ANTENATAL CARE

When a woman is pregnant, it is important to have regular check-ups with the doctor. These check-ups are called antenatal care or antenatal visits. Antenatal means before birth. Regular medical care, knowledge of her choices, and understanding the unknown events during pregnancy can make childbirth an extremely enriching and joyful event. A series of appointments is usually offered with a doctor who specialises in pregnancy and birth (an obstetrician).

About AnteNatal Care

For most women, pregnancy is a simple, joyful and hale and hearty time. Having regular antenatal check-ups is an important part of staying healthy and making sure baby is healthy too. Regular checks during pregnancy can help in finding and decreasing risks to mother or baby. Although expecting mother may be feeling fine, it is still important to get regular antenatal check-ups. This gives a chance to ask any questions and to talk about any issues that one is unsure about. Before each visit, one can plan and think about the things one want to talk about from the gynaecologist.

When to start antenatal care?

As soon as a lady thinks that she is pregnant, it’s important to discuss with the gynaecologist for

  • What type of care one would like to have, and
  • When and where one should have next visit

Before the first antenatal visit, what all requirements and arrangement needs to be done for necessary tests (blood tests, scans).After first antenatal visit, the later visits are then every 4 weeks until expecting mother is near her Expected Due Date (EDD) when visits become more frequent.

First Antenatal care visit

At the first antenatal visit,  expecting mother will be asked lots of questions about her health, any other pregnancies, herself, her partner, and her family. This will assist the doctor to plan her care. At the first visit, she may also undergo some diagnostic test like blood group, viral markers, Hb electrophoresis, thyroid panel& urine test as well.

Gynaecologist will need medical history, including information about illnesses, operations, and allergic reactions to drugs, heart or kidney problems. Also, doctor will need gynaecological and obstetric history and any other health issues and information about any family medical problems such as diabetes, chronic diseases, genetic disorders or a history of twins.

To help gynaecologist to find out if she need any special antenatal need care, it’s important to share if expecting mother:

  • Had any complications in a previous pregnancy or birth, such as pre-eclampsia or a premature baby
  • Are being treated for a long-term condition, such as diabetes or high blood pressure
  • Have previously had a baby with a birth defect (or anyone in your family has), for example spina bifida
  • Have a family history of an inherited disease, for example sickle cell anaemia or cystic fibrosis

Next successive antenatal visits till expected due date (EDD) will be a great way to learn about how  the baby is growing and what is happening to expecting mother’s body. Many women and their partners enrol for antenatal classes to learn more about pregnancy and birth, partner’s role etc.

DELIVERY

It’s time! After nine months, little bundle of joy is finally ready to make an appearance.

Every delivery is different, and some women need extra help. It’s good to know ahead of time about the medical interventions that may be offered, and how doctor may assist labour.

Sometimes couple can have a choice about how their baby will enter the world; other times (due to medical necessity or emergency) they do not. As a woman waits out her pregnancy, it’s a good idea to learn about possible types of delivery so that she can make an educated choice when she have an option. The basic methods of delivery are

  • Normal Delivery –  is Natural  (vaginal) childbirth
  • Caesarean Delivery (also called a C-section) is childbirth through an cut in the mother’s abdomen
  • Painless Delivery – Epidural Analgesia helps in reducing the discomfort of childbirth. The goal of an epidural is to provide pain relief, rather than anaesthesia which leads to total lack of feeling which allow women to remain alert and be an active participant in your birth.
  • Assisted Delivery – Assisting baby’s birth with vacuum or forceps is a safe, well-practiced procedure.

Feeling anxious about labour is normal and to be expected. Knowing the signs and stages of real labour can help manage the same. The main signs of labour starting are strong, regular contractions, and a ‘show’.

Signs of labour

  • Regular painful contractions
  • Blood stained mucous discharge or “show”
  • Any fluid loss from the vagina or ruptured membranes

Other symptoms that will need attention:

  • Abdominal pain
  • Bleeding from the vagina
  • Headache not settling with simple pain relief and rest
  • Vomiting
  • Diarrhoea

Stages of labour

There are three stages to labour:

  • The first stage, when cervix gradually open up (dilate) due to contractions. This is usually the longest stage.
  • The second stage is when the cervix is fully open. This is the part of labour where expecting mother help her baby move through her vagina by pushing with your contractions.
  • The third stage is after the birth of the baby, when the womb contracts and causes the placenta to come out through the vagina.

Induction of Labour

An induction may be offered if it’s felt that continuing the pregnancy poses a risk to mother or baby’s health. Before setting a date for induction, doctor may offer to strip mother’s membranes to help her go into spontaneous labour.

Induction is not the same as an augmentation of labour, which is when drugs are used to increase the efficiency of contractions, when woman have already gone into labour spontaneously.