What Is Prenatal Care?
Robin Elise Weiss, Ph.D. | Sep 25th 2017 Sep 25th 2017
Prenatal care is a term that refers to the ongoing medical care a woman receives while pregnant. During prenatal care visits, the medical care and education a woman receives will vary greatly depending on her health, the health of her baby, and the philosophy of the practitioner. Here we’ll look at the basics of prenatal care.
The information you provide to your doctor or midwife about your health prior to getting pregnant, the health of the baby’s father, and family history helps to paint a picture of the things you and your practitioner will want to watch for in pregnancy. Your health history can set the tone for the full 40 weeks of pregnancy. This information can help you and your doctor predict potential issues that may arise. For these reasons, it is important to have an honest and exhaustive conversation.
At every prenatal visit, you will be asked to provide a urine sample. This sample helps your practitioner get information about the health of your pregnancy. Typically, they look at things like sugar and protein levels. Other tests may be run on the sample as well, particularly earlier in pregnancy as you establish care, or to screen for infections and other problems.
Your blood pressure will be taken at every visit as well. Taking your blood pressure in the early part of pregnancy will establish what is known as your baseline blood pressure. Most women will see a rise in their blood pressure as the end of pregnancy nears, and your practitioner will monitor it as it compares with the earlier readings. Taking your blood pressure is important during pregnancy because it helps screen for a serious diseases involving blood pressure in pregnancy, such as preeclampsia.
Weight gain or loss
You will be asked to weigh yourself at each prenatal visit. Your midwife or doctor will be looking at the weight loss or gain. While it is not an exact science, sudden gains in weight may be indicative of certain diseases. Weight loss in certain parts of pregnancy may also indicate a problem. For example, a sudden weight loss late in the first trimester may indicate hyperemesis gravidarum (severe morning sickness).
Once the baby is big enough, usually after the 20th week, your practitioner will measure their growth by taking a tape measure to your abdomen and measuring from the top of your pubic bone to the top of the uterus (fundus). At this point, the measurement in centimeters should be within a week or two of how many weeks you are in pregnancy. For example, at 30 weeks, you would measure between 28 and 32 centimeters. Measurements outside of that may require an ultrasound to check in on your baby.
Fetal heart rate
Your baby’s heart starts to beat early on in pregnancy, before it can be heard with a traditional Doppler. Usually your doctor or midwife will begin looking for the heartbeat after about 8 weeks. The biggest indicator of health is hearing the heartbeat. Once they find it, they will listen and record the heart rate in your chart. While the baby’s heart rate is usually faster than an adult’s, there are also variations your practitioner is looking for to indicate problems.
A baby begins moving in the first trimester. Most women will not feel their babies move until the end of the second trimester. Your practitioner will ask at each visit if you’re feeling the baby move. They may ask you to talk about what you’re feeling, when you’re feeling it, where you’re feeling it, and how often. This can help them figure out the baby’s position and give information about general well-being.
Genetic testing was once offered only to mothers at high risk of problems. Now that we have screening tests that pose no physical risk to the baby, you may have testing offered to you no matter your risk. Testing is usually offered at the end of the first trimester and into the early second trimester. Most tests are done with blood work. The follow-up tests to a problematic result would be a more definitive amniocentesis or chorionic villus sampling (CVS).
Prenatal visits are also a time to learn. Your visit is a chance for you to ask questions and gather information specific to your pregnancy. You are probably taking classes and reading about pregnancy. As you learn, form questions about how this material relates to you and your pregnancy. Topics you might have questions about include sex in pregnancy, nutrition, fetal development, exercise, and more. You can usually also call in between visits to leave questions for your practitioner.
The entire pregnancy is spent gearing up for labor and birth. Asking questions about how that experience might look, finding the right team members, and choosing a place of birth are all part of the preparation. Your midwife or doctor can help you by answering questions that bring the focus on you and your baby, within the context of your personal goals and hopes for the labor. Your practitioner can also help you find resources like classes, birth place tours, and doulas.