Being pregnant and preparing for a new member in the family is an exciting event. There are many aspects to having a successful birth. One important part is early and consistent prenatal care.
It is important for a woman to see her doctor before getting pregnant so she can take folic acid, which has been found to decrease neurotube defects in the fetus. Neurotube defects are birth defects that cause abnormalities of the spine, spinal cord and brain development, such as spina bifida. Folic acid is found in leafy green vegetables, including salad. Because the modern woman does not get enough folic acid in her daily diet, doctors recommend all women planning a pregnancy in the coming months take vitamin supplements with 0.4 m.g. folic acid every day.
Another concern for women planning a pregnancy is when to discontinue the birth control pill, have an IUD removed, or be off DepoProvera. The most common recommendation is to be off hormones or to have an IUD out for three months prior to getting pregnant.
The first 12 weeks of a pregnancy are very important for the actual development of the fetus. Newly pregnant woman should avoid chemicals such as alcohol, medications (prescribed and over the counter), herbal compounds, nicotine and other drugs until she has talked with her doctor. A woman should not stop currently prescribed medications, but should see her doctor as soon as she suspects a pregnancy to discuss the issue.
Pregnant women also need to avoid exposure to X-ray and other sources of radiation. Inform your doctor, dentist or chiropractor if you are, or may be, pregnant.
If you suspect you are pregnant, it is an ideal time for you to see your doctor. At this visit, a confirmatory exam for pregnancy can be done to check uterine size, confirm accurate dates for delivery and check for any abnormalities, such as tubal pregnancy or cervical problems. Your doctor may also prescribe prenatal vitamins, review dates for events in the pregnancy and answer questions.
Your next appointment will be 10 to 12 weeks from the first day of the last normal menstrual period. This is a comprehensive visit that includes a family history and a full physical. Usually the fetal heart tones can be heard at this visit. Tests are done for infection, anemia and blood type. If there are any genetic concerns, plans can be made for referral and evaluation.
During the pregnancy, the woman is seen every four weeks from 12 weeks to 28 weeks into the pregnancy, then every two weeks from 28 weeks to 36 weeks, then weekly until delivery. Average pregnancies are 40 weeks long, from the woman's first day of her last normal period. Several important tests are done during the routine prenatal visits. At 14 or 16 weeks, a triple test including AFP (alpha fetoprotein) can be done to assess the risk for neurotube defects and Down syndrome. Later in the pregnancy, a glucose challenge test is done for diabetes.
During all of the prenatal visits, a woman's blood pressure, urine and uterine growth are checked. The doctor will also look for leg swelling, abnormal weight gain or other problems. Doctors also educate expectant mothers about pregnancy, childbirth, breast-feeding, infant care and post-delivery contraception.
The end result of prenatal care is hopefully a healthy mother, a healthy new baby and a supportive family structure.
(Dr. Huffmire is an obstetrician at Moffat Family Clinic.)