Prenatal Care
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• What is prenatal care?
• Why do I need prenatal care?
• I am thinking about getting pregnant. How can I
  take care of myself?
• I'm pregnant. What should I do or avoid for a healthy baby?
• I don't want to get pregnant right now. But should I
  still take folic acid every day?
• How often should I see my doctor during pregnancy?
• What happens during prenatal visits?
• I am in my late 30s and I want to have a child now.
  Should I do anything special?

 
What is prenatal care?

Prenatal care is the health care you get while you are pregnant. Take care of yourself and your baby by:

• Getting early prenatal care. If you know you're pregnant, or think you might be, call your doctor to schedule a visit.
  
  
• Getting regular prenatal care. Your doctor will schedule
  you for many appointments over the course of your pregnancy. Don't miss any -- they are all important.
  
  
• Following your doctor's advice.

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Why do I need prenatal care?

Prenatal care can help keep you and your baby healthy. Babies of mothers who do not get prenatal care are three times more likely to have a low birth weight and five times more likely to die than those born to mothers who do get care.

Doctors can spot health problems early when they see mothers regularly. This allows doctors to treat them early. Early treatment can cure many problems and prevent others. Regular health care is best for you and your baby.

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I am thinking about getting pregnant. How can I take
care of myself?

You should start taking care of yourself before you start trying to get pregnant. By staying active, eating right, and taking a multivitamin, you can help keep yourself and your baby healthy even before it is conceived. This will help you have a healthy pregnancy and lower your chances of having a baby born with
a birth defect.

Here are some ways to take care of yourself before you get pregnant:

• Eat healthy foods, exercise regularly (30 minutes per day most days of the week is best), and get enough rest and sleep. Talk to your doctor about what kinds of food and exercise are best for you.
  
  
• Get 400 micrograms (mcg) of folic acid (one of the B vitamins) every day. The best way to do this is to take a daily multivitamin with this amount of folic acid. Getting enough folic acid every day before you get pregnant and during early pregnancy can help prevent certain birth defects. Many breakfast cereals and other grain products are enriched with folic acid. But only some products contain 400 mcg of folic acid per serving. Always check the labels to be sure you're getting your daily dose.
  
  
• See your doctor for a complete check up. Make sure that you've had all your shots, especially for rubella (German measles). Rubella can cause serious birth defects. Chickenpox can also be dangerous during pregnancy. If you've had chickenpox and rubella in the past, you should be immune to them.  If not, talk to your doctor about the vaccines.
  
  
• Tell your doctor about any prescription or over-the-counter medicines (including herbal remedies) you are taking. Some medicines are not safe to take during pregnancy.
  
  
• Stop smoking cigarettes, drinking alcohol, or taking drugs. Ask your doctor for help. Members of your faith community, counselors, or friends can also give support.

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I'm pregnant. What should I do or avoid for a healthy baby?

Some things you can do to take care of yourself and the precious life growing inside you include:

• Take a multivitamin or prenatal vitamin with 400 micrograms (mcg) of folic acid every day.
  
  
• Get early and regular prenatal care. Whether this is your first pregnancy or third, health care is extremely important. Your doctor will check to make sure you and the baby are healthy at each visit. If there are any problems, early action will help you and the baby.
  
  
• Eat a healthy diet that includes fruits, vegetables, grains, and calcium - rich foods. Choose foods low in saturated fat.
  
  
• Unless your doctor tells you not to, try to be active for 30 minutes, most days of the week. If you don't have much time, get your exercise in 10 minute segments, three times a day.
  
  
• If you smoke, drink alcohol, or use drugs, STOP! These can cause long-term harm to your baby. Ask your doctor for help.
  
  
• Ask your doctor before taking any medicine. Some are not safe during pregnancy. Remember that even over-the-counter medicines and herbal products may cause side effects or other problems. So ask your doctor before taking these products too.
  
  
• Avoid hot tubs, saunas, and x-rays.
  
  
• If you have a cat, ask your doctor about toxoplasmosis. This infection is caused by a parasite sometimes found in cat feces. When left untreated toxoplasmosis can cause birth defects. Your doctor may suggest avoiding cat litter and working in garden areas used by cats.
  
