undercooked meat and fish such as sushi
• Exercise regularly for at least 30 minutes per day most days of the week
• Ensure that you take 400 micrograms (0.4mg) of folic acid as part of your daily multivitamin to prevent certain birth defects
• Choose a maternity caregiver and birth-setting that suits your needs
• Get regular prenatal care during the first trimester, second trimester and third trimester
• Have good oral health during pregnancy as it can affect the development of the fetus
• Get plenty of rest
• Stay informed by reading pregnancy books, watching videos and talking to other mothers
• Attend a childbirth class with your partner
• Both you and your partner should stop smoking, drinking alcohol or taking drugs if you have decided to start a family
• Avoid cat litter or working in areas used by cats because you may develop an infection called toxoplasmosis (caused by a parasite found in cat feces)
• Avoid using chemicals such as pesticides, herbicides, paint or detergents

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