Prenatal care: more than a visit to the doctor

Pregnancy is an exciting and somewhat stressful period of time for an expecting mother and her partner....

Pregnancy is an exciting and somewhat stressful period of time for an expecting mother and her partner. The health of mother and child is of paramount importance to parents, but they may not be familiar with medical options available. Prenatal care, also known as antenatal or antepartum care, is healthcare that a mother and child receive throughout the pregnancy. Such medical attention allows doctors to evaluate mothers for certain ailments that may pass from mother to child, develop nutritional plans and conduct tests to identify defects affecting the unborn baby. Knowing what doctors to consult and the nature of antenatal care may alleviate some stress by giving parents piece of mind.

Pregnant women may receive care from several types of medical practitioners: obstetricians, gynecologists, general practitioners and certified midwives. Obstetricians focus exclusively on pregnancies, labor and delivery. Gynecologists are doctors specializing in women's healthcare. General practitioners treat patients of all genders and ages and may have specialized training in obstetrical care. Nurse midwives are capable of providing antepartum care, childbirth and postpartum care.

First trimester care

Obstetrician care usually begins during the first six to eight weeks of pregnancy. Throughout the pregnancy, healthcare providers conduct screening and, if necessary, diagnostic tests. Screening tests determine the likelihood of a child developing certain medical conditions through the administration of blood tests and ultrasounds; these tests are considered safe for mother and child. If an unborn child is found to be at risk for a genetic condition or ailment, diagnostic tests may be performed in order to confirm the diagnosis. These tests are invasive because they require blood and tissue samples; consequently, there is a risk of miscarriage.

The first visit is very thorough. Physicians ask questions that influence the medical care the mother will receive throughout her pregnancy. Typical questions include

  • Date of last menstrual cycle
  • Birth control usage
  • Personal and family medical history
  • List of current medications
  • Previous pregnancies
  • Alcohol consumption
  • Smoking habits

Blood tests are performed for several reasons during the first visit. First, checking a mother's blood type allows doctors to determine her Rhesus (Rh) status. Rh is a genetic trait passed down from parents to child that is related to a protein found on red blood cells; if a mother is Rh negative and the father is Rh positive, special precautions may be necessary. Blood tests also measure the levels of hemoglobin in red blood cells. Hemoglobin facilitates the passage of oxygen from lungs to other parts of the body and exhalation of carbon dioxide; low levels of hemoglobin indicate a paucity of healthy red blood cells.

Doctors also need to ensure that a mother is immune or vaccinated from certain infections like chicken pox. Blood tests also detect the current presence of infections like hepatitis B and sexually transmitted diseases. Care providers may also request a urine sample and perform a Pap smear. Pap smears screen for cervical cancer.

Although such visits may seem invasive, they exist for good reason. According to the March of Dimes, 13.8 percent of infants in Georgia are born premature; the most common risk factors include a previous history of premature births, the presence of multiple fetuses and certain cervical conditions. 9.4 percent of Georgia babies have low birth weights; causes for such conditions include multiple fetuses, smoking, malnutrition and mothers of advanced ages.

Second trimester care

After the first three months, mothers-to-be should see prenatal care providers once a month. These visits are frequent and designed to monitor the mother's health and baby's growth. Care providers weigh mothers and record their blood pressure. Doctors ensure that a baby is growing properly by measuring the mother's abdomen from the top of her uterus to her pubic bone in centimeters; this measurement should equate to the number of weeks the mother has been pregnant. Expecting mothers should also be able to hear their baby's heartbeat through a Doppler machine or stethoscope; mothers should also begin to notice the baby moving.

Screenings for spina-bifida and Down syndrome also takes place in the second trimester. This is accomplished by measuring the level of alpha-fetoprotein in the mother's blood. This protein is produced by the fetus. If a mother carrying one child has a high level of alpha-fetoprotein, the child may have spina bifida, a condition that occurs when the backbone and spinal canal do not close. Low levels of alpha-fetoprotein indicate chromosomal disorders like Down syndrome.

Third trimester care

The check-ups performed in the second trimester continue into the third trimester. Since it is late in the pregnancy, doctors perform screenings designed to facilitate childbirth. The most common is related to the baby's positioning. Health care providers feel for your baby's head in your lower abdomen in relation to the birth canal. If the baby is positioned feet first, gentle pressure may be applied to turn the baby around; otherwise a Caesarian section may be required during childbirth.

Finding the right doctor

Expecting mothers in the metro-Atlanta area should choose a doctor that is competent and accessible. Pregnant women can ensure that their physician is allowed to practice in Georgia by visiting the "Look Up a Licensed Provider" on the Georgia Composite Medical Board website. Prospective healthcare providers should be willing to have an initial consultation allowing expecting mothers to ask questions about their medical background, facility and intended course of action for providing medical care throughout the pregnancy.

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