What is prenatal care?
Prenatal care is the act of having a healthy lifestyle while you are pregnant. This includes making good choices and going to the doctor for regular visits. You are more likely to have a healthy birth if you maintain a healthy pregnancy.
Schedule an appointment with your doctor as soon as you find out you are pregnant. Your doctor will start by reviewing your medical history. They also will want to know about your symptoms. At each visit, the doctor will record your weight and blood pressure. These measurements help to track your health during pregnancy.
Urine and blood samples will be taken on the first visit and again at later visits. Urine tests check for bacteria, high sugar levels (which can be a sign of diabetes), and high protein levels (which can be a sign for preeclampsia, a type of high blood pressure during pregnancy). Blood tests check for blood cell count, blood type, low iron levels (anemia) and infectious diseases (such as syphilis, HIV, and hepatitis).
The doctor may do other tests at your first visit. These may vary based on your background and risk for problems. Tests can include:
- A pelvic exam to check the size and shape of your uterus (womb).
- A Pap smear to screen for cervical cancer.
- An ultrasound to view your baby’s growth and position. An ultrasound uses sound waves to create an image of your baby on a video screen.
After your first visit, you will have a prenatal visit every 4 weeks. In months 7 and 8, you will have a visit every 2 weeks. In your last month of pregnancy, the visits will occur each week until you deliver your baby. At each visit, the doctor will check your weight and blood pressure and test your urine. The doctor will listen to your baby’s heartbeat and measure the height of your uterus in your abdomen after the 20th week. You should always discuss any issues or concerns you have with your doctor.
Path to improved health
Prenatal care is very important. Follow some simple guidelines to take care of you and your baby during pregnancy.
How much weight should I gain during pregnancy?
Talk to your doctor about how much weight you should gain. It is different for everyone, but most women should gain about 25 to 30 pounds. If you are underweight when you get pregnant, you may need to gain more. If you are overweight, you may need to gain less.
What should I eat?
Eating a balanced diet is one of the best things you can do for yourself and your baby. Be careful of the following foods and drinks during pregnancy.
- Meat, eggs, and fish. Food that is not fully cooked can put you at risk for an Do not eat more than 2 or 3 servings of fish per week (including canned fish). Do not eat shark, swordfish, king mackerel, or tilefish. These fish have high levels of mercury, which can harm your baby. If you eat tuna, make sure it is light tuna. Do not eat more than 6 ounces of albacore tuna and tuna steaks per week. It is safe to have 12 ounces of canned light tuna per week.
- Fruit and vegetables. Wash all produce before eating it. Keep cutting boards and dishes clean.
- Dairy. Eat 4 or more servings of dairy each day. This will give you enough calcium for you and your baby. Do not drink unpasteurized milk or eat unpasteurized milk products. These may have bacteria that can cause infections. This includes soft cheeses such as Brie, feta, Camembert, and blue cheese, or Mexican-style cheeses, such as queso fresco.
- Sugar substitutes. Some artificial sweeteners are okay in moderation. These include aspartame (brand names: Equal or NutraSweet) and sucralose (brand name: Splenda). If you have phenylketonuria (PKU), do not use aspartame at all.
- Caffeine. Do not drink more than 1 or 2 cups of coffee or other drinks with caffeine each day.
Can I take medicine?
Check with your doctor before taking any medicine. This includes prescriptions, pain relievers, and over-the-counter medicines. Some medicines can cause birth defects, especially if taken during the first 3 months of pregnancy.
Can I take vitamins?
Pregnant women should take at least 400 micrograms (mcg) of folic acid each day. It can help prevent problems with your baby’s brain and spinal cord. Ask your doctor if you need more than 400 mcg.
It is best to start taking folic acid before you get pregnant. You can get folic acid from taking a prenatal vitamin. You should take this every day. Do not take other vitamins or supplements without your doctor’s approval.
How long can I keep working?
How late you work in pregnancy varies for each person. Your job and work environment play a big role. For instance, radiation, lead and other materials, such as copper and mercury, can be harmful to your baby. If your job is active, you may not be able to work as late. Desk jobs are not thought to cause harm to your baby. However, you should not rest a computer on your stomach or uterus.
Your overall health also plays a part in how late you work. If you are at risk of certain issues or preterm labor, you may be on bed rest.
What about exercise?
Unless you have issues during pregnancy, you should get regular exercise. Exercise promotes a healthy lifestyle and can help ease discomfort. Try to get at least 30 minutes of exercise each day. Talk to your doctor about any conditions that may prevent exercise.
Some women say exercising while you are pregnant makes labor and delivery easier. Walking and swimming are great choices. If you were not active before pregnancy, start slowly. Listen to your body and do not overdo it. Drink plenty of water to prevent overheating or dehydration. It is best to avoid exercises that may cause you to fall. This includes skiing and rock climbing. You also should avoid contact sports, such as soccer or basketball. If you were active before pregnancy, it is probably safe to continue. Ask your doctor if you have any concerns.
