Question

Define prenatal care and discuss in detail how it affects pregnancy. If you were management for an OBGYN department and found the rate of pregnant women receiving prenatal care was low, how—specifically—might you attempt to increase those rates for your patients?

Minimum 300 to 400 words

with exact references and in-text citations

Ref:

An Introduction to Community Health. 8th ed.

McKenzie, J.F., Pinger, R.P., Kotecki, J.E.

Jones & Bartlett Learning. 2015  

Answer 1

Prenatal care: Health care that a pregnant woman receives from an obstetrician or a midwife. Services needed include dietary and lifestyle advice, weighing to ensure proper weight gain, and examination for problems of pregnancy such as edema and preeclampsia.

ANC, IFA supplementation, and TT vaccination during pregnancy reduced the likelihood of child mortality in Bangladesh. The findings suggest that considerable gains in improving child survival could be achieved through ensuring universal coverage of ANC, promoting TT vaccination during pregnancy and IFA supplementation among pregnant women  

Examination and advice during pregnancy is called antenatal care.
It comprises of:: 1. History taking
                         2. General physical examination
                         3. Advice
Why it is done?
It helps to screen the high risk cases, to detect and treat any complications as early as possible, education of mother, to remove the fears and anxiety, about place, time and mode of delivery, family planning, appropriate advice on medical termination of pregnancy.

What will doctor ask you in history::
She will ask you firstly your particulars, followed by your age, then about any past pregnancies and there history. With this they will derive a formula known as obstetrics formula.
Then they will ask about your occupation and life style. This is followed by the chief complaints, sleep, appetite, bowel habits and urination.
If this is your second pregnancy whole history of the past pregnancy about year and date, pregnancy events, labour events, method of delivery and condition of the baby is taken.
The next important question they will ask you is your last menstrual period (LMP). From LMP, the doctor will calculate the expected date of delivery, its 9 months and 7 days if the periods are regular.

Examination performed on you during first visit.
General physical examination to see your build, nutrition, height, weight, any signs of anaemia, jaundice, neck veins, edema, pulse, blood pressure, breast examination, etc
Obstetrics examination- Muscle, signs of any tenderness, herniation and skin over abdomen. palpation of the fundus of uterus which just becomes palpable at 12 weeks.
Vaginal Examination- It is done to diagnose the pregnacy, to rule out any pathology. At times bivalve speculum is used in a good light source when any sample is required for vaginal swab, or exfoliative cytology.
Ultrasonography examination. It helps to detect number of fetuses, dating accurately, any gross fetal abnormality, etc.
Blood investigation especially hemoglobin, ABO, and Rh testing along with VDRL, HIV, HBs screening
Urine examination for protein, sugar and pus cells.
Maternal serum Alpha Feto Proteins- In mothers carrying the risk for neural tube defects (above 35 years of age), Down syndrome, or other chromosomal abnormalities.
A Tetanus Toxoid could be given but is usually given around 4th month.
These are basically the things done at the first visit to the gynecology and obstetrics department.

Attending antenatal classes will give you and your partner an opportunity to ask questions you don’t always remember at your regular pregnancy check-ups, and you’ll meet other expecting parents and make new friends too. Plus, birthing experts are at the forefront of new technologies, trends or birthing practices so it’s a great way to gather new information without having to do the research yourself.

In addition to seeing your gynaecologist for regular scans and check-ups, here’s a few more reasons why you should sign up to antenatal classes or a course.

It boosts awareness which can help to prevent complications. “A small minority of pregnant women develop complications such as hypertension and diabetes. If you’re under the watchful eye of healthcare experts, any complications will be picked up early and you’ll be monitored and treated accordingly,” explains midwifery consultant, Dr Diana du Plessis.
Antenatal care also gives caregivers a chance to explain things in more detail. For instance, you might discuss the importance of proper nutrition during pregnancy and breastfeeding.
Antenatal classes will help you to gain insight and get fact-based information on your pregnancy, birthing options, breastfeeding and caring for your new baby so you can make informed choices.
“Antenatal classes also give partners an opportunity to understand the whole process of pregnancy, birth and early parenting,