  
• Don't eat uncooked or undercooked meats or fish.
  
  
• Stay away from chemicals like insecticides, solvents (like some cleaners or paint thinners), lead, and mercury. Not all products have pregnancy warnings on their labels. If you're unsure if a product is safe, ask your doctor before using it.
  
  
• Avoid or control caffeine in your diet. Pregnant women should have no more than two servings of caffeine per day. Remember that teas, sodas, and chocolate may contain caffeine.
  
  
• Stay active. Most women continue working through pregnancy. Few jobs are unsafe for pregnant women. But if you're worried about the safety of your job, talk with your doctor.
  
  
• Get informed. Read books, watch videos, go to a childbirth class, and talk with experienced moms.
  
• Ask your doctor about childbirth education classes for you and your partner. Classes can help you prepare for the birth of your baby.

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I don't want to get pregnant right now. But should I still take folic acid every day?

Experts recommend that all women of childbearing age get 400 micrograms (mcg) of folic acid every day. Even women with very little chance of getting pregnant should get their daily dose of folic acid. This is because many pregnancies are not planned. Often women don't know they are pregnant for a number of weeks. And some birth defects happen during this very early part of pregnancy.

Taking 400 mcg of folic acid every day will help prevent some birth defects that happen in early pregnancy. If a woman doesn't start taking vitamins until the second or third month of pregnancy, it may be too late to prevent birth defects. Folic acid may also have other health benefits for women.

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How often should I see my doctor during pregnancy?

Your doctor will give you a schedule of all the doctor's visits you should have while pregnant. As your pregnancy progresses, you'll see the doctor more often. Most experts suggest you see your doctor:

• about once each month for the first six months of pregnancy
  
  
• every two weeks for the seventh and eight month of pregnancy
  
• every week until the baby is born

If you are over 35 or your pregnancy is high risk because of health problems (like diabetes or high blood pressure), you'll probably see your doctor more often.

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What happens during prenatal visits?

During the first prenatal visit, you can expect your doctor or nurse to do the following:

• ask about your health history including diseases, operations, or prior pregnancies
  
• ask about your family's health history
  
• do a complete physical exam
  
• do a pelvic exam with a Pap test
  
• order tests of your blood and urine
  
• check your blood pressure, urine, height, and weight
  
• figure out your expected due date
  
• answer your questions

At the first visit, you should ask questions and discuss any issues related to your pregnancy. Find out all you can about how to stay healthy.

Later prenatal visits will probably be shorter. Your doctor will check on your health and make sure the baby is growing as expected.  Most prenatal visits will include:

• checking the baby's heart rate
• checking your blood pressure
• checking your urine for signs of diabetes
• measuring your weight gain

While you're pregnant your doctor or midwife may suggest a number of laboratory tests, ultrasound exams, and other screening tests. 

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I am in my late 30s and I want to get pregnant. Should I do anything special?

As you age, you have an increasing chance of having a baby born with a birth defect. Yet most women in their late 30s and early 40s have healthy babies. See your doctor regularly before you even start trying to get pregnant. She will be able to help you prepare your body for pregnancy. She will also be able to tell you about how age can affect pregnancy.

During your pregnancy, seeing your doctor regularly is very important. Because of your age, your doctor will probably suggest some additional tests to check on your baby's health.

More and more women are waiting until they are in their 30s and 40s to have children. While many women of this age have no problems getting pregnant, fertility does decline with age. Women over 40 who don't get pregnant after six months of trying should see their doctors for a fertility evaluation. 

Experts define infertility as the inability to become pregnant after trying for one year. If you think you or your partner may be infertile, talk to your doctor. She or he will be able to suggest treatments such as drugs, surgery, or assisted reproductive technology.

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Information provided by the United States Office on Women's Health in the Department of Health and Human Services. This information is provided for educational purposes only and is not intended to be used as a substitute for diagnosis and treatment by a medical doctor. Central Carolina Obstetrics & Gynecology does not endorse and has no responsibility for the content of any other sites listed on ccobgyn.com, and provides links, references, and educational material merely as a convenience to its users. Seek immediate medical attention if your condition is urgent.