Saturday, 25 November 2017

Medical Care During Pregnancy

 

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Prenatal Care

The Importance of Prenatal Care

Vitamin regimens, doctor’s visits, and self-care, oh my! Some women regard prenatal care as a nuisance, but it’s one of the most beneficial ways you can keep yourself and your baby healthy during pregnancy. Poor prenatal care can affect mood and energy levels at its best and cause serious health problems or death at its worst. Here’s what you need to know:

What’s Prenatal Care? 

Prenatal care includes all preventative health measures taken before giving birth. This often includes taking recommended prenatal vitamins, going to monthly checkups, receiving routine screenings, and attending classes. Your doctor can effectively address numerous conditions early on if you adhere to his or her recommendations. Women who do not receive prenatal care during pregnancy put themselves and their babies at serious risk.
Undiagnosed preeclampsia can lead to the deaths of mothers and fetuses if not addressed. Failing to take proper vitamins, such as folic acid, can increase the risk of infant neural defects. Only a licensed physician can identify risk factors and symptoms and provide you with an effective plan for prenatal care.

When Should I Start Prenatal Care? 

Ideally, every woman would begin prenatal care before she finds out she’s pregnant. Before pregnancy, a physician can help a woman and her partner identify risk factors and make necessary lifestyle changes before they conceive (i.e., ceasing alcohol, cigarette, and drug use). After pregnancy, a physician may recommend a particular daily health regimen and schedule intermittent visits for testing and check-ups. Each pregnancy is different, which is why reaching out to a health care professional is so important. Every woman has unique body chemistry and may need special care during pregnancy.
If you have not reached out to a physician for prenatal care early in your pregnancy, go as soon as possible. While earlier is better, it’s never too late to start protecting yourself and your child with preventative care. You also need prenatal care for each child you carry. Don’t assume that your second or third pregnancy will be the same as your first.

Basic Prenatal Health 

For otherwise healthy women, your doctor will suggest taking a prenatal vitamin with folic acid (at least 400 micrograms) every day. You may need to stop taking certain medications or change your medication regimen. Get a flu shot, and always tell every health care provider, including your pharmacist, that you’re pregnant.
If you’re pregnant or thinking of conceiving, reach out to our team to schedule a prenatal appointment.

Why is Prenatal Care Important?


Why is Prenatal Care Important?

Early and regular prenatal care is very important to the health of your baby and to your own health during pregnancy. If problems do arise, regular visits to your doctor can allow him or her to identify and treat complications as soon as possible. Studies also show that compared with babies whose mothers get prenatal care, those whose mothers don’t have a greater risk of low birth weight and of death.

What Happens Throughout Each Trimester?

Each trimester, or three-month period, of pregnancy is marked by different phases of development for the fetus and changes to the mother’s body. Regular visits to the doctor remain important throughout each trimester. Appropriate exams and tests will be performed as pregnancy progresses.
First Trimester
During the first trimester (the first 12 weeks after the first day of the last menstrual period), an egg is released by the mother’s body and is fertilized by a sperm. The fertilized egg then travels down the fallopian tube toward the uterus, where it implants (attaches) to the lining of the uterus. The fertilized egg is now considered an embryo and will grow in size and develop throughout the first trimester. By the end of the third month, the embryo is called a fetus.
During this time, the mother’s breasts will start to change, but she is not likely to look pregnant. She may also begin to experience dizziness, frequent urination, heartburn, food aversions and cravings, and morning sickness. Hormonal changes may also cause irritability and mood swings.
Second Trimester
At the beginning of the fourth month of pregnancy, when the second trimester begins, the baby is about 4 inches long and weighs just over an ounce. Some mothers begin to feel the baby move at this time. As the second trimester continues, the baby begins to grow muscle and hair and becomes more active. Toward the end of this trimester, the baby’s skin is covered with fine hair, called lanugo, and a waxy substance that protects the skin, called vernix. Brain development continues. He or she will be around 11 to 14 inches long by the end of the sixth month and weigh about 1 to 1.5 pounds.
Pregnant women may find that some of the discomforts of the first semester will ease during the second and that other discomforts will increase. Second-trimester discomforts can include skin changes, forgetfulness, swelling, backaches, nosebleeds, heartburn, constipation, and hemorrhoids. Pregnancy starts to show as the baby grows, and many women start to wear maternity clothes.
Third Trimester
The third trimester begins with the seventh month of pregnancy. The baby can open and close his or her eyes, continues to move, and can suck his or her thumb and make grasping motions. The baby continues to grow and gain weight throughout the third trimester. By the ninth month, the baby drops into a head-down position to be ready for birth. He or she now weighs between 6 and 9 pounds and is about 20 inches long.
For the mother, symptoms of the second trimester are likely to increase during the third, and she may have swelling in the legs, leg cramps, backaches, and shortness of breath and develop varicose veins.

