Prenatal care includes a whole package of assessing and monitoring your pregnancy, prenatal supplements and nutritional care, vaccination, treatment and prevention of pregnancy complications and anticipation and planning for successful delivery.  Having at least 3 prenatal checkups or completing your prenatal care can help reduce life-threatening complications, optimize your baby’s health and prevent maternal and infant mortality.  

How often should a pregnant mother go for a prenatal checkup?

In general, as soon as the pregnancy is detected, the mother should immediately go for their first prenatal check-up to accurately assess the age of the features and to initiate early supplementation, and to treat possible comorbidities which may complicate the pregnancy such as Hypertension and Diabetes. For healthy pregnant women, the recommended schedule depending on the age of the fetus in weeks are:

• If your baby is < 28 weeks old: Monthly prenatal check-up during the first 2 trimesters
• If your baby is 28 – 36 weeks old: Every 2 weeks
• If your baby is > 36 weeks old or near term: Every week

An immediate prenatal checkup is also important for high-risk pregnancies such as adolescent mothers or mothers who are greater than 35 years old, twin pregnancies or mothers who have comorbidities such as Diabetes, Hypertension, Autoimmune disorders, or HIV so they can be monitored closely. Recommended schedules may vary depending on the mother’s risk status, but checkups may occur in 1 - 2-week intervals.

What should you expect in your first prenatal visit?

On your first visit, your doctor will do a complete assessment and physical exam and may perform tests to assess your pregnancy such as:

• Take your height and weight to determine whether you are underweight, normal or overweight
• Taking your baseline blood pressure
• Pelvic examination
• Ultrasound to assess your baby’s age, position, and whether it is a single or twin pregnancy
• Request for labs such as 75 g OGTT to assess your risk for developing Gestational diabetes or the elevation of blood sugar levels due to pregnancy
• Assessment for possible STDs such as HIV screening, Rubella, Syphilis and Hepatitis B

Aside from a complete assessment, you will also be advised to take some prenatal vitamins including:

• Folic acid - Ideally taken 30 days before pregnancy and continued daily through the first trimester or the first three months of pregnancy to prevent neural tube defects and infants with incomplete closure of the skull or spine
• Ferrous sulfate - May be started as soon as pregnancy is detected or no later than the 3rd month of pregnancy to prevent anemia
• Calcium carbonate - Given by the 4th month of pregnancy to support the development of your baby’s bones during this time and to protect the mother’s bones from thinning out

Aside from prenatal vitamins, your doctor may give you several nutritional advices such as:

• Eating a balanced and varied diet rich in fiber, fruits and vegetables
• Eating adequate amounts of protein from lean meats such as fish and poultry or from beans and legumes
• Use iodized salt as a source of Iodine to prevent iodine deficiency during pregnancy and to prevent your baby from having mental retardation upon birth
• Doing regular light physical activity such as yoga, walking or light jogging, moderate-intensity strength training or swimming to promote good blood circulation and wellbeing

Special cases on when to go for a check-up?

As pregnancy progresses, there are numerous changes that must be monitored or danger signs that may need to be treated immediately:

• Sudden onset, persistent or severe headache
• Blurring of vision
• Prolonged vomiting
• Fever
• Edema or “Pamamanas” of the face, arms or legs that is not relieved by movement or elevation of the area
• Abdominal pain
• Decreased movements or kicks from the baby
• Painful urination
• Bloody vaginal discharge
• Watery vaginal discharge

In case you start to experience the above-mentioned danger signs, consult your doctor immediately or take note of these symptoms and let your doctor know on your next prenatal checkup.

/AET

References:

[1] Cunningham, F. G., Leveno, K. J., Bloom, S. L., Spong, C. Y., & Dashe, J. S. (2014). Williams obstetrics, 24e. New York, NY, USA: Mcgraw-hill.

[2] Luna, J.T.P., Oblepias, E.G.C., Soriano, C.J.L., Banzuela-Cruz, N.K.C., Factor, P.A.A., Aherrera, J.A.M., Tiongson, M.D.A. & Banzuela, E.P.C. (2021). OB-GYN Platinum, 1st ed. Quezon City: Top Practice Medical Publishing Corp.