Pregnancy 101: The Beginning And The End
There has never been better news for pregnancy planning: maternal and fetal
complications of pregnancy and childbirth are at an all time low, prenatal
diagnostics and interventions have continued to improve, and the "information
age" has offered unprecedented access to medically related input. Contraceptive
options are also increasing and improving, so that the goal of eliminating
unwanted pregnancies in the 21st century is no longer in the realm of fantasy.
Yet despite this, too many American women spend more time planning a one week
vacation than they do planning a pregnancy.
Preconception Visit:
Your most important prenatal visit may actually be a
preconception visit: a visit to your doctor before getting pregnant to discuss
and identify any preventive measures you should take prior to conceiving,
discuss family and personal medical histories, discuss various risk factors, and
discuss current medications. Preconception prevention plans should include:
if you smoke, stop.
if your partner smokes, stop.
reduce alcohol consumption to one drink per day or less (eliminate once
pregnant).
discuss all medications-prescription and non-prescription--with clinician if
you use any recreational or illegal drugs, stop.
begin taking folic acid (400 mcg/day) to reduce incidence of spinal and
brain-related birth defects.
begin taking other vitamins, minerals, or supplements recommended by
clinician (especially iron and calcium).
start/maintain a regular exercise regimen.
if you have any uncontrolled medical problems (e.g. high blood pressure,
diabetes, depression, thyroid problems, etc.), work with your physicians' advice
to get them under control.
a complete history and physical, along with having any overdue preventive
tests (e.g. Pap smear, cholesterol count, etc.) and treating any abnormal
results.
take any necessary vaccines (e.g. rubella, varicella,
hepatitis) screening for any genetic conditions (in both partners) if indicated.
Receiving early and consistent prenatal care increases the likelihood of a
healthy birth outcome. . .for mother and child. Adequate prenatal care is
dependent upon both receiving care early and an appropriate number of times
throughout the pregnancy. Estimates are that in 1994, 12.0% of minority women
received inadequate prenatal care compared to 4.9% of white women. By age, teen
mothers are the least likely to get adequate prenatal care.
A wide range of health care providers offer prenatal care in a number of
different settings: obstetricians, family clinicians, women's health care
clinicians, nurse midwives, clinician assistants, nurse practitioners and
nurses. For the purposes of this article, they'll all be included under the term
"clinicians".
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Receiving early and consistent prenatal care increases the likelihood of a
healthy birth outcome. . .for mother and child.
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