What does prenatal care include?

Prenatal care covers the full cycle of care from confirmation of pregnancy to the onset of labor, including medical screening, lifestyle adjustment, psychological counseling, and intervention for complications. It is far more than the regular prenatal check-up that everyone usually thinks of.

I have been in the obstetrics clinic for almost 6 years. I just received a 30-week pregnant mother with her second child last week. I always thought that prenatal care consisted of regular B-ultrasounds. My legs were swollen for almost 10 days without taking it seriously. When I came for the prenatal check-up, I found that my urine protein was 2+, and I already had signs of mild preeclampsia. If I were to come a few days later, both adults and children would be at risk.

Many pregnant mothers will search for a lot of care lists when they first become pregnant. In fact, there is no need to think about this matter too complicated. A prenatal check-up at the hospital is the most basic guarantee. The screening items corresponding to different gestational weeks are all developed by predecessors with decades of experience. Testing for thyroid function and teratogenic factors in early pregnancy is to worry about early embryonic pregnancy. Fetal development is affected by adverse factors. Massive abnormalities and sugar screening in the second trimester screen for fetal structural malformations and gestational diabetes. Fetal heart rate monitoring done every week in the third trimester is to check whether the baby has intrauterine hypoxia. When the time comes, the doctor will naturally remind you, so you don’t need to keep it in the memo and become anxious.

What’s more important is your daily care at home. I’ve seen too many pregnant mothers who got the green light all the way through prenatal check-ups, but ended up eating and drinking so much that they thought “one person eats and two people take care”, and gained more than 40 kilograms during the entire pregnancy. When the baby was born, either the baby was too big to undergo an autopsy, or the blood sugar couldn’t be lowered after delivery, leading to type 2 diabetes. Now we generally calculate the weight gain range based on your pre-pregnancy body mass index. For example, a thin pregnant mother can gain 12-18 kilograms during the entire pregnancy, and the fatter woman is best to control it to 7-10 kilograms. You don’t need to drink bone soup all the time. Eating enough eggs, milk, lean meat, and fresh fruits and vegetables is better than anything else. High-sugar milk tea, durian, etc. can be eaten occasionally to satisfy your cravings. It is really unbearable to eat them every day.

In recent years, we have paid more and more attention to psychological care. After pregnancy, hormones fluctuate greatly and emotional sensitivity is very normal. Don’t bear it. Last month, there was a 25-year-old mother who was pregnant with her first child. She watched many negative videos about massive bleeding and side incision during the entire pregnancy. At 37 weeks, she couldn't sleep all night. Her contractions were so frequent that she went to the emergency room three times a week. Later, she made two appointments with the midwife for delivery rehearsals. She was shown the delivery room and taught the Lamaze breathing method, and then she slowly relaxed. If you always feel low and anxious, you can talk to your family or talk to the doctor who does prenatal care. It's really not hypocritical.

There is no need to go to extremes when it comes to exercise. Either lie in bed every day without moving, or practice high-intensity movements. As long as there are no contraindications such as placenta previa and cervical insufficiency, take a half-hour walk every day, practice Kegel exercises at home, and practice gentle yoga in the second trimester. Not only can you control your weight, but the labor process will be much smoother during delivery.

There are also many pregnant mothers struggling with controversial care options, such as whether to do Tang screening or non-invasive DNA, and whether to supplement DHA. In fact, there is no absolute standard answer to these. For example, for screening projects, if you are under 35 years old, have no history of adverse pregnancy, and have a low-risk pregnancy test, it is enough. If you are elderly, or are really worried about missing the screening, you can just go for non-invasive or even amniotic biopsy. You don’t have to listen to other people’s experience to say which one is better. The same goes for DHA. Some studies say that supplementation is good for the baby's neurological and visual development. Others say that as long as you eat deep-sea fish two or three times a week and eat nuts regularly, the amount you get from food is enough. Whether you supplement it or not depends entirely on your own diet and financial conditions. You shouldn't worry about it.

To put it bluntly, prenatal care is never a step-by-step task. It is dynamically adjusted according to the situation of you and your baby. Don’t just follow the so-called standard strategies on the Internet. If you are not sure about anything, ask your prenatal care doctor, which is more reliable than anything else.