Johns Hopkins The Importance of Prenatal Care

The Importance of Prenatal Care

Patients often ask me when they should start getting prenatal care. My answer is, “Before you get pregnant.” Optimally, prenatal care starts before conception and then continues through postpartum. Let’s discuss the critical stages of care.

Pre-conceptual planning

Planned pregnancies are best for all involved. Once you decide that you would like to have a baby, you should schedule a pre-conceptual visit with your GYN healthcare provider. At this visit, your provider can screen you for any infections, update your Pap smear if needed, adjust any of your medications that might harm a pregnancy, start you on prenatal vitamins (which are key in preventing defects of the spine), and help you consider any other health issues that might affect your pregnancy.

Once you are pregnant

Once you have a confirmed pregnancy, you should ideally have your first obstetric visit by the sixth to eighth week of the pregnancy. This first visit includes a complete history, blood work, screening tests like a Pap smear and cultures for sexually transmitted infections, and often an ultrasound to accurately date the pregnancy. It is important that these procedures be completed early in the pregnancy to ensure that your dates are correct and that any complications in the pregnancy are identified early.

As the pregnancy progresses

For a normal, healthy pregnancy, you should visit your obstetric healthcare provider

• every 4 weeks until you are 28 weeks pregnant
• then every 2 weeks until you are 36 weeks pregnant
• and then weekly until delivery

If you have complications, you might need to be seen more often. At certain points along the way, tests will be done to screen for genetic defects, gestational diabetes, and vaginal or cervical infections. If your early blood tests have shown that you have Rh-negative blood, you will be given Rhogam, a medication to prevent you from forming antibodies to the Rh-positive blood type that the baby may have. You will also be given opportunities to discuss birth control after delivery, the pros and cons of breastfeeding, and any concerns or requests about your birth experience. As your due date approaches, most hospitals provide an opportunity to learn about childbirth classes and tour their birthing center.

Delivery and beyond

Armed with all the proper information from your prenatal visits, you will be prepared for the childbirth experience. The postpartum period can of course present some challenges with a new baby. You will have 1 to 2 postpartum visits, to verify that you are recovering properly and adjusting to motherhood. If you find that you are struggling for any reason, call your provider’s office and be seen immediately.
With the proper prenatal care starting from preconception and continuing through the postpartum phase, you will feel supported on your journey to motherhood, with the best outcomes possible for you and your baby.