It's common knowledge that good prenatal care is important for the health of both mother and child. But what, exactly, should a pregnant woman be doing?
How does a woman ensure she is getting the best prenatal care possible?
The National Institutes of Health says that prenatal care is more than just health care while you are pregnant. You and your doctor may discuss a full range of issues including nutrition, exercise, childbirth and basic newborn care.
NIH recommends the following schedule for health care while pregnant, with more care for women over 35 or with risk factors.
- About once each month during your first six months of pregnancy
- Every two weeks during the seventh and eighth month of pregnancy
- Weekly in the ninth month of pregnancy
Catherine Browne, D.O., an obstetrician in Austin, Texas says that sometimes healthy women, who have already had healthy pregnancies, may wonder what the point is of special prenatal care. "I tell those women that the point of prenatal care in her case is that it should be short, easy, painless.
Those 5-10 minute visits may seem inconsequential and a waste of time, but they give us doctors a chance to quickly narrow out any important problems."
A typical visit will include a quick blood pressure measurement, baby heart rate check, and mommy tummy check, says Dr. Browne. "These things can tell you in 2 minutes that all is well." In the rare cases where something problematic may be brewing, regular care can also enable a health care provider to find it quickly and avoid further potential harm to mom and baby in many cases.
"That is one of the crucial points of prenatal care-- routine check ups to quickly identify who is having something potentially dangerous happening," Dr. Browne says. "The other important aspect of prenatal care is giving routine healthy women a chance to have their questions answered as they prepare for two important events: labor and having a new baby be part of her life forever forward."
The U.S. Department of Health and Human Services Office on Women's Health (OWS) states that babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care. OWS suggests that women begin taking care of themselves before trying to become pregnant.
Dr. Browne's partner in her practice, Jennifer Mushtaler, MD, agrees. "If you are able, choose your care provider before you become pregnant and meet with her/him to discuss upcoming pregnancy. A thorough physical and identification of health concerns prior to pregnancy can get everything off to a great start."
OWS shares the five most important steps a woman can take before becoming pregnant:
- Take 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. You can get folic acid from some foods. But it's hard to get all the folic acid you need from foods alone. Taking a vitamin with folic acid is the best and easiest way to be sure you're getting enough.
- Stop smoking and drinking alcohol. Ask your doctor for help.
- If you have a medical condition, be sure it is under control. Some conditions include asthma, diabetes, depression, high blood pressure, obesity, thyroid disease, or epilepsy. 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. At the same time, stopping medicines you need also can be harmful.
- 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.
Once you are pregnant, seeing your health care provider early and keeping regular appointments is essential. "The bottom line is that prenatal care has been scientifically proven to improve the outcomes of mothers and infants," says Dr. Mushtaler. She recommends that women make a written list of questions before their appointment, to cover all the concerns and issues relevant to pregnancy.
Healthy eating, prenatal vitamins and physical activity are all important aspects of prenatal care. Drs. Mushtaler and Browne are both big advocates of staying physically fit during pregnancy.
"We see on a day to day basis that healthier women who are active during pregnancy tend to have healthier pregnancies, shorter labors, and faster recoveries after birth of their children," says Dr. Browne. "In contrast, obese women have a multitude of problems including increased weight gain in pregnancy, higher chances of lots of medical problems during pregnancy, higher chances of big/overweight babies (who later have higher risk of diabetes later in life themselves), more problems in labor, etc."
OWS recommends getting at least two and a half hours of moderate-intensity aerobic activity a week. If you had an exercise regimen before pregnancy, it's fine to keep up your regular activity level as long as you talk to your doctor about it and don't notice any difficulties.
It's important to eat a variety of healthy foods during pregnancy. Fruits and vegetables, whole grains, foods low in saturated fat and high in calcium are good for mother and baby. Pregnant women should drink plenty of water and stay away from fish that are high in mercury, such as swordfish, mackerel and shark. Make sure you thoroughly wash all fruits and vegetables, don't eat undercooked meat and always handle food properly to protect yourself and your baby from food-borne illnesses.
Iron is an especially important nutrient, helping to prevent anemia which has been linked to premature birth and low birth weight. Folic acid is also important, especially in early pregnancy. It helps to prevent birth defects of the brain and spine which happen in very early pregnancy. Ask your doctor about iron supplements or prenatal vitamins.
By following these steps, you can help ensure a healthy and safe pregnancy and childbirth, and a bright future for your baby.