Pregnancy care

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Prior to modern medicine, many mothers and their babies did not survive pregnancy and the birth process. Today, good prenatal care can significantly improve the quality of the pregnancy and the outcome for the infant and mother.

Good prenatal care includes:

• Good nutrition and health habits before and during pregnancy
• Frequent prenatal examinations to detect early problems
• Routine ultrasounds to detect fetal abnormalities and problems
• Routine screening for:
  • Sexually transmitted diseases
  • Rubella immunity
  • Blood type problems (Rh and ABO)
  • Diabetes
  • Genetic disorders -- if there is a family history or the age of the mother indicates the need
  • Blood pressure abnormalities
  • Urine protein

Women who choose to have an abortion usually do so in the very early stages of the pregnancy (usually before 12 weeks gestation). Abortion is legal through the 24th week of pregnancy. The abortion procedure, however, becomes more difficult with advancing gestational age, and many providers do not perform pregnancy terminations in the second trimester.

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:

• physicians specializing in obstetrics and gynecology (OB/GYN)
• certified nurse midwives (CNMs)
• some family practice physicians
• some family nurse practitioners (FNPs) or physician assistants (PAs) who work in conjunction with a physician

Family health care providers, or generalists, are proficient in managing women throughout normal pregnancies and deliveries. If a problem in the pregnancy is identified, a generalist will refer the patient to obstetric specialist.

The goals of prenatal care are to:

• monitor both the pregnant woman and the fetus throughout the pregnancy
• identify anything that could change the outlook for the pregnancy from normal to high-risk
• explain nutritional requirements throughout the pregnancy and postpartum period
• explain activity recommendations or restrictions
• address common complaints that may arise during pregnancy (for example, backache, joint pain, nausea, heartburn, headaches, urinary frequency, leg cramps, and constipation ) and how to manage them, preferably without medications