Call your doctor if you have symptoms with exercise, such as:
- blurred vision
- chest pain
- stomach pain.
Can I have sex?
It is safe to have sex while you are pregnant. However, talk to your doctor if you have concerns or are at risk for problems. Some women’s level of interest in sex changes when they are pregnant. As you grow, you may need to try different positions, such as lying on your side or being on top.
What can I do to feel better?
Below are common side effects of pregnancy with tips on how to manage them.
Nausea or vomiting may strike anytime during the day (or night). Try eating frequent, small meals. Avoid foods that are greasy, spicy or acidic. Some women are more nauseous when their stomach is empty. Keep crackers nearby to prevent an empty stomach. Talk to your doctor if morning sickness causes you to lose weight or lasts past the first 3 months of pregnancy.
Fatigue is very common when you are pregnant. Try to get enough rest or take a nap if possible. Talk to your doctor if you have symptoms with fatigue. You may have anemia.
Being active can help reduce leg cramps. Stretch the calf of your leg by flexing your foot toward your knee.
Drink plenty of fluids. Eat foods with lots of fiber, such as fruits, vegetables, and bran cereal. Do not take laxatives without talking to your doctor first. Stool softeners may be safer than laxatives.
Try to avoid becoming constipated. Do not strain during bowel movements. Clean yourself well after a bowel movement. Wet wipes may feel better than toilet paper. Take warm soaks (sitz baths) if necessary.
Urinating more often
You may need to urinate more often when you are pregnant. Changing hormones can be a factor. As your baby grows, they will put pressure on your bladder.
Avoid clothing that fits tightly around your waist or legs. Rest and put your feet up as much as you can. Avoid sitting or standing still for long periods. Ask your doctor about support or compression hose. These can help prevent or ease varicose veins.
Your hormones are on a roller coaster ride during pregnancy. Plus, your whole life is changing. Don’t be too hard on yourself. Get help right away if you feel sad or think about suicide.
Eat frequent, small meals. Avoid spicy, greasy or acidic foods. Do not lie down right after eating. Ask your doctor about taking antacids.
The amount of discharge from your vagina can increase during pregnancy. Yeast infections, which can cause discharge, are common as well. Talk to your doctor if you see any unusual discharge or if it smells.
Brush and floss regularly, and see your dentist for cleanings. Do not avoid dental visits because you are pregnant. Be sure to tell your dentist you’re pregnant.
Changes in the levels of the female hormone estrogen can cause a stuffy nose. You may also have nosebleeds.
Edema (retaining fluid)
Rest with your legs up as much as you can. Lie on your left side while sleeping. This position helps blood flow from your legs back to your heart better. Do not use diuretics (water pills).
Stretch marks appear as red marks on your skin. Lotion with shea butter can help keep your skin moist and reduce itchy, dry skin. Stretch marks cannot be avoided. They do often fade after pregnancy.
You may have other skin changes. These can include darkening of the skin on your face or around your nipples. Some women get a dark line below their belly button. Try to stay out of the sun or use sunscreen to help lessen these marks. Most marks will fade after pregnancy.
Things to consider
There are several things you should avoid while you are pregnant. Take notice to follow this list of warnings. Talk to your doctor if you need help.
- Do not smoke. Smoking raises your risk for miscarriage, preterm birth, low birth weight, and other health problems.
- Do not use drugs. Cocaine, heroin, marijuana, and other drugs increase your risk of miscarriage, preterm birth, and birth defects. Your baby could be born addicted to the drug you’ve been abusing. This is called neonatal abstinence syndrome. It can can cause severe health problems for your baby.
- Do not drink alcohol. Drinking alcohol is the major cause of preventable birth defects, including fetal alcohol disorder.
- Do not clean your cat’s litter box or eat raw or undercooked red meat. You could get toxoplasmosis, a disease that can cause birth defects.
- Do not douche. Your vagina doesn’t require cleansing in addition to normal bathing. Douching disrupts the helpful bacteria that keep your vagina clean.
When to see a doctor
Call your doctor if you have:
- blood or fluid coming from your vagina
- sudden or extreme swelling of your face or fingers
- headaches that are severe or won’t go away
- nausea and vomiting that won’t go away
- dim or blurry vision
- severe pain or cramps in your lower abdomen
- chills orfever
- a change in your baby’s movements
- less urine or burning when you urinate
- an illness or infection
- any other symptoms that bother you.
Questions to ask your doctor
- What medicines can I take during pregnancy?
- When should I start taking a prenatal vitamin? What kind is best?
- How much folic acid do I need to take each day?
- How can I prevent or reduce swelling?
- How much weight should I gain while pregnant?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.