Prenatal Care

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  What Is Prenatal Care?

  Prenatal care is the care you receive from a health care provider, such as a doctor or midwife, during pregnancy. During prenatal 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 prenatal care as soon as you know you're pregnant.

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  What Will Happen During My First Prenatal Care Visit?

  The first prenatal 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

  • a breast exam
  • a Pap test
  • tests for chlamydia and gonorrhea

  You may be offered blood or skin tests to check for

  • anemia — including sickle cell anemia
  • blood type
  • certain inherited diseases, such as Gaucher's and Tay-Sachs
  • cystic fibrosis
  • hepatitis
  • HIV/AIDS
  • rubella
  • syphilis
  • thalassemia
  • tuberculosis

  You may also be given urine tests to check for diabetes or other infections.

  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.

  Diet, Exercise, and Lifestyle Changes During Pregnancy Many pregnant women have questions about diet, exercise, and other lifestyle changes during pregnancy. Prenatal care visits are the perfect time to discuss these concerns with your health care provider. Many women choose to make lifestyle changes before they become pregnant. Eating a healthy diet, exercising regularly, and, if you smoke, drink, or do drugs, quitting those activities, are all important things a woman can do to help have the healthiest pregnancy possible.

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  How Often Will I Have Prenatal 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 prenatal 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 prenatal care more often.

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  What Will Happen During My Follow-Up Prenatal Care Visits?

  Your health care provider will check that your pregnancy is progressing well. During prenatal 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 prenatal testing

  Each visit is also an opportunity to discuss any questions or concerns that have come up since your last visit.

  Medication and Pregnancy Certain medicines are dangerous to take during pregnancy. Discuss with your health care provider which medications and treatments you ought to continue, start, or put on hold during your pregnancy. Check with your provider before taking any medicines.

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  What Is Prenatal 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 prenatal tests for birth defects and other abnormalities include

  • ultrasound
  • multiple marker screening
  • CVS — chorionic villus sampling
  • amniocentesis

  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.

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  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 prenatal care visits.

  Common discomforts during pregnancy include

  • nausea or vomiting
  • heartburn
  • constipation
  • aches and pains in the abdomen and lower back
  • tiredness

  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.

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  How Will I Know If Something Is Wrong?

  Most pregnancies proceed without any problem. But problems can happen unexpectedly. Contact your health care provider right away if you think you may have been exposed to a sexually transmitted infection or if you have any of these warning signs:

  • sudden weight gain of more than two pounds within one day
  • severe swelling of the face, ankles, legs, or feet
  • severe or frequent headaches that last more than two or three hours and do not get better after taking the medication your health care provider has recommended
  • fainting
  • blurred vision, flashes of light, or spots before your eyes
  • pain or burning while urinating
  • sudden increase in thirst
  • dramatic increase or decrease in urination
  • unusual vaginal discharge
  • light vaginal bleeding or spotting

  Very Dangerous Warning Signs

  Premature Labor — Pregnancy takes about 40 weeks. If contractions cause your cervix to open earlier than normal — between the 20th and 37th week — it's called premature labor. Premature labor can be very dangerous.

  The signs of premature labor include

  • uterine contractions — strong tightening in the abdomen — every 10 minutes or less
  • repeating or constant menstrual-like cramps in the lower abdomen
  • abdominal cramps with or without diarrhea
  • pelvic pressure that feels like the fetus is pushing down
  • increase or change in vaginal discharge
  • sudden gush of watery fluids from the vagina (water breaking)
  • feeling like the fetus is "balling up"

  Signs of other dangerous problems include

  • heavy bleeding from the vagina
  • constant severe lower abdominal pain or cramps on one or both sides
  • dimness or blurring of vision that lasts two or three hours
  • dizziness or double vision
  • severe or continued vomiting
  • chills and/or fever of 101°F or more
  • fever of 101°F or more with pain or burning while urinating
  • sudden severe swelling or puffiness of the face, hands, legs, ankles, or feet, especially if you have a headache or vision change
  • after six months of pregnancy, the fetus moves a lot less than before
  • after six months of pregnancy, you think the fetus hasn't moved in eight hours or more

  If you are experiencing any of these signs, contact your health care provider or go to the hospital immediately.