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Life As a Parent: Prenatal Care
Prenatal Information

5 Steps to Get Ready for a Healthy Pregnancy
1. Take 400 micrograms (mcg) of folic acid every day for at least 1 month before getting pregnant to help prevent birth defects.
2. Stop smoking, drinking alcohol, and using illegal substances.
3. If you have a medical condition, be sure it is under control. Some conditions include asthma, diabetes, oral health, obesity, or epilepsy. Also be sure that your vaccinations are up to date.
4. Talk to a health care provider about any over-the-counter and prescription medicines you are taking. These include dietary or herbal supplements.
5. Avoid contact with toxic substances or materials that could cause infection at work and at home. Stay away from chemicals and cat or rodent feces.

Congratulations!
This material has been prepared to answer some of the questions that might arise during the course of your pregnancy. We encourage you to talk with your health care provider. We hope your health care experience during your pregnancy, labor, and delivery will be a positive one.

Importance of Prenatal Care
Early prenatal care, including regularly scheduled health care visits, helps promote the deliver of a healthy baby. Prenatal care is also the best way to discover and treat problems that may arise in pregnancy. At your prenatal clinic appointments, your health care provider will give you advice about your pregnancy and discuss a plan of care.

Duration of Pregnancy
The average duration of pregnancy is about 280 days or 40 weeks counting from the first day of the last menstrual period. It is important to remember that due dates are not exact. It is common for women to deliver from two weeks before to two weeks after their due date.

Prenatal Care Visits
Early in your pregnancy, you will have a complete history and physical examination. It is important to inform your health care provider of all details of your health history. Routine laboratory tests will be obtained, looking for specific issues that could influence the pregnancy.

After the initial visit, you will be seen about every 4 weeks until your 7th month (28 weeks). Then, you will be seen every other week until the last month, when you will be seen weekly.

At each visit, your weight, blood pressure, and urine will be checked. Your health care provider will measure the size of your uterus, and after 12 weeks, listen to your baby’s heartbeat.

Special Tests During Pregnancy
Certain tests may be recommended during your pregnancy to evaluate your progress and that of your baby. Although not all of the tests are standard procedure, your health care provider may recommend some of the following:
• Alpha Fetoprotein (AFP) – This is a screening test for certain birth defects in the fetus. Since this test is not foolproof, a mother with an abnormally high or low AFP level will require further evaluation.
• For women greater than 35 years old or with family history of a genetic problem, options for genetic evaluation will be discussed including Nuchol Fold measurements maternal blood test first change, chronic villi sampling or amniocentesis.
• Fetal Movement – A very good way to check the health of your baby is to be aware of its movement. At about the 20th week or pregnancy, most mothers will be feeling their babies moving each day. Any sudden loss of fetal movements should be reported immediately.
• Non-Stress Test (NST) – This painless and harmless test is sometimes done later in pregnancy to evaluate the health of the baby, particularly if there are any concerns. An electronic fetal monitor is used to see how the baby’s heart beat responds to its’ own movements. The test takes about 20-40 minutes to complete.
• Ultrasound – Ultrasound can be very helpful in determining the baby’s size, position, and due date. It also can locate the placenta and determine the amount of amniotic fluid present. In some circumstances, it can evaluate fetal structures.

Medical Information
For questions and concerns of a non-emergency nature, call during regular office hours (603) 752-2040.
For emergencies, call 911 or AVH (603) 752-2200

Most women do not experience problems during pregnancy. It is important to know how and when to get immediate medical advise if you suspect a problem. The following are reasons to seek immediate medical advice during pregnancy:
1. Any fluid leaking from the vagina.
2. Vaginal bleeding of any kind.
3. Sudden swelling of your hand or face.
4. Bad headaches or headaches that don’t go away with simple remedies.
5. Changes in vision (blurred, flashes of light or spots before your eyes).
6. Dizziness or fainting.
7. Sudden weight gain (more than 2 pounds in a week).
8. Severe or continual abdominal pain, not relieved by a bowel movement.
9. Fever (temperature of 101 degrees or more).
10. Burning sensation while urinating.
11. Contractions or pelvic pressure, if you are less than 37 weeks pregnant.
12. Vomiting lasting 24 hours or more.
13. Decrease in fetal movement after the 28th week.



Premature Labor
Premature labor is labor that starts between the 24th and 37th week of pregnancy. Prematurity can be a very serious problem. If you know what to look for, you may be able to prevent your baby from being born too early, or give your provider enough time to improve the situation. Know these warning signs:
1. Uterine contractions which happen every 10 minutes or more often.
2. Menstrual-like cramps in the lower abdomen (may come and go or be constant).
3. Low, dull backache felt below the waistline (may come and go or be constant).
4. Pelvic pressure which feels like the baby is pushing down. Pressure that comes and goes.
5. Abdominal cramping with or without diarrhea.
6. Vaginal discharge may suddenly increase in amount, become mucousy, watery, or slightly bloody.

Reducing the Risks
When you are pregnant, you need to be concerned about your own health and the health of your baby. Whatever you eat, inhale, or rub on your skin may affect the baby within the first few hours of conception through to delivery! Before coming in contact with any material, stop and think about whether it will have any effects.

Drugs
Do not take any drugs, street drugs, pills or medicines, prescribed or purchased “over-the-counter,” without checking first with your health care provider. Some medications are safe and others are not.

Alcohol
Alcohol is a toxic substance. Babies of mothers who drink alcoholic beverages regularly during their pregnancy may have symptoms of Fetal Alcohol Syndrome, characterized by tremors, sleep disturbances, mental retardation and physical changes in their appearance. There is no clear dividing line between what is definitely safe and what level of drinking is definitely harmful to the baby. It is therefore wise to avoid alcohol entirely during your pregnancy from the day of conception.

Smoking
Smoking cigarettes while pregnant poses significant risks to the pregnancy. Please don’t smoke during pregnancy. If you were smoking before you realized you were pregnant, it is not too late to stop, avoiding most of the problems associated with smoking during pregnancy. Call your health care provider for help.

Toxoplasmosis
Toxoplasmosis is an infection that may cause serious birth defects to the unborn baby. A pregnant woman may become infected with the toxoplasmosis organism if she eats raw meat or if she comes into contact with the feces of cats infected with the disease. To avoid infection with toxoplasmosis, a pregnant woman should always cook meat thoroughly and avoid contact with cat litter boxes or outdoor areas where cats go to the bathroom.


Medication in Pregnancy
You should try to avoid any medication unless it is prescribed or approved by your prenatal health care provider who knows you are pregnant.

Sex during Pregnancy
For normal pregnancies, sexual relations may be safely continued throughout pregnancy. Intercourse and orgasms will not harm the baby nor predispose toward premature labor.


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