by Kimberly Allen, RN
According to the CDC approximately 4 million women in the US give birth every year, of those approximately one third will experience some form of pregnancy related complication. Women that don’t receive adequate prenatal care have a greater risk that any complications that develop will not be detected or treated in a timely manor which can lead to serious consequences for both mother and child. Because of the potential for numerous complications many doctors recommend starting prenatal care before becoming pregnant. However, the reality is that’s not always possible so starting prenatal care as soon as you suspect or know you are pregnant.
One of the first things a woman must do after finding out she’s pregnant is decide on a health care provider. There are several options available to women today. There are doctors that specialize in pregnancy and childbirth known as obstetricians, doctors that specialize in women’s health care in addition to pregnancy and childbirth or OB/GYN’s and family practitioners, which are doctors trained to provide care for the whole family which can include pregnancy and childbirth. Then there are certified midwifes which are nurse practitioner’s with advanced training in women’s health care including prenatal care along with labor and delivery as well as postpartum care in pregnancies that don’t have any complications. However, certified midwifes are required to have a doctor available for delivery in case the birth doesn’t go as planned and a cesarean section is needed.
There are also doctors that specialize in what is considered high risk pregnancies. High risk pregnancies would be those where the mother has an existing chronic health condition like diabetes or cardiac problems, if the mother is over 35 years of age, or is carrying multiple babies as well as women that are at risk for pre-term labor or any other factor that can cause you to have a high risk pregnancy.
So when should you contact your doctor? The best time to contact your doctor and schedule your first visit is when your period is 2 to 4 weeks late or during the first 6 to 8 weeks of pregnancy. The initial visit with your doctor is very important and can significantly impact your pregnancy. The first visit is usually longer than subsequent visits because it’s during this visit that you will be asked to provide an extensive medical and social history including any known past or current medical problems of both the mother and father as well as any family history of genetic disorders. You will also be given a complete physical exam including both a pelvic and rectal exam. During the pelvic exam the doctor will do a Pap smear to test for cervical cancer. The doctor will also order blood tests for a complete blood count, Rh antibody screening and blood typing. The blood will also be tested for certain infections like hepatitis and HIV as well as for any STD’s including chlamydia, gonorrhea, and syphilis. It will also be checked for signs of previous exposure to certain viral infections including measles, mumps and rubella as well as chicken pox. Many health care providers are also testing for cystic fibrosis whether or not there is a family history. Then there are tests that are for women of a particular ethnic group that may have a higher risk of carrying genes associated with specific diseases. For example, African American women are usually tested for sickle cell disease or women that are of Ashkenazi Jewish descent are usually tested for genes associated with Tay-Sachs disease.
If your doctor determines you are healthy and you have no risk factors that can complicate your pregnancy he/she will set up a schedule for prenatal visits. For a normal healthy pregnancy, you should expect to visit your health care provider every 4 weeks until your 28th week, then every 2 weeks until you reach 36 weeks and then weekly until delivery. During each visit you can expect your doctor to check your blood pressure and weight which will be recorded and tracked. Then usually around the 22nd week the doctor will start measuring the size and shape of your uterus to monitor fetal growth and development. Your urine will also be monitored for sugar and protein as these are indicators of potential complications.
At anytime during regular prenatal visits if your doctor suspects that you have developed or are at risk for developing any complications he/she may increase your visits or refer you to a specialist for further care.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.