Prenatal care issues and measures

Wrong nursing behaviors caused by cognitive biases, lack of individualized response plans for physical discomfort, anxiety and depression and other emotional problems are generally ignored. The core logic of the corresponding solution is "individualized assessment as the basis + hierarchical precise intervention + two-way collaboration between medical care and family". There is no need to apply a unified template. A plan that adapts to the individual situation of pregnant women is an effective solution.

Let’s talk about the most common misunderstandings first, which are also the source of many family conflicts. Last week, I met an expectant mother who was 32 weeks pregnant at a community prenatal check-up point. Her mother-in-law stared at her lying on the sofa every day and said that if she moved too much, she would have fetal gas and give birth prematurely. As a result, she went for a follow-up examination in half a month and found that her glucose tolerance was not passed. She was also constipated and had anal fissures, so she cried and came to the nurse to prescribe a vaginal plug. In fact, there has been no unified standard in the academic community regarding activities during pregnancy: traditional nursing concepts advocate that "it is better to be still and not move during the second and third trimesters of pregnancy." Modern obstetrics generally recommends that pregnant women with physical conditions permit to maintain moderate exercise for about 30 minutes a day. However, it is also clear that pregnant women with placenta previa, cervical insufficiency, and a history of premature birth must strictly control the amount of activity, and the standard of "walking more for better health" cannot be applied rigidly. In practice, we now ask the prenatal check-up doctor to write each pregnant woman's "activity taboos" in red pen on the cover of the prenatal check-up book, so that family members can see it at a glance, which saves the family from quarreling over whether to move or not. Oh, by the way, there is also the old saying that "you cannot use skin care products or cut your hair during pregnancy". There is really no need to believe it. Non-functional moisturizing products from regular brands can be used. If you are really worried about using baby cream, it is ok. You don't have to wait until your face is dry or cracked after giving birth.

What is more worrying than cognitive bias is that many pregnant women’s first reaction when encountering physical discomfort is to bear it. I had a friend who vomited in the early stages of pregnancy to the point where she couldn't even drink water. She even heard from relatives that "morning sickness is normal and will be fine after three months." She fainted at home and was sent to the hospital to find out that she had an electrolyte imbalance. She had to replenish fluids for three days before she recovered. There are now different intervention paths to deal with physiological discomfort: Western medicine generally gives programs such as vitamin B6 to stop vomiting and low-molecular-weight heparin to improve blood circulation according to the degree of symptoms. Traditional Chinese medicine recommends more gentle methods such as acupoint massage and taking warm water with tangerine peel and ginger. Both programs are supported by clinical data. The premise is that you must first consult your prenatal doctor, and do not blindly search for folk remedies. For edema that is common in late pregnancy, we generally recommend that you prepare a foot pillow with a 15-degree slope. You can use it when watching TV on the sofa at night. It is much more comfortable than directly stacking your legs on the pillow. There is no need to buy a pillow for pregnant women that costs hundreds of dollars. It is also completely effective to find a suitable cushion instead.

There is another problem hidden under the water. Many people still think that "having a bad mood during pregnancy is hypocritical." A while ago, we followed up on an expectant mother who was 28 weeks pregnant. She was an English teacher at a training institution. After she became pregnant, she quit her job as a substitute teacher to recuperate at home. She read about various birth accidents and postpartum depression every day. She suffered from insomnia and cried for half a month. Her family also said, "You just have free time, just go out and walk more." After the final psychological screening, she reached the critical value of prenatal depression, and it took almost a month for her to undergo psychological intervention before she gradually improved. There are now two different directions regarding prenatal emotional intervention: one group advocates that pregnant women who are prone to anxiety should try to avoid negative content related to pregnancy and childbirth, and find more friends to chat and do crafts to distract their attention. ； The other group believes that if you have the personality of "you need to understand everything before you feel at ease", it is better to go directly to the maternity school run by a public hospital to systematically learn the full process of pregnancy and childbirth. Unraveling the fear of the unknown can relieve anxiety. There is no difference between the two methods. The most effective method is to adapt to the personality of pregnant women.

To be honest, I have been in the obstetrics department for almost 6 years, and the most effective care plan I have ever seen is never the list of "100 things you must do during pregnancy" on the Internet. Some pregnant women drink iced milk tea every day and nothing happens, and some have diarrhea after taking a bite of cold drinks. There is really no need to apply strict standards. The only thing you need to remember is that whether you feel pain in your body or feel unhappy, see your prenatal doctor as soon as possible. Don’t listen to the “experience talks” of relatives around you. After all, everyone’s body is really different. Finally, I would like to say one more thing. The core of prenatal care has never been to "treat a pregnant woman as a glass figure", but to help her spend these ten months comfortably and safely. Family members should pay more attention to the feelings of the pregnant woman, which is more effective than buying more supplements and reading more popular science.