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Prenatal Care:
Proper Development and Reduced Birth Defects
The main objective of prenatal care is creating the best conditions for the development of a baby and its mother's health before and during the pregnancy. For women who have never been pregnant, prenatal care offers information on the best diet for pregnancy, reducing possible risk factors for birth defects, screening for potential health problems in the mother and avoiding certain chemicals or lifestyles that may put mother and baby at risk.
For women who have already had babies, prenatal care offers health screening and tests for mother and baby as well as current advice on diet and risk factors. Prenatal care has been shown to significantly reduce the mortality rate of infants and improve birth weight in babies.
Beginning Prenatal Care Before Pregnancy
Prenatal care can begin before pregnancy. Women who have never had children have many questions about proper diet, exercise and lifestyle.
In the last several years, studies have shown a decrease in neural tube defects by adding foods or vitamins rich in folic acid to the diet before and during pregnancy. Now, doctors recommend that women begin taking folic acid before they become pregnant. Doctors also recommend that women begin taking prenatal vitamins before pregnancy to ensure they are getting the proper amount of vitamins. Further, should you decide to become pregnant it may be a good idea to make sure all of your immunizations are up to date.
Factors Affecting Fetal Development
Drinking alcohol, taking illegal drugs and smoking cigarettes have consequences for the developing fetus. These lifestyle behaviors can lead to decreased birth weights and early delivery. Abuse of drugs can lead to birth defects. Excessive alcohol is linked to fetal alcohol syndrome, a condition in newborns that can lead to devastating defects and learning disabilities.
Less obvious factors like using a Jacuzzi or steam room, performing strenuous exercise or even prolonged periods of stress can raise the body's core temperature, modify blood circulation, and affect fetal development. Getting enough rest, eating a nutritious diet and finding ways to relieve stress can produce positive effects in the development of your baby.
Cleaning chemicals, insecticides, paints and toxic substances including hair dyes can be dangerous for the baby's health. Exposure to cats and cat litter can also be a risk for pregnant women. A condition known as toxoplasmosis can be transferred from cats to pregnant women and to the developing fetus. Babies born with toxoplasmosis can have serious eye infections that lead to blindness or other birth defects.
Even certain foods can interfere with fetal development. Undercooked meats, raw fish and eggs or soft cheeses can cause infections in the mother that can be transferred to the baby.
Your First Prenatal Visit
A prenatal visit with your doctor should be scheduled if you have a positive home pregnancy test. At this time, the doctor will obtain a full health history of you, your baby's father and your immediate families. The medical history will include previous health problems, surgeries and medications. Once the doctor knows more about your current health, she will do some tests and perform a medical exam.
Be prepared to step on the scale at each visit. Maintaining a healthy weight throughout pregnancy is a high priority in prenatal care. Drastic weight changes can be early warning signs for other potential conditions. Your blood pressure and heart rate will also be monitored at each visit. Evidence of rising blood pressure can be an early sign of pre-eclampsia, pregnancy induced hypertension or toxemia, conditions that can be life-threatening.
A urine test will be performed at each visit. Proteins, red bloods cells or white blood cells in the urine indicate a urinary tract infection. Increased sugars or ketones are an early warning sign for gestational diabetes. Gestational diabetes is high blood sugar that only occurs during pregnancy. The condition usually resolves itself after the delivery, but requires some treatment to reduce any risk to the developing fetus.
Blood tests will be used to check for anemia and for past infections. Your doctor will give you the option to test for HIV, the virus that causes AIDS. In the exam, the doctor will perform a pap smear to check for early symptoms of cervical cancer or vaginal infections.
A pelvic exam confirms the pregnancy. If prenatal vitamins have not yet been prescribed, the doctor will make a recommendation. And, using the last menstrual period as reference, the doctor will determine the baby's due date.
Routine Visits Throughout Pregnancy
After the first prenatal visits, those that follow become routine. Weight, blood pressure, urine, and belly measurements are customary. After the twelfth week of pregnancy, the doctor will listen for the baby's heart rate each time. Later in the pregnancy, other tests such as an ultrasound and blood tests will be performed. For women over the age of thirty-five, your doctor may recommend amniocentesis.
Typical Prenatal Care Visits
Pregnancies with little or no risk follow a typical pattern of scheduled visits. It may look something like the following:
- 4th week to 28th week: one visit per month
- 28th week to 36th week: two visits per month
- 36th week to birth: one visit per week
Regularly scheduled prenatal visits are of utmost importance. Higher risk pregnancies may require additional visits to the doctor to prevent complications.
Resources
Beers, M. H. & Berkow, R., eds. (1999). Normal pregnancy, labor, and delivery [electronic version]. The Merck Manual of Diagnosis and Therapy, 17th Edition. NJ: Merck Research Laboratories.
Callahan, T. L., Caughey, A. B., & Heffner, L. J. (2001). Blueprints in Obstetrics and Gynecology, 2nd ed. MA: Blackwell Publishing.
March of Dimes. (2004). Prenatal care.
March of Dimes (2004). Stress.
