Ask the Doctor: Am I late for antenatal?

Dear Doctor, I am expecting my first baby and I'm really excited. I am in my second trimester now and have had a couple of scans that tell me that my baby is okay. However, recently, a friend asked me about antenatal visits to the hospital and I have no clue what she is talking about.

Dear Doctor,

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I am expecting my first baby and I’m really excited. I am in my second trimester now and have had a couple of scans that tell me that my baby is okay. However, recently, a friend asked me about antenatal visits to the hospital and I have no clue what she is talking about.

The doctor who has been doing the scans never mentioned anything about it but my friend says it is important as she had a baby and went to every antenatal appointment. My friend also says I’m a few visits late. Will this affect my baby? Can I start now?

Dorothy, 28

Dear Dororthy

Antenatal visits are the ones a pregnant woman makes to a doctor for assessment of her pregnancy, for the entire period till delivery. These visits include examination of the general health status of the mother, like weight, blood pressure measurement, to look for any infection pelvic or urinary, sexually transmitted diseases, swelling over feet, blood glucose measurement, e.t.c. Test for HIV is done for all antenatal mothers to screen for HIV because if positive, there is a risk of the baby being born with the infection.

The mother to be is also vaccinated for tetanus during these visits, thus preventing tetanus after delivery, which was one of the major causes of death after delivering a baby in olden times. In summary, antenatal visit is the assessment of the mother to screen her for any possible condition that could harm her or the baby’s health.

The pregnant women are also given iron folic acid tablets. During pregnancy the demand for iron is increased, failing to meet which there is risk of chronic iron deficiency anemia. Hence these iron supplements are useful to prevent this. These visits also incorporate evaluation of the health of the growing fetus. Whether the fetus is growing normally as per the gestational age or there is some problem or potential problem, this is assessed by means of clinical examination and ultrasound examination of the pregnant uterus.

The would be mother is also counseled about the precautions she has to take during pregnancy, signs of distress during pregnancy for which one should seek urgent medical attention and given tips on baby care which would be needed later. Around full term depending on the general health status of the mother and that of the fetus, if a cesarean section is deemed necessary, a suitable date is fixed for it after fetus is viable to survive outside.

Thus antenatal visits are very useful in ensuring safe motherhood. Maternal mortality and neonatal mortality the world over have reduced due to regular antenatal screening for would be mothers. It also has a positive effect on the mental well being of the pregnant woman. When a pregnant woman, particularly during first pregnancy, goes for the antenatal visit, she sees many other women like her there. This removes her fears and apprehensions to a large extent. She also gets a chance to interact with other pregnant ladies and can discuss her doubts and problems like morning sickness, food cravings e.t.c with them. This helps in keeping her stress free.

Ideally antenatal visits start as soon as pregnancy is confirmed. Initially it is once a month, but as due date approaches, one is called every fortnight or even earlier if the condition demands. But second trimester is not too late. Better late than never. You can visit a health centre or hospital close to you which offers this service.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hospital.

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