What Happens During Childbirth?

When you arrive at the hospital to have your baby, be prepared to give your healthcare providers the following information about your labor so far:
  • The date and time contractions began and their average duration and frequency
  • The date, time, color, and amount of vaginal discharge
  • The date, time, and color of fluid if your water has broken
  • When you last ate, had a bowel movement, and if you’ve had diarrhea
You’ll typically be given an exam that will include taking your temperature, pulse, breathing rate, blood pressure, and possible other tests.
Labor and Delivery
There are four stages of labor, which include: 1) from onset of progressive contractions until the cervix is completely dilated; 2) from complete dilation to birth of the baby; 3) from birth of the baby to delivery of the placenta; 4) from delivery of the placenta to when the mother’s medical condition is stable and safe. Labor is different for every mother and can vary in length and difficulty.
Labor can also be induced if your doctor determines that it’s time for your baby to born but true labor hasn’t started. Medication is used to induce labor.

What Is an Epidural?

An epidural is a type of anesthesia that’s used to relieve pain during labor. An anesthesiologist administers an epidural as follows: A local anesthetic is injected into a small area of the back to numb it. A catheter is then inserted into the numbed area. As needed during labor, anesthesia is injected through the catheter.
By relieving pain, an epidural allows the mother to rest and focus on the birth instead of the pain. Other advantages of an epidural include little exposure to the medicine for the baby and no drowsiness for the mother, as with some other pain relievers.
Although research has widely proven that use of an epidural during childbirth is generally safe, there are several risks:
  • The risk for a sudden drop in blood pressure: A mother’s blood pressure is monitored for this event so that it can be addressed immediately.
  • The risk for severe headache caused by leakage of spinal fluid: This occurs in less than 1 percent of women.
  • Possible side effects: These including shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating.
  • Difficulty pushing: Forceps may be needed to help pull the baby through the birth canal.
  • Numbness in the lower half of your body: The mother may require assistance walking after the birth.

Having a Healthy Pregnancy

In addition to seeing your doctor regularly during pregnancy, these general tips will help keep you and your fetus healthy:
  • Avoid X-rays. If you must have diagnostic tests, including dental X-rays, tell your doctor or dentist that you are pregnant. Precautions can be taken.
  • Get a flu shot. Flu may be more severe in pregnant women and require hospitalization.
  • Ask your doctor whether you should take a daily prenatal vitamin.
  • Don’t smoke, drink alcohol, or use drugs.
  • Gain a healthy amount of weight—your doctor will help you determine how much you should be gaining.
  • Unless your doctor has told you to avoid physical activity, stay active. If you’ve always been active, talk with your doctor about what level of activity you can maintain. A minimum recommendation is two-and-a-half hours per week of moderate-intensity activity, spread out throughout the week.
  • Avoid hot baths and hot tubs.
  • Manage stress levels and get plenty of sleep.
  • Learn about childbirth and caring for a newborn—books, classes, videos, your doctor, and other mothers can all be excellent resources.
Nutrition Tips
  • Eat healthy foods, including plenty of fruits and vegetables and foods that are rich in calcium.
  • Drink plenty of fluids—mostly water.
  • Get adequate nutrients from a variety of healthy foods. Iron is particularly important—it prevents anemia, which puts your fetus at risk for preterm birth and low birth weight.
  • Don’t eat fish that tend to be high in mercury. These include swordfish, king mackerel, shark, and tilefish.
  • Protect yourself from food-borne illnesses: wash fruits and vegetables thoroughly and don’t eat undercooked meat or fish.
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A pregnant woman smiling and talking to a doctor.

