Why do I need pregnancy care?
When a woman gets pregnant, chances are she has a number of
questions regarding her health from the moment she finds out she has
conceived. When a woman is pregnant it is important that she is
taking care of her body to the best of her ability to create the best
possible environment for her baby.
Pregnancy care can help
keep you and your baby healthy. Babies of mothers who do not get
pregnancy care are three times more likely to have a low birth weight
and five times more likely to die than those born to mothers who do
get care.
Doctors can spot health problems early when they see mothers
regularly. This allows doctors to treat them early. Early treatment
can cure many problems and prevent others. Doctors also can talk to
pregnant women about things they can do to give their unborn babies a
healthy start to life.
What is pregnancy care?
Pregnancy care is the care you receive from a health care
provider, such as a doctor or midwife, during pregnancy. During
pregnancy care visits, your health care provider will make sure you
and the developing fetus are healthy and strong. These regular
checkups are your chance to learn how to manage the discomforts of
pregnancy, have any testing you may need, learn warning signs, and
ask any questions you may have.
It's best to begin before you are pregnant - this is
sometimes called pre-pregnancy health or preconception planning. But
if that is not possible, begin pregnancy care as soon as you know
you're pregnant.
What will happen during my first pregnancy care visit?
The first pregnancy
care visit is usually the longest. The examination is very
thorough. You will be asked questions about your medical history. You
will also be asked about your partner's medical history and your
family's medical history. You will have a complete physical exam.
Your health care provider will measure your height, weight, blood
pressure, breathing, and pulse.
Usually, you will be given a gynecological exam that will include:
You may be offered blood or skin tests to check for:
Some pregnancy care doctors will also do an overall physical
health check involving listening to your heart and lungs, feeling the
front of your throat to see if your thyroid
gland is enlarged, checking your breasts for lumps and looking at
your legs to check for varicose veins.
You may also be given urine tests to check for diabetes or other
infections.
Tell your doctor or nurse if you traveled to a country with Zika
or think your partner has Zika.
They may test you for Zika and check to see if the baby has it, too.
Your health care provider may take this opportunity to discuss
your lifestyle and habits and to suggest certain changes that may
help make the pregnancy healthy. One of the most important things a
woman can do is to take folic
acid — a B
vitamin — every day to prevent serious birth defects.
You
may have an earlier ultrasound
if you experienced bleeding during early pregnancy, or your pregnancy
may need to be 'dated', if you are unsure about when your last period
was (or you didn't have a last period to speak of). Sometimes an
early ultrasound is done as a genetic test, known as a nuchal
translucency scan. Some pregnancy care doctors purchase ultrasound
machines to perform 'informal' ultrasounds at every pregnancy visit
in their private rooms (however, this is not essential and you can
decline having this done if you prefer). Generally, the ultrasound
your pregnancy care doctor does can only provide a limited amount of
information. You would need to have an ultrasound performed by a
qualified technician and reported on by a qualified ultrasonographer,
to definitely confirm your pregnancy care doctor's ultrasound
findings.
Genetic
testing may be offered to you (or you may request it) to screen
for inherited abnormalities in your baby. There are many options to
consider, with these tests usually being organised after a
consultation with a genetic counsellor. This is covered in more
detail in genetic testing and early ultrasound.
The main aims of the first pregnancy visit are for your pregnancy
care doctor to obtain detailed information about your health, medical
and pregnancy history as well as provide you with information about
various aspects of the pregnancy and your care and perform (or order)
some routine pregnancy tests.
How often will I have pregnancy care visits?
If you are 18 to 35 years old and
healthy, you will probably have a "low-risk" pregnancy. If
so, plan to have pregnancy care visits about
- every four or six weeks, from the
first to seventh month of pregnancy (the first 28 weeks)
- every two or three weeks in the
eighth month (from week 28 to 36)
- every week in the ninth month
(from week 36 until delivery)
If you have a high-risk pregnancy, your
health care provider may ask you to come in for pregnancy care more
often.
Specific factors that might contribute
to a high-risk pregnancy include:
- Advanced
maternal age. Pregnancy risks are higher for mothers age 35 and
older.
- Lifestyle choices. Smoking
cigarettes, drinking alcohol and using illegal drugs can put a
pregnancy at risk.
- Medical history. A prior
C-section,
low birth weight baby or preterm birth - birth before 37 weeks of
pregnancy - might increase the risk in subsequent pregnancies.
Other risk factors include a family history of genetic conditions, a
history of pregnancy loss or the death of a baby shortly after
birth.
- Underlying conditions. Chronic
conditions - such as diabetes, high blood pressure and
epilepsy -
increase pregnancy risks. A blood
condition, such as anemia, an infection or an underlying mental
health condition also can increase pregnancy risks.
- Pregnancy complications. Various
complications that develop during pregnancy pose risks, such as
problems with the uterus, cervix or placenta.
Other concerns might include too much amniotic fluid
(polyhydramnios) or low amniotic fluid (oligohydramnios),
restricted fetal growth, or Rh (rhesus)
sensitization - a potentially serious condition that can occur
when your blood group is Rh negative and your baby's blood group is
Rh positive.
- Multiple pregnancy. Pregnancy
risks are higher for women carrying twins or higher order multiples.
What will happen during my follow-up pregnancy
care visits?
Your health care provider will check
that your pregnancy is progressing well. During pregnancy care visits
your provider may
- test your urine
- check your blood pressure
- check your weight
- check for swelling in the face,
hands, or feet
- examine your abdomen to check the
position of the fetus
- measure the growth of your uterus
- listen for the sounds of the fetal
heartbeat
- offer pregnancy testing
Each visit is also an opportunity to
discuss any questions or concerns that have come up since your last
visit.
