Antenatal Care (ANC)

Antenatal care involves various components aimed at assessing the health of the pregnant individual, monitoring fetal development, and providing essential support and guidance. The key components include:

1. Initial visit and assessment: The first antenatal care visit typically involves a comprehensive assessment of the pregnant individual's medical history, physical examination, and baseline tests.

2. Ongoing visits and monitoring: Subsequent antenatal care visits are scheduled at regular intervals to monitor the progress of the pregnancy, assess maternal and fetal well-being, and address any concerns or questions.

3. Screening and diagnostic tests: Various tests are performed throughout the pregnancy to screen for conditions such as gestational diabetes, chromosomal abnormalities, and infections. Diagnostic tests may be recommended if any abnormalities are detected.

4. Nutrition and lifestyle guidance: Healthcare providers offer guidance on maintaining a healthy diet, taking prenatal supplements, and engaging in appropriate physical activity during pregnancy.

5. Emotional support and education: Antenatal care includes counseling and education on various topics such as breastfeeding, labor and childbirth, postnatal care, and newborn care.

The Best Time To Begin Antenatal Care

Antenatal care needs to be started early following confirmation of pregnancy. It is best started within the 4 to 8 weeks or by 12 weeks into pregnancy from the last menstruation. If possible, commencing antenatal care one month before conception is ideal. Before starting a family, parents can consult an obstetrician for a comprehensive health evaluation.

Early visits help the health care providers to obtain a baseline of the mother's health, screen for conditions such as high blood pressure and diabetes, properly date the pregnancy using ultrasound, perform essential screening for genetic disorders and infections, advise the mother on diet and activity, give prenatal vitamins like folic acid for the prevention of birth defects, and establish a customized plan for care. 

Tests For Antenatal Care

Antenatal tests generally include a battery of tests that are supposed to monitor the well-being of the mother and growing fetus continuously. These tests can be generally classified as blood tests, urine tests, ultrasounds, or other abnormality tests. The breakdown goes like this:

Medical History: The obstetrician compiles a thorough medical history, which will include menstrual history (LMP), congenital disorders, drugs used, drugs tolerated, past pregnancies, present pregnancy (possible twins, childbirth, miscarriages, complications), and any past surgery such as removal of fibroids, cysts. Family history emphasizing health matters like diabetes, thalassemia, Down syndrome, and smoking or drug use history, if applicable.

Blood Tests: Tests which include Wiki-Complete Blood Count (CBC) mainly to rule out anemia and infections; Blood Group and Rh Factor (to determine the type of blood), Infection Screening on HIV, hepatitis B, syphilis, rubella, Glucose Screening to screen for gestational diabetes, Thyroid Function Tests to check thyroid health, and Genetic Screening for other conditions like Down syndrome. 

Urine Tests: These are to check for urinary tract infection, protein (might indicate pre-eclampsia), and glucose.

Ultrasound Scans: The ultrasounds done in the first trimester are to confirm pregnancy, estimate gestational age, and exclude multiple pregnancy. The second-trimester ultrasound is performed to assess the fetal anatomy for any abnormality and growth, while the third-trimester scans monitor fetal growth, position, and amniotic fluid assessment.

Other screenings: Cervical screenings can be done in high-risk pregnancies, whereas Group B Streptococcus (GBS) tests are usually done in the third trimester to check for bacterial infection. 

Weighing the pregnant mother: To keep monitoring the relation between the mother and child weight gain, all pregnant mothers from 3 months upward must gain at least about 0.5 kg/week.

Measuring height: Any woman under 140 cm in height may be at risk of labor dystocia due to a narrow pelvic floor. Therefore, the obstetrician will plan an appropriate delivery method to minimize this risk.

Measuring blood pressure: Hypertension in pregnancy can impair the normal function of organs and result in low birth weight and premature birth. If the blood pressure is low, sufficient oxygen and nutrients may not reach the fetus, leading to moderate growth and preterm birth.

Recommended Advice During Antenatal Care

Here is an overview of suggestions usually given during antenatal care: 

• Eat a variety of nutrient-rich foods and prenatal vitamins, particularly folic acid, iron, and calcium.  
• Drink copious amounts of water throughout the day. Raw or undercooked meats, seafood, unpasteurized dairy products, and high-mercury fish are to be limited or avoided.  
• Moderate exercise, such as walking, swimming, or prenatal yoga, may be performed with your health care provider's approval. Get enough rest and sleep.  
• Avoid activities that can put you at risk of falling or trauma to your abdomen.
• Do not smoke or let anyone smoke near you. Stay away from alcohol.  
• Get your health care provider's advice before taking any medications, including over-the-counter drugs and herbal supplements.  
• Engage in stress-reducing measures such as deep breathing, meditation, and yoga.  
• If feelings of anxiety or depression appear, reach out for support from family and friends. Keep your doctor informed about emotional changes during pregnancy.   
• Maintain hygiene to safeguard from infections and ask your health care provider before making any travel plans.  
• Be on the lookout for worrying signs like intense abdominal pain, vaginal bleeding, or reduced fetal movement.  
• It is vital to attend all scheduled antenatal appointments. 

Benefits of Antenatal Care

Antenatal care has a lot of benefits for mothers and babies. It also helps detect and manage complications as early as possible, thereby promoting health through nutrition and lifestyle counseling. Emotional support and counseling prepare mothers for childbirth and postpartum care. For the baby, antenatal care follows fetal development, decreases complication risks, increases chances of healthy births, and decreases infant mortality. Thus, it decreases maternal and neonatal death rates, improves pregnancy outcomes, and sets a basis for both maternal and infant health.

Antenatal care can be defined as a set of the various health services and activities aimed at maintaining the well-being of the mother and fetus during pregnancy. Antenatal care takes on a wide range of insinuations. The initial antenatal care visit is an essential step in establishing a baseline for the pregnancy. During this visit, the healthcare provider will:

1. Health Monitoring and Assessment:

Collect a detailed medical history, including previous pregnancies, medical conditions, and medications. Perform a physical examination, which may include measuring height, weight, blood pressure, and abdominal examination. Order baseline tests, such as blood tests, urine analysis, and screening for infectious diseases. Discuss the expected schedule of antenatal care visits and address any immediate concerns or questions.

2. Education and Counseling: 

Nutritional counseling, exercise regimen, and avoidance of alcoholic and narcotic drug consumption. The expectant mother should be educated about the stages of labor, pain-alleviation options, and modes of delivery. Discussing recovery after delivery, nursing care, and newborn care. To address emotional factor responses through an examination and to provide support regarding any worries or concerns.

3. Preventive Measures: 

Recommended vaccines such as flu and Tdap vaccines will ensure better protection for the mother and the baby. Prenatal vitamins like folic acid and iron are prescribed to ensure proper nutrient intake. Adoption of multi-faceted approaches toward pre-existing medical conditions like diabetes or hypertension to minimize risk from such conditions during pregnancy.

4. Early Detection and Treatment of Complications: 

The identification and management of pregnancy-related complications like gestational diabetes, pre-eclampsia, and infections. If necessary, it may require referral of the patient to specialists for further evaluation and treatment.

5. Childbirth Preparation: 

The obstetricians have to control the childbirth in such a way that a mother-to-be and her baby remain safe for vaginal or abdominal birth. Further, they will assist postnatal birth control planning, especially in contraceptive options. The obstetrician would also continue to prescribe the necessary vitamins and supplements for pregnancy.