Antenatal Care and Visits
But what are your care-givers actually checking? And why?
There are three main indicators of fetal wellbeing that are assessed at each visit:
- increasing weight of the mother in relation to the growing uterus size and height of fundus (top of the womb)
- fetal movements
- fetal heart rate (this should be between 110-160 beats per minute)
Ten indicators of RISK that are checked for, are:
- reduced fetal movements, or no movements felt
- haemoglobin level (iron) lower than 10g/dl
- poor weight gain, or weight loss
- protein or sugar found in the urine
- a blood pressure reading of 140/90 or above
- malpresentation (abnormal lie of baby in the womb)
- vaginal, cervical or uterine bleeding
- premature labour signals
- chronic illness in the mother
Antenatal care begins at the first visit to confirm a pregnancy and ends with the birth. Your caregivers should provide an approach to the woman and her family so that the mother-to-be can make informed choices about what she needs to know and do. A midwife’s five aims usually are:
- finding out what is important to the woman
- to use information obtained from clinical observations
- to seek and assess evidence to make informed decisions
- to talk things through
- to reflect on outcomes of results
The first visit is called a Booking Visit. This initially introduces the woman and her family to the maternity service. She should be told what to expect, what will happen and when she should receive results. There are a lot of questions such as medical history of both the mother and her immediate family, menstrual history, marital status, environment and advice will be given about nutrition and tests.
But these visits are very much a two-way street and you must always feel comfortable to ask your own questions if you have any. This is YOUR baby!
Baseline readings will be taken of blood pressure and checked at each subsequent visit, along with signs of oedema (swelling, usually of the hands and feet). A due date will also be given and appointments made for ultra sounds which we will go into in further detail in another article.
Abdominal examination will take place at later visits to check that the fundal height corresponds with the gestation period. For example, if you’re thirty weeks pregnant, your fundus height should be 30cm.
Blood samples will be taken to check for type, rhesus factor, HIV, rubella and hepatitis B. Your height and weight may also be checked, but this is starting to become less common.
The baby’s position and lie will be checked to see if it is transverse (laying across the tummy, hip to hip) or breech (head positioned beneath the mother’s ribs). Yet babies in these positions can still have time to move in the latter weeks, but your caregiver will discuss the matter with you, depending upon how many weeks you have left to go.
As you get closer to your due date, your caregiver will also check to see if the baby’s head has engaged within the pelvis. And at most visits, you will have the opportunity to hear your baby’s heartbeat, a very special moment! I can recall taking my son along to hear the twin’s heartbeats at one of my checks and he thought there was a train in my stomach!
Always remember, that these checks, though some may seem unconnected to pregnancy, are vital and important. But if you have any worries or questions about what your team are doing for you, then you must ask for clarification. Also make sure that you are given a contact number so that if you have an emergency or a health worry that won’t wait until your next check-up, then you will be able to get instant help whenever you need it.
So, if in doubt, ask.. It’s your body. Your baby. Don’t be afraid to ask what might seem a silly question. Don’t be afraid to voice your worries or concerns. Your caregivers have heard it all before and they are there for YOU.
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