What is pregnancy testing?
Your health care provider may offer you
certain tests during your pregnancy. These tests are used to make
sure that you are healthy and the fetus is doing well. Some tests
identify possible birth defects.
The different tests are done at certain
times. Your health care provider will let you know what tests you may
want or need, and when you will need them.
Some common pregnancy tests for birth
defects and other abnormalities include
Another common test is the biophysical
profile (BPP). It is most commonly given during the third trimester.
The BPP uses ultrasound combined with a fetal monitor to observe
fetal heartbeat and movement. BPP allows your health care provider to
evaluate the well-being of the fetus.
What is an ultrasound?
Ultrasound allows a health care
provider to take pictures of the embryo or fetus as it develops. An
ultrasound scan builds a picture of the embryo or fetus on a screen
by bouncing sound waves into your uterus. Ultrasound is also called a
sonogram. Depending on when it is done during pregnancy, it may
- confirm your due date
- find certain abnormalities
- find multiple pregnancies
- measure the length of your cervix
- show the position and size of the
fetus
- show the position of the placenta
Ultrasound is a very safe procedure -
no x-rays are involved.
Between 11 and 13 weeks of pregnancy,
some providers combine a blood test with a special kind of
ultrasound. Some providers refer to this as the combined test. It is
used to screen for Down syndrome and other genetic birth defects.
How ultrasound is done?
There are two ways to do an ultrasound - through the abdomen or through the vagina. Ultrasounds may be
performed by your health care provider or by a trained ultrasound
technician.
During an abdominal ultrasound, your
provider will place the ultrasound wand on your abdomen, using a
small amount of gel to help lubricate the area. You may feel pressure
during the exam, but it is not painful.
During a vaginal ultrasound, your
provider will insert the ultrasound wand into the vagina. This may
feel similar to a vaginal exam. You may feel pressure during the
exam, but it is not painful.
What changes can I expect during pregnancy?
There are many changes that occur
during pregnancy. Your body will go through a lot of hormonal
changes. Your uterus will grow up to 18 times larger than it normally
is. Your breasts and nipples will become larger. And you will gain
weight.
You may have increased and decreased
sexual desire. You may have changes in the texture of your hair and
in the amount of body hair you have. And you may experience other
discomforts and changes that are new to you. You can discuss these
changes at your pregnancy care visits.
Common discomforts during pregnancy
include
nausea or vomiting
Nosebleeds
and nasal stuffiness are common during pregnancy. They are caused
by the increased amount of blood in your body and hormones acting
on the tissues of your nose. The hormones that seem to have the
most to do with this process include the pregnancy hormone human
chorionic gonadotropin (hCG), estrogen,
and progesterone.
Abnormal levels of thyroid
hormones have also been reported in women with severe vomiting,
indigestion and heartburn
Hormones and the pressure of the
growing uterus cause indigestion and heartburn. Pregnancy hormones
slow down the muscles of the digestive tract. So food tends to move
more slowly and digestion is sluggish. This causes many pregnant
women to feel bloated. Hormones also relax the valve that separates
the esophagus from the stomach. This allows food and acids to come
back up from the stomach to the esophagus.
The food and acid causes the burning feeling of heartburn. As your
baby gets bigger, the uterus pushes on the stomach making heartburn
more common in later pregnancy.
constipation
Many pregnant women complain of
constipation. Signs of constipation include having hard, dry
stools; fewer than three bowel movements per week; and painful
bowel movements. Higher levels of hormones
due to pregnancy slow down digestion and relax muscles in the
bowels leaving many women constipated. Plus, the pressure of the
expanding uterus on the bowels can contribute to constipation.
aches and pains in the abdomen and
lower back
As your uterus
expands, you may feel aches and pains in the back, abdomen, groin
area, and thighs. Many women also have backaches and aching near
the pelvic bone due the pressure of the baby's head, increased
weight, and loosening joints. Some pregnant women complain of pain
that runs from the lower back, down the back of one leg, to the
knee or foot. This is called sciatica
(SYE-AT-ick-uh). It is thought to occur when the uterus puts
pressure on the sciatic nerve.
tiredness
During your pregnancy, you might
feel tired even after you've had a lot of sleep. Many women find
they're exhausted in the first
trimester. Don't worry, this is normal! This is your body's way
of telling you that you need more rest. In the second
trimester, tiredness is usually replaced with a feeling of well
being and energy. But in the third
trimester, exhaustion often sets in again. As you get larger,
sleeping may become more difficult. The baby's movements, bathroom
runs, and an increase in the body's metabolism might interrupt or
disturb your sleep. Leg cramping can also interfere with a good
night's sleep.
Tips for avoiding nausea and vomiting
- Eat a small portion of something
before getting out of bed.
- Drink small cups of ginger or
peppermint tea.
- Have several small meals
throughout the day instead of fewer large ones.
- Drink fluids between meals rather
than with your meals.
- Avoid strong spices and odors and
greasy foods.
Tips for avoiding heartburn
- Have several small meals
throughout the day instead of fewer large ones.
- Chew your food slowly.
- Don't lie down for at least an
hour after eating.
- Wear clothes that are loose around
your waist.
- Raise your head with several
pillows while sleeping.
Tips for avoiding constipation
- Increase the amount of liquids and
fiber in your diet.
- Eat more dried or raw fruits and
vegetables.
- Use whole-grain bread and cereals.
- Get exercise.
