Millions of American women give birth every year, and nearly a third of them will have some kind of pregnancy-related complication. Those who don't get proper prenatal care run the risk that such complications won't be detected or dealt with soon enough, which can lead to potentially serious consequences for both the mother and her baby. This is why it's so important to start prenatal care as early as possible – ideally, before a woman even becomes pregnant.
If you're planning a pregnancy, see your healthcare provider for a complete checkup. Routine testing can ensure you're in good health and you don't have any illnesses or other conditions that could affect your pregnancy. If you've been having any unusual symptoms, this is a good time to report them. Specific topics that should be discussed at this checkup include:
If you're already being treated for a chronic condition, such as diabetes, asthma, high blood pressure, a heart problem, allergies, lupus, depression or something else, you should talk to your doctor about how it could affect a pregnancy.
In some cases, you may need to change or stop certain medicines – especially during the first trimester – to reduce risk to the fetus. Or, you may need to be even more careful about managing your condition. For example, women with diabetes must take extra care to keep their blood glucose levels under control, both before they begin trying to conceive and during pregnancy.
This is also a good time to talk with your healthcare provider about any habits that could pose a risk to your baby, such as drinking alcohol or smoking. Ask about taking a prenatal vitamin that contains folic acid, calcium and iron. It's especially important for women who plan to become pregnant to take vitamins with folic acid to prevent neural tube defects (complications with the development of the spine and nervous system). These defects happen in the first 28 days of pregnancy, often before a woman even knows she's pregnant.
Family health history
Assessing the health history of both potential parents will give your healthcare provider helpful information about conditions that may run in your family. Download this family health history form from the March of Dimes to get started. If you or your partner have a family history of a significant genetic disorder and think either of you may be a carrier, genetic testing may be wise. Talk this over with your healthcare provider, who can refer you to a genetic counselor if necessary.
If you find out that you're pregnant before you do any of this, don't worry. It's not too late to get the care that will help to protect your health and that of your baby.
Finding the right care
Pregnant women usually are cared for by:
- Obstetricians - doctors who specialize in pregnancy and childbirth
- Obstetricians/gynecologists (OB/GYNs) - doctors who specialize in pregnancy and childbirth, as well as women's healthcare
- Family practitioners - doctors who provide a range of services for patients of all ages (sometimes, this includes obstetrical care)
- A certified nurse-midwife - an advanced practice nurse specializing in women's healthcare needs, including prenatal care, labor and delivery and postpartum care for pregnancies without complications
Any of these care providers is a good choice if you're healthy and there's no reason to anticipate complications with your pregnancy and delivery. However, nurse-midwives do need to have a doctor available for the delivery in case a C-section has to be performed.
Your healthcare provider may refer you to a doctor with expertise in high-risk pregnancies if you:
- Have a chronic condition like diabetes or heart problems
- Have an increased risk of pre-term labor
- Are older than 35
- Are pregnant with more than one fetus
- Have another complicating factor that might put you in a high-risk category
Even if your pregnancy isn't high risk, this may still be a good time to make a change in healthcare providers.