Before modern medicine, many mothers and their babies did not survive pregnancy and childbirth. Today, good prenatal care can significantly improve the quality of the pregnancy and the outcome for the baby and mother.
Good prenatal care includes:
- Good nutrition and health habits before and during pregnancy
- Frequent prenatal exams
- Routine ultrasounds to detect problems with the baby
- Routine screening for:
Women who plan to continue a pregnancy to term need to choose a health care provider who will provide prenatal care, delivery, and postpartum services. Provider choices in most communities include:
- Doctors specializing in obstetrics and gynecology (OB/GYN)
- Certified nurse midwives (CNMs)
- Family medicine physicians
- Family nurse practitioners (FNPs) or physician assistants (PAs) who work with a doctor
- Perinatologists (doctors who specialize in the very high risk pregnancy)
Family health care providers or midwives can help you if you have a normal pregnancy and delivery. But if there is a problem, your doctor will refer you to a specialist.
The goals of prenatal care are to:
- Monitor both the mother and baby throughout the pregnancy
- Look for changes that may lead to a high-risk pregnancy
- Explain nutritional requirements during and after pregnancy
- Explain activity recommendations or restrictions
- Discuss common pregnancy complaints such as morning sickness, backaches, leg pain, frequent urination, constipation, and heartburn and how to manage them, preferably without medications
- Give support to the pregnant woman and her family
Women who are considering becoming pregnant, or who are pregnant, should eat a balanced diet and take a vitamin and mineral supplement that includes at least 0.4 milligrams (400 micrograms) of folic acid. Folic acid is needed to decrease the risk of certain birth defects (such as spina bifida). Sometimes higher doses are prescribed if a woman has a higher than normal risk of these conditions.
Pregnant women are advised to avoid all medications, unless the medications are necessary and recommended by a prenatal health care provider. Women should discuss all medication use with their providers.
Pregnant women should avoid all alcohol and drug use and limit caffeine intake. They should not smoke. They should avoid herbal preparations and common over-the-counter medications that may interfere with normal development of the growing baby.
How often you need to see your doctor depends on whether or not you have a high-risk pregnancy. Usually, prenatal visits are scheduled:
- Every 4-6 weeks during the first 28 weeks of gestation
- Every 2-4 weeks from 28 to 36 weeks gestation
- Weekly from 36 weeks to delivery
Your health care team will usually check your weight gain, blood pressure, fundal height, and the baby's heart beat (as appropriate) at each visit. Routine urine screening tests may be done.
WHEN TO CALL YOUR HEALTH CARE PROVIDER
Call your health care provider if you are pregnant or think you are pregnant and:
- You take medicines for diabetes, thyroid disease, seizures, or high blood pressure
- You are not getting prenatal care
- You cannot manage common pregnancy complaints without medication
- You might have been exposed to a sexually transmitted infection, chemicals, radiation, or unusual pollutants
Call your health care provider immediately if you are pregnant and you:
- Have a fever, chills, or painful urination
- Vaginal bleeding
- Severe belly pain
- Physical or severe emotional trauma
- Have your water break (membranes rupture)
- Are in the last half of your pregnancy and notice the baby is moving less or not at all
You should see your doctor before you get pregnant.
You should take a prenatal vitamin with at least ____ of folic acid every day.
You don't need folic acid.
The goals of prenatal care include:
Check your health and your baby's health
Look for changes that may lead to a high-risk pregnancy
Talk with you about diet and exercise while you're pregnant
Explain how to manage pregnancy symptoms, such as morning sickness
A and B
All of the above
Pregnant women should avoid:
A, B, and C
All of the above
Some medicines and herbal remedies can harm your baby.
Pregnant women should not exercise.
Which of the following is NOT a common pregnancy symptom?
Having to urinate often
Bleeding from the vagina
You should call your doctor for which of the following symptoms:
Fever, chills, or pain when you urinate
Belly pain that is new or becomes worse
Your water breaks
Bleeding from the vagina
Which of the following can lead to a high-risk pregnancy?
Health problems such as diabetes or high blood pressure
Unhealthy lifestyle, such as using tobacco, alcohol, or illegal drugs
Not getting regular prenatal care
Any of the above
A woman can always tell when she goes into labor.
Cunningham FG, Leveno KJ, Bloom SL, et al. Preconceptional counseling. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 7.
Cunningham FG, Leveno KJ, Bloom SL, et al. Prenatal care. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 8.
Cunningham FG, Leveno KJ, Bloom SL, et al. Prenatal diagnosis and fetal care. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 13.
McDuffie RS Jr, Beck A, Bischoff K, Cross J, Orleans M. Effect of frequency of prenatal care visits on perinatal outcome among low-risk women. A randomized controlled trial. JAMA. 1996 Mar 20;275(11):847-51.
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- Vaginal bleeding in early pregnancy
- Teenage pregnancy
- Common symptoms during pregnancy
- Managing your weight gain during pregnancy
- When you need to gain more weight during pregnancy
- Skin and hair changes during pregnancy
- Aches and pains during pregnancy
- Vaginal bleeding in late pregnancy
- Problems sleeping during pregnancy
Review Date: 7/23/2012
Reviewed By: Melanie N. Smith, MD, PhD, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.