Prenatal care includes medical checkups and screening tests which help keep pregnant women and her baby healthy during pregnancy.
Health care providers that care for woman during pregnancy include:
- An obstetrician (OB) who is specialized in the care of pregnant women and in delivering babies.
- A certified nurse-midwife (CNM) and certified professional midwife (CPM) who are trained to provide pregnancy and postpartum care and family practice doctors who provide care for the whole family through all stages of life, including care during pregnancy and delivery, and the following birth.Most family practice doctors cannot perform cesarean deliveries.
Woman can also choose a doula who is a professional labor coach, who gives physical and emotional support to women during labor and delivery because recent study shows that that continuous doula support during labor was linked to shorter labors and much lower use of pain medicines, medicine to help labor progress (Oxytocin) and cesarean delivery. A doula must have a certification from Doulas of North America (DONA) or another professional group.
Usually, checkups during pregnancy occur once each month from fourth through the 28th week of the pregnancy, twice a month from 28 through 36 and weekly from 36 to birth. Women who have high-risk pregnancies must see their doctors most often.
During the first visit, the doctor will perform a full physical exam, take blood for lab tests, calculate due date, breast exam, a pelvic exam to check woman’s uterus (womb) and a cervical exam, including a Pap test. Also, a doctor will ask a woman lot of questions about her lifestyle, relationships, and health habits and it important that woman is honest.
Other prenatal visits will include:
- checking the woman’s blood pressure and weight
- checking the baby's heart rate
- measuring woman’s abdomen to check your baby's growth
After 28 weeks, a woman will have to keep track of the baby’s movement with the “count-to-10” approach. The baby tends to be most active in the evening, so a woman should then lie down and count movements in next 20 minutes.
Most women count 10 of them but it is rare to count less than 10 movements within two hours at times when the baby is active so the woman must count baby's movements every day so she could know what is normal for her. If she notices that her baby is moving less than normal or is not moving at all, she should call her doctor right away.
Few of the common prenatal tests are:
- An ultrasound exam ,which can be performed at any point during pregnancy to look baby’s organs and confirm the age of the fetus and proper growth.
- Nonstress test (NST) ,which is performed after 28 weeks to monitor baby’s health with a belt placed around the mother’s belly so it can measure the baby’s heart rate in response to its own movements.
- Urine test, which is performed to look for signs of a health problem like diabetes, preeclampsia, and urinary tract infection.
- Amniocentesis, which can diagnose certain birth defects like Down syndrome, spina bifida and cystic fibrosis and it is performed at 14 to 20 weeks with a thin needle which is used to draw out a small amount of amniotic fluid and cells from the sac surrounding the fetus.
- A biophysical profile, which monitors the overall health of the baby and helps to decide if the baby should be delivered early and involves and ultrasound exam along with a nonstress test.
- Chorionic villus sampling (CVS),which can be performed at 10 to 13 week to diagnose certain birth defects like genetic and chromosomal disorders with a needle which is used to draw out a small sample of cells from the placenta.
“High-risk” pregnancies are the ones with a greater chance of complications. It can be increased in a woman who are very young age or older than 35, overweight or underweight woman, pregnancy with twins or other multiples, a woman who have diabetes, preeclampsia, high blood pressure, autoimmune disorders, cancer, and HIV.
Woman with high-risk pregnancies must more often have a prenatal visit to the doctor, sometimes to a medical doctor that cares for high-risk pregnancies – a maternal-fetal medicine specialist.
A woman can deliver her baby at a hospital, birth center, or at home. Her health insurance provider, the doctor, and midwife that woman is considering can tell her what options are available for her.
Hospitals are a good choice for women with health problems, pregnancy complications, or those who are at risk for problems during have the most advanced medical equipment and highly trained doctors for pregnant women and their babies. Also, in a hospital doctors can do a cesarean delivery if it is necessary and woman can get epidurals.
Birth centers can be a part of a hospital or completely separate facilities and they must meet the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers.
They try to make labor and delivery a natural and personal process and usually certified nurse-midwives, not obstetricians, deliver the baby so this is an option for healthy women who are at low risk for problems during pregnancy, labor, and delivery. If during labor, a cesarean delivery becomes necessary, women must be moved to a hospital for the procedure.
Home birth is an option for healthy pregnant women with no risk factors for complications during pregnancy, labor or delivery but only with a strong after-care support system at home.
Also, some certified nurse midwives and doctors can deliver babies at home but the American Congress of Obstetricians and Gynecologists (ACOG) does not support homebirth because they state that hospitals are the safest place to deliver a baby.
Women in every state can get help to pay for medical care during their pregnancies and she can find out about the program in her state by:
- Calling 800-311-2229 (calling 800-504-7081 for information in Spanish) – This toll-free telephone number will connect you to the Health Department in your area code.
- Calling or contacting her local Health Department.
- Contacting local hospital or social service agencies.
- Contacting community clinics because some areas have free clinics or clinics that provide free care to women in need.
- Contacting Women, infants, and children (WIC) program which are a government program is available in every state and provide help with food, nutritional counseling, and access to health services for women, infants, and children.
- Contacting places of worship.