Prenatal Care

Prenatal care is the health care a woman receives while she is pregnant. It includes checkups and prenatal testing. Prenatal care can help keep mothers and babies healthy. Babies of mothers who do not get prenatal care are 3 times more likely to have a low birth weight and 5 times more likely to die than those born to mothers who do get care.

Prenatal care also lets health care providers spot health problems early. Early treatment can cure many problems and prevent others. Doctors can also talk to pregnant women about things they can do to give their unborn babies a healthy start to life.

Most experts suggest that women see their doctors about once each month for weeks 4 through 28 of pregnancy, twice a month for weeks 28 through 36, and weekly for weeks 36 to birth. Women should expect to see their health care providers more often as the due date gets closer. If a mother is over 35 years old or her pregnancy is high risk because of health problems like diabetes or high blood pressure, the doctor will probably want to see her more often than the normal schedule recommends.

You will notice many changes in your body early in your pregnancy. Your breasts might be tender and swollen. Nausea with or without vomiting, called morning sickness, also is common. Talk to your healthcare provider if your morning sickness is severe.

Near the end of the first trimester — by about nine to 12 weeks of pregnancy — you might be able to hear your baby's heartbeat with a small device that bounces sound waves off your baby's heart (Doppler).

Your health care provider is there to support you throughout your pregnancy. Your prenatal appointments are an ideal time to discuss any questions or concerns — including things that might be uncomfortable or embarrassing.

Ideally, you should start taking care of yourself before you start trying to get pregnant. This is called preconception health. It means knowing how health conditions and risk factors could affect you or your unborn baby if you become pregnant. For example, some foods, habits, and medicines can harm your baby — even before he or she is conceived. Some health problems also can affect pregnancy.

Talk to your doctor before pregnancy to learn what you can do to prepare your body. Women should prepare for pregnancy before becoming sexually active. Ideally, women should give themselves at least 3 months to prepare before getting pregnant.

Several important things women can do before becoming pregnant include:

• Taking 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of folic acid every day for at least 3 months before getting pregnant to lower your risk of some birth defects of the brain and spine.
• Stop smoking and drinking alcohol.
• If you have a medical condition, such as asthma, diabetes, depression, high blood pressure, obesity, thyroid disease, or epilepsy, be sure it is under control. Be sure your vaccinations are up to date.
• Talk to your doctor about any over-the-counter and prescription medicines you are using. These include dietary or herbal supplements. Some medicines are not safe during pregnancy. Do not start or stop any medications without talking to your doctor or pharmacist.
• Avoid contact with toxic substances or materials at work and at home that could be harmful. Stay away from chemicals and cat or rodent feces.

During the first prenatal visit, you can expect your doctor to:

• ask about your health history including diseases, operations, or prior pregnancies
• ask about your family's health history
• do a complete physical exam, including a pelvic exam and Pap test
• take your blood and urine for lab work
• check your blood pressure, height, and weight
• calculate your due date
• answer your questions

At the first visit, you should ask questions and discuss any issues related to your pregnancy. Find out all you can about how to stay healthy.

Later prenatal visits will probably be shorter. Your doctor will check on your health and make sure the baby is growing as expected. Most prenatal visits will include:

• checking your blood pressure
• measuring your weight gain
• measuring your abdomen to check your baby’s growth (once you begin to show)
• checking the baby's heart rate
• assessing fetal movement

While you are pregnant, you also will have some routine tests. Some tests are suggested for all women, such as blood work to check for anemia, your blood type, HIV, and other factors. Other tests might be offered based on your age, personal or family health history, your ethnic background, or the results of routine tests you have had.

If you are pregnant, take steps to keep yourself and your baby helthy.

Get early and regular prenatal care. Whether this is your first pregnancy or you have been pregnanct before, health care is extremely important. Your doctor will check to make sure you and the baby are healthy at each visit. If there are any problems, early action will help you and the baby.

• Take a multivitamin or prenatal vitamin with 400 to 800 micrograms (400 to 800 mcg or 0.4 to 0.8 mg) of folic acid every day. Folic acid is most important in the early stages of pregnancy, but you should continue taking folic acid throughout pregnancy.
• Avoid x-rays. If you must have dental work or diagnostic tests, tell your dentist or doctor that you are pregnant so that extra care can be taken.
• Get a flu shot. Pregnant women can get very sick from the flu and may need hospital care.
• Eat a variety of healthy foods. Choose fruits, vegetables, whole grains, calcium-rich foods, and foods low in saturated fat. Also, make sure to drink plenty of fluids, especially water.
• Get all the nutrients you need each day, including iron. Getting enough iron prevents you from getting anemia, which is linked to preterm birth and low birth weight. Eating a variety of healthy foods will help you get the nutrients your baby needs. But ask your doctor if you need to take a daily prenatal vitamin or iron supplement to be sure you are getting enough.
• Protect yourself and your baby from food-borne illnesses, including toxoplasmosis and listeria. Wash fruits and vegetables before eating. Do not eat uncooked or undercooked meats or fish. Always handle, clean, cook, eat, and store foods properly.
• Do not eat fish with lots of mercury, including swordfish, king mackerel, shark, and tilefish.
• Gain a healthy amount of weight. Your doctor can tell you how much weight gain you should aim for during pregnancy.
• Do not smoke, drink alcohol, or use drugs. These can cause long-term harm or death to your baby.
• Unless your doctor tells you not to, try to get at least 2 hours and 30 minutes of moderate-intensity aerobic activity a week. If you worked out regularly before pregnancy, you can keep up your activity level as long as your health does not change and you talk to your doctor about your activity level throughout your pregnancy.
• Do not take very hot baths or use hot tubs or saunas.
• Get plenty of sleep and find ways to control stress.
• Get informed. Read books, watch videos, go to a childbirth class, and talk with moms you know.
• Ask your doctor about childbirth education classes for you and your partner. Classes can help you prepare for the birth of your baby.
• Stay away from chemicals like insecticides, solvents (like some cleaners or paint thinners), lead, mercury, and paint (including paint fumes).
• If you have a cat, ask your doctor about toxoplasmosis. This infection is caused by a parasite sometimes found in cat feces. If not treated toxoplasmosis can cause birth defects. You can lower your risk of by avoiding cat litter and wearing gloves when gardening.
• Avoid contact with rodents, including pet rodents, and with their urine, droppings, or nesting material. Rodents can carry a virus that can be harmful or even deadly to your unborn baby.
• Take steps to avoid illness, such as washing hands frequently.
• Stay away from secondhand smoke.

If you are pregnant or thinking about becoming pregnant, talk with your doctor about any medications you are taking or thinking about taking. This includes prescription and over-the-counter medications, as well as dietary or herbal products. Not all drugs are safe for use during pregnancy.

Throughout your pregnancy, communicate with your health care provider and ask questions. Be informed about your care options and obtain additional information to make sure you have peace of mind concerning your health and your baby’s health.