you and your health

The importance of comprehensive maternity care

By JAMES LOMAX, MD
Posted 3/31/21

Comprehensive maternity care involves all aspects of family planning, prenatal, pregnancy and postpartum medical care of the mother and fetus. Each phase has its own defined evaluations and education …

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you and your health

The importance of comprehensive maternity care

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Comprehensive maternity care involves all aspects of family planning, prenatal, pregnancy and postpartum medical care of the mother and fetus. Each phase has its own defined evaluations and education for the mother and her family. Receiving early and regular prenatal care improves the chances of a successful pregnancy for both the mother and child. Women without adequate prenatal care are seven times more likely to give birth to premature babies and the infant is five times less likely to survive.

Care should be preceded with a discussion with the mother’s primary obstetrical care physician to plan out the timing of the pregnancy; anything the mother can do in advance concerning diet and controlling any existing medical condition, like diabetes or excessive weight; and to follow up with genetic counseling if there is a history of prior pregnancies or family history of genetic-associated conditions, such as Down syndrome. The mother needs to stop smoking and avoid exposure in her household or work situation where there is cigarette smoking, along with discontinuing alcohol before becoming pregnant.

Prenatal care begins with a comprehensive laboratory screen to test the fetus for any genetic changes. The mother is followed on a monthly basis to screen for things like diabetes, anemia and elevated blood pressure. Ultrasounds are performed periodically to make sure is the fetus is growing and developing normally. A fetus should grow about two inches per month. By the seventh month, the baby should be about 14 inches long. By the end of the pregnancy, the fetus should be about 18 to 20 inches long and weigh around 6.6 pounds. Any deviation from this growth pattern requires further evaluations.

Diet and exercise are important parts of maternal care. Even though mothers are prescribed specific vitamins during the pregnancy, a balanced diet and avoiding specific substances like alcohol are important to prevent or modify anemia, fatigue and morning sickness. An active exercise program is helpful in controlling excessive weight gain. A supervised exercise program also helps with posture as the baby bump enlarges and reducing low back pain.

Some pregnancy warning signs that require urgent/emergency medical evaluation include the following:

Bleeding at any time during the pregnancy prior to going into labor
Severe nausea and vomiting
Decreased infant activity
Contractions early in the 3rd trimester
Leakage of amniotic fluid
Persistent severe headache, stomach pain, visual disturbance and excessive swelling of hands and feet indicating possible preeclampsia.
Flu symptoms or other signs of infection.

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