Of all types of physician visits, prenatal care (also known as antenatal care) is one of the most common reasons for a physician visit by women. Almost every study about prenatal care has demonstrated that it improves both foetal and maternal outcomes, especially if the care begins early in the first trimester.
In fact, maternal mortality was reduced when prenatal care began in the first trimester according to one study, meaning that women who sought late prenatal care were more at risk1
So what is it about prenatal care that makes it so crucial to a successful delivery?
What is prenatal care?
Prenatal care is the healthcare you receive while pregnant. It includes a combination of office visits, screening, and diagnostic tests, ultrasounds, counselling, education, emotional and social support, and foetal monitoring (i.e. monitoring foetal growth, heart rate, maternal blood pressure, and screening for signs of premature labour).
What you can expect during your visits
Here's a rundown of everything you may expect during your prenatal appointments:
- 6-12 weeks: Traditional prenatal care begins with an extended office visit with the obstetrician or midwife. A detailed history2 is taken, including a family history of genetic disorders with possible tests3 that include: ultrasound, pelvic exam, blood work, blood pressure, weight and urine screening for proteins and sugar.
- 12-16 weeks: The second appointment is usually a month after your first appointment. The most likely things that will happen during your visit are blood pressure checks, urine screenings, weight recording and any additional tests if needed.
- 18-22 weeks: If an ultrasound is already done, then fundal height (FH) is measured, and foetal heart tones (FHTs) are documented. FH is the distance in centimetres from the pubic bone to the top of the uterus and FHTs are listening and measuring the foetal heart rate with a hand-held device called a Foetal Doppler.
- 22-26 weeks: This appointment is similar to the last with the inclusion of a diabetes screen that can be screened at 26 weeks or more. Your doctor may also check your hands and feet for swelling.
- 26-30 weeks: This appointment is likely similar to the last, with a screening for diabetes if not already done.
- 28-32 weeks: Your visits may start to become more frequent now as you are getting close to delivery. FH and FHTs may be conducted at every visit from here to 34 weeks to check on the baby.
- 32-36 weeks: Cervical checks begin at 36 weeks, to see the baby's position in the womb (vertex, breech, posterior etc.)
- 36-40 weeks: Your appointments may continue to become more frequent, and you'll be seen every week until about the 41st week of your pregnancy. Visits are routine to check health, growth and position of the child with very few additional tests being performed.
Most doctors recommend delivery before 42 weeks. If labour has not spontaneously occurred by 41 weeks, there is a discussion about delivery options and ultrasound may be repeated.
5 Benefits of Prenatal Care
Going to regular appointments means your healthcare provider can spot any problems early, provide treatment and possibly prevent other issues. Here are some ways it can help you and your baby.
1. Learn more about your pregnancy and develop a plan
Your prenatal visit doesn't just confirm your pregnancy, it offers you the chance to discuss different procedures and potential scenarios, and address any questions and concerns with a doctor through your pregnancy. This includes learning and educating5 yourself about labour, delivery and postpartum birth injuries, so that you can make informed decisions for you and your family and react appropriately when a new situation arrives.
2. Reduce the risk of complications and defects
Regular screenings, for problems like gestational diabetes, can help prevent complications by detecting it early and providing the right treatment4. Screening for congenital abnormalities is at 15-19 weeks.
3. Offer appropriate immunisation
Vaccines help protect both you and your baby from easily preventable diseases. During pregnancy, a mother's white blood cells act as the first line of defense for their babies. Getting the right vaccines (e.g. flu shot) allows mothers to pass on the kinds of antibodies their baby needs to fight off infections while in the womb.
4. Get accurate nutritional advice
Your diet will need to go through changes to accommodate for the nutritional needs of your baby. Your doctor will educate you on the recommended dietary intake for the next nine months, including how much to eat, what you should and should not eat.
Nutrition is vital for the proper development of your baby, and we recommend prenatal visits to check on your blood to ensure you're getting an adequate intake or you might be at risk to develop iron-deficient anaemia.
5. Keep track of development
Your child's development inside the womb is a good indicator of their health. During prenatal appointments, your doctor may measure your child to see how your baby is growing. Modern technology, such as ultra-sounds may also be used to verify the development of the child, as well as find out the gender.
Whichever stage of your pregnancy you're in, staying educated about your body and baby's progression is crucial for a healthy pregnancy and delivery. You should show up to your appointments armed with questions for your healthcare professional to answer; many mothers may forget what they wanted to ask, so writing down anything you want to ask is helpful!
1. Villar, J., & Bergsjø, P. (1997). Scientific basis for the content of routine antenatal care. I. Philosophy, recent studies, and power to eliminate or alleviate adverse maternal outcomes. Acta Obstetriciaet Gynecologica Scandinavica, 76, 1–14.
2. NHS. (2018, October). Your first midwife appointment. Retrieved February 02, 2021, from https://www.nhs.uk/pregnancy/finding-out/your-first-midwife-appointment/
3. Family Health Service. (2020, January). Antenatal Blood Investigations. Retrieved February 02, 2021, from https://www.fhs.gov.hk/english/health_info/woman/14745.html
4. U.S. Preventive Services Task Force. (2008). Screening for asymptomatic bacteriuria in adults: U.S. Preventive Services Task Force reaffirmation recommendation statement. Annals of Internal Medicine, 149, 43–47.
5. GovHK: Pregnancy. Retrieved February 02, 2021, from https://www.gov.hk/en/residents/health/sexedu/pregnancy.htm