Midwives and Perinatal Care

Introduction:

Prenatal care during pregnancy is essential for maintaining the mother's and the developing baby's health. Women visit a doctor, nurse, or midwife throughout their pregnancy for checkups. Prenatal care is crucial for maintaining the health of the pregnant woman. A healthcare professional comprising the doctor, nurse, or midwife will monitor an unborn child's growth and perform regular tests to help identify and solve any potential issues. These routine visits are also a good opportunity to ask additional questions regarding pregnancy and the delivery of the unborn child.

What Are the Different Trimesters of Pregnancy?

Nine months of pregnancy is divided into three phases as follows:

• First Trimester - The duration from the first month of pregnancy to the third month.

• Second Trimester - The duration from the fourth to the sixth month of pregnancy.

• Third Trimester - The duration from the seventh month of pregnancy till the child's birth.

When Should Women Begin Scheduling Prenatal Care Appointments?

Women can begin prenatal treatment as soon as they find out they are pregnant. The optimum time to see a doctor is before a woman gets pregnant; this process is referred to as pre-pregnancy care or preconception planning. Prenatal visits should start right away after the pregnancy is confirmed.

What Are the First-trimester Appointments for Prenatal Care?

Prenatal treatment during the first trimester involves blood testing, a physical examination, and discussions about life. An essential component of a healthy pregnancy is prenatal care. Here are the things to anticipate during the first few prenatal appointments, regardless of whether a person selects a family doctor, obstetrician, midwife, or group prenatal care.

1. The Initial Visit: Women should make their first prenatal appointment as soon as they know about pregnancy. Doctors allocate time during the initial visit to review medical history and discuss any risk factors or pregnancy-related issues. This will enable the doctor to provide the best treatment for the mother and the unborn child. In addition, a doctor will inquire about the following:

• Monthly cycle, gynecological history, and previous pregnancies.

• Exposure to potentially harmful substances.

• The intake of any over-the-counter drugs, vitamins, and dietary supplements.

• Consumption of coffee, alcohol, tobacco, and other drugs.

• Travel history to regions where malaria, tuberculosis, pox, or other infectious diseases are prevalent.

2) Due Date: It is crucial to determine the due date or anticipated delivery date. It enables the doctor to monitor both the development of the unborn child and the progress of the pregnancy. The doctor will use the beginning of the last period, plus seven days, and go back three months to predict the day the woman will give birth. The due date is calculated as 40 weeks post the first day of the last period. The doctor can use a prenatal ultrasound to determine the day. The ultrasound is typically utilized to determine the due date if the difference between the date determined using the last period and the date determined using an early ultrasound is more than seven days.

3) Physical Examination of the Body: A doctor will take weight, height, and body mass index measurements to determine how much weight women need to acquire for a healthy pregnancy. The doctor may perform a physical examination, including a breast and pelvic exam. Depending on the circumstances, thyroid, lung, and heart tests may be asked to be performed.

4. Laboratory Tests: The following tests are required during the first trimester:

• Blood tests may be performed during the initial prenatal visit to determine the blood type and Rh status. Rh factor, a protein on the surface of red blood cells, is a hereditary feature.

• Check hemoglobin level. Red blood cells have the iron-rich protein hemoglobin, which enables the cells to transport oxygen from the lungs to other body regions. Carbon dioxide is also transported to the lungs by hemoglobin from other body parts. Anemia is indicated by low hemoglobin or a low level of red blood cells. Being pregnant may be impacted by anemia, which can make women extremely exhausted.

• Verification of resistance to certain infections. This often includes varicella and rubella.

• Check for exposure to more infections. The doctor may advise blood tests to look for diseases like hepatitis B, syphilis, gonorrhea, chlamydia, and HIV (human immunodeficiency virus) AIDS (acquired immunodeficiency syndrome)-causing virus.

• A urine sample may also be examined for indications of a bladder infection or urinary tract infection.

5) Tests for Fetal Concern: Prenatal tests can reveal important details about the unborn child's health. These include blood or ultrasound testing for fetal genetic issues like Down syndrome.

6) Lifestyle Concerns: The doctor may speak about the value of prenatal vitamins and nutrition. They may inquire about travel while pregnant, vaccines, dental care, exercise, sex, and other lifestyle-related concerns.

7) Pregnancy Discomfort: Initially, the body may change. Women can have painful, swollen breasts. Morning sickness, or nausea with or without vomiting, is another typical symptom. If morning sickness is severe, consultation with the doctor is important.