What is prenatal care and why is it important?

Having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular prenatal care improves the chances of a healthy pregnancy. This care can begin even before pregnancy with a preconception care visit to a health care provider.

Citations

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  1. Centers for Disease Control and Prevention. (2015). Preconception health and health care. Retrieved May 20, 2016, from http://www.cdc.gov/preconception/planning.html [top]
  2. U.S. Preventive Services Task Force (2017). Final recommendation statement: Folic acid for the prevention of neural tube defects: Preventive medication. Retrieved January 17, 2017, fromhttps://www.uspreventiveservicestaskforce.org/Page/Document/
    RecommendationStatementFinal/folic-acid-for-the-prevention-of-neural-tube-defects-preventive-medication
     External Web Site Policy [top]
  3. March of Dimes. (2011). Your first prenatal care checkup. Retrieved May 20, 2016, from http://www.marchofdimes.org/pregnancy/your-first-prenatal-care-checkup.aspx External Web Site Policy [top]
  4. Child Trends Databank. (2015). Late or no prenatal care. Retrieved May 20, 2016, from http://www.childtrends.org/?indicators=late-or-no-prenatal-care External Web Site Policy [top]
  5. American College of Obstetricians and Gynecologists. (2014). Preeclampsia and high blood pressure during pregnancy. FAQ034. Retrieved May 20, 2016, from http://www.acog.org/Patients/FAQs/Preeclampsia-and-High-Blood-Pressure-During-Pregnancy External Web Site Policy [top]
  6. American College of Obstetricians and Gynecologists. (2013). Tobacco, alcohol, drugs, and pregnancy. FAQ170. Retrieved May 20, 2016, from http://www.acog.org/Patients/FAQs/Tobacco-Alcohol-Drugs-and-Pregnancy External Web Site Policy [top]
  7. Centers for Disease Control and Prevention. (2011). Fetal alcohol spectrum disorders. Retrieved August 1, 2012, from http://www.cdc.gov/Features/FASD [top]
  8. Eckstrand, K. L., Ding, Z., Dodge, N. C., Cowan, R. L., Jacobson, J. L., Jacobson, S. W., et al. (2012). Persistent dose-dependent changes in brain structure in young adults with low-to-moderate alcohol exposure in utero. Alcoholism: Clinical and Experimental Research, 36(11), 1892–1902. PMID: 22594302 [top]
  9. Centers for Disease Control and Prevention. (2016). Folic acid. Data and statistics. Retrieved December 12, 2016, from https://www.cdc.gov/ncbddd/folicacid/data.html [top]
  10. NIH Office of Dietary Supplements. (2016). Folate.Dietary supplement fact sheet. Retrieved May 20, 2016, from http://ods.od.nih.gov/factsheets/Folate-HealthProfessional  [top]
  11. American Pregnancy Association. (2015). Acne during pregnancy. Retrieved May 20, 2016, from http://americanpregnancy.org/pregnancy-health/acne-during-pregnancy/ External Web Site Policy [top]
  12. Office on Women’s Health. (2012). Prenatal care fact sheet. Retrieved May 20, 2016, from http://www.womenshealth.gov/publications/our-publications/fact-sheet/prenatal-care.html [top]

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How do I know if I’m pregnant?
What is prenatal care and why is it important?
What are some common complications of pregnancy?
What is a high-risk pregnancy?
What infections can affect pregnancy?
What is labor?
What is a cesarean delivery?
What should I know about postpartum depression?