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Dr Duncan

What you need to know about antenatal care

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Women have been having babies “since Adam was a lad” as the saying goes, so we should know by now what pregnancy entails shouldn’t we? To start with, it is well known that pregnancy lasts 9 months, or is it 40 weeks? Get the drift? Already there is a tiny air of uncertainty about the whole “having a baby” event: if we can’t be sure of when exactly the baby is due, what can we be sure of?

The simple answer is that we don’t have all the answers so that’s one of the reasons that ante-natal care is so important for the future health of both Mum and babe. What happens inside the womb to the developing infant is extraordinarily complicated, with billions of processes being set up that will help maintain life in the developing individual for the following 8 or 9 decades. And then there are the changes occurring within the mother too as her body is adapting to having an immunologically “alien” human individual grow inside her body, whilst at the same time feeding and protecting it. It’s astonishing that in the vast majority of cases, it all appears to happen so naturally.

But let’s begin at the beginning. At conception, human genetic material is mixed from the parent gametes and the fertilized egg slowly wafts down the fallopian tube to be implanted into the womb up to 7 to 10 days later. Once inside the uterus, the egg burrows into the lining of the womb and the process of differentiation of placenta from embryo begins. From now on until the growing baby reaches a stage of maturity– perhaps around the 24 weeks stage at the very earliest - there is little that anyone can do should things start to go wrong. But that doesn’t mean that damage can’t be done to the infant as it develops and matures within the womb.

Ante-natal care is about education of the parent group, particularly the mother, and to help identify any risks that may put the health of either infant or mother at serious risk. In the non-complicated pregnancy, a reasonable calendar of care would be:

The First Visit

This is usually made by the expectant mother to confirm pregnancy, but it’s also the visit where your Doctor will work out the Estimated Date of Delivery (EDD) and organise appropriate blood tests.  An ultrasound may be requested to aid in determining the maturity of the growing baby and the EDD if there are doubts about the menstrual cycle; and also if there is a family history of multiple births, then if twins are present or not. It is also good time to start the conversation with parents as to which Obstetrician, and which hospital they would like their baby delivered at. This needs to be organised early as places and people do get busy and booked out: so it’s always a good idea to talk to family and friends who have had a baby recently and discuss their experiences. I have found that as this first visit can often be a fairly emotional occasion, there is a danger of giving too much information too quickly. That’s why I suggest an early follow up visit where a partner/family member/friend can come along as well to take notes and ask questions.

The Second Visit

This will go through your blood tests results and discuss any issues that may arise from those. As the first 6 to 8 weeks of the developing infant’s life is so critical to the future well-being of the human individual, it is important that the mother lives as healthily as possible and reduces any harmful risks to herself, as these might easily be passed on to her baby inside. Of particular concern are:

  • Smokers
  • Alcohol
  • Drugs – legal and illegal
  • Vaccination status
There are also occupational hazards for people such as Radiographers and those in the chemical industry etc who might be exposed to risks that would be damaging to both mother and child, and these need to be discussed and acted upon.

How Mum looks after herself will reflect in how the baby starts their life. Children of mothers who smoke will have higher risks of chest infections,  they will be smaller at birth but fatter as toddlers with an increased risk in later life of obesity and type II diabetes. Smoking is bad for mother and for baby.

Diet needs to be talked about too with the general principal that if it’s fresh and cooked fresh it will be good for both mother and child. But eat too much and you put on weight – some things never change – and with each pregnancy comes the fact that weight will increase by 10 to 13kgs, so it can be tempting to “not bother” and graze away through the whole 9 months and put on 15 to 20kgs. Believe me, you do not want to do that! Putting on too much weight may increase the risk of Gestational Diabetes, high blood pressure and a potentially dangerous medical condition known as Pre Eclampsia.

Visit two is packed with information and that’s why it’s good to have two heads there. Most larger practices these days have a practice nurse, so make sure you get to know her on the way out and you’ll find that she will be a mine of useful information as time goes on.

Subsequent Visits

For a normal pregnancy, from the second visit on, you should have a regular 4 week visit until week 30. From then it should be every 2 weeks until 36 weeks and then from there it should be weekly until baby is born. Of course, this may well be shared between your Specialist and your GP or may be totally hospital based depending on the circumstances. Whatever your arrangements, make sure you do get seen because the purpose of these visits is to identify problems early and treat them before things go “pear shaped”. At each visit you will have:

  • Your blood pressure checked
  • Your weight recorded
  • Your urine tested
  • You will be examined for signs of fluid retention by checking your ankles or looking for signs of tightening rings on fingers.
  • Your tummy will be gently examined externally for signs of your enlarging uterus – this is important to determine whether the child is maturing appropriately, or whether there are multiple births present, or if your baby is “failing to thrive”. At about 20 weeks your Doctor will start listening for your baby’s heart beat to make sure all is going well.
At each visit you should bring a list of questions to ask your Doctor: she or he will also ask you about how you are, your diet, any illnesses within the family etc.

Ante-natal care is all about prevention and education because bad actions and lack of knowledge could condemn your child to a lifetime of ill health.

Article written by Dr. Duncan Jefferson. More articles here. For more information on health care and private health cover, visit HBF Insurance at www.hbf.com.au.

The content of these articles is not tailored for any particular individual's circumstances. The author does not take into account your physical condition, medical history or any medication you may be taking. Any advice or information provided by the author cannot replace the advice of your health care professional. The views expressed in this article are those of the author and do not represent those of HBF unless clearly indicated.

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