8) Additional First Trimester Visits: The subsequent prenatal appointments, typically made every four weeks throughout the first trimester, can be shorter than the initial one. For example, a small gadget called a Doppler bounces sound waves off to the baby's heart so that a person can hear the baby's heartbeat before the end of the first trimester, around 12 weeks to 14 weeks of pregnancy.

What Is Second Trimester Prenatal Care?

A restored sense of well-being is common throughout the second trimester. Usually, morning sickness starts to subside. Women start to sense the baby's movement. The abdomen becomes more apparent. The doctor may arrange prenatal appointments every four weeks on average during the second trimester. Also, routine laboratory tests are done to check for the baby's growth.

What to Anticipate During Appointments of the Second Trimester?

1) Review the fundamentals:

• The doctor will weigh and check blood pressure. The patient can verbalize any concerns if present.

• Watch the child's development.

• The healthcare professional determines the unborn child's size by measuring the distance between the pubic bone and fundal height (the top of the uterus). This measurement in centimeters usually corresponds to the number of weeks a woman has been pregnant, plus or minus 2 cm after 20 weeks.

• Audible heartbeats. The baby's heartbeat should be heard. A Doppler device may detect the unborn child's heartbeat during second-trimester checkups.

• Check the fetal movement. When women start to feel flutters or kicks, tell the doctor about it. Remember that mothers experience various motions at different times and that movement is generally unanticipated during pregnancy. Flutters may be felt for the first time during weeks 18 and 20 of pregnancy.

• Additionally, inquire with the doctor about any immunizations women may require.

2. Prenatal Testing: Pregnant women require several prenatal screenings or tests throughout the second trimester.

3. DNA Analysis: Blood tests to check for chromosomal or genetic disorders such as spina bifida or Down syndrome. If the results are alarming, the doctor will advise a diagnostic procedure, usually an amniocentesis. A sample of the fluid that surrounds and shields a developing fetus during pregnancy is taken from the uterus during amniocentesis and tested.

4) Pregnancy Ultrasound: Fetal ultrasound is an imaging test that creates images of a developing child inside the womb using high-frequency sound waves. A thorough ultrasound can assist medical professionals in assessing fetal anatomy. It may also provide the chance to determine the infant's gender.

5) Blood Test: During 24 weeks to 28 weeks of pregnancy, blood tests may be conducted to evaluate blood count and iron levels and to check for diabetes, which can develop during pregnancy (gestational diabetes).

What Are the Third Trimester Appointments for Prenatal Care?

Prenatal care during the third trimester may include vaginal examinations to check the baby's position. In addition, the third trimester includes continued health checkups along with the following:

1. Regular Checkup - The doctor will ask about symptoms like contractions, bleeding, or fluid leakage. The doctor will monitor blood pressure, weight increase, and the heartbeat and movements of the unborn child.

2. Movement of Baby - The doctor may advise tracking how often women feel the baby move each day to be informed if the baby stops moving around as often.

3. Immunization - Additionally, women should discuss with the doctor any immunizations required, such as the TDAP (tetanus, reduced diphtheria, and acellular pertussis) vaccine and the flu shot. The ideal time to administer the TDAP vaccine is between 27 weeks and 36 weeks of pregnancy.

4. Obtain a Group B Strep Test - Throughout the third trimester, anticipate being examined for group B streptococcus (GBS). Adults typically have no symptoms from the common bacterium GBS, which is frequently carried in the bowels or lower genital tract. However, infants exposed to GBS following vaginal delivery may develop life-threatening symptoms. The doctor will swab the lower vagina and anal area to check for GBS. A lab test will be conducted on the sample.

5. Verify the Infant's Posture - A doctor checks to ensure the baby is lying head-first in the uterus as the delivery date draws closer. Suppose the baby is lying rump-first (frank breech) or feet-first (complete breech) after week 36 of pregnancy. In that case, a healthcare professional will manually move the baby into a head-first position while applying pressure to the abdomen. A skilled physician often performs this with the supervision of ultrasound. A doctor will discuss a C-section if the baby continues to be in the breech position.

Conclusion:

Prenatal care is essential throughout pregnancy for the mother and the developing fetus. Prenatal sessions are a great opportunity for the family and the mother to ask questions and get answers. A doctor should be contacted in case of any problems. The peace of mind comes from knowing support is available. However trivial or unimportant, the concern should be shared with the healthcare professional frankly.