 	        			What is prenatal care?

Prenatal care means health care during your
pregnancy before your baby is born. Take care of
yourself and your baby by:

    *

      Getting early prenatal care. If you know you
are pregnant, or think you might be pregnant, call
your health care provider as soon as possible and
schedule a visit.
    *

      Getting regular prenatal care. Follow your
health care provider's schedule for visits and
don't miss appointments.
    *

      Doing everything you can to keep yourself
and your baby healthy during your pregnancy.

Why is prenatal care so important?

Prenatal care is important because, by seeing you
regularly, your health care provider has the
chance to find problems early so that they can be
treated as soon as possible. Other problems might
also be prevented. Many studies have shown that
early and regular prenatal care is important for
the health of both mothers and their babies.
I am thinking about getting pregnant. How can I
take care of myself?

Taking care of yourself before you get pregnant
helps you have a healthy pregnancy and lowers your
chances of having a baby born with a birth defect.
Here are ways to take care of yourself before you
get pregnant:

    *

      Eat healthy foods, exercise regularly (30
minutes per day for most days of the week is
best), and get enough rest and sleep. Talk to your
health care provider about what kinds of food and
exercise are best for you.
    *

      Take 400 micrograms (mcg) of folic acid (one
of the B vitamins) every day. The best way to do
this is to take a daily multivitamin pill that
contains this amount of folic acid. Getting enough
of the synthetic (manufactured) form of folic acid
every day before you get pregnant and during early
pregnancy can help prevent certain birth defects.
Many breakfast cereals and other grain products
have folic acid added to them, but only certain
cereals contain 400 mcg of folic acid per serving.
Check the label on your multivitamin or cereal to
find the amount of folic acid in the food.
    *

      See your health care provider for a complete
check up. Make sure that you have had all your
shots, especially for rubella (German measles).
Rubella can cause serious birth defects.
Chickenpox is another illness you want to avoid
during pregnancy. If you have had chickenpox and
rubella in the past, you should be immune to
them.
    *

      Tell your health care provider about any
prescription or nonprescription medicines
(including herbal remedies) you are taking. Some
medicines are not safe to take during pregnancy.
    *

      Stop smoking cigarettes, drinking alcohol,
or taking drugs. Ask your health care provider for
help. You can also get help with alcohol and drugs
by talking with a member of your faith community,
a counselor, or a trusted friend.

I just found out that I am pregnant. How can I
take care of myself?

Here are ways to take care of yourself and the
precious new life growing inside you:

    *

      Continue taking your multivitamin with 400
micrograms (mcg) of folic acid every day.
    *

      Get early and regular prenatal care. It
doesn't matter if this is your first pregnancy or
if you already have children - it is really
important to see a health care provider during
your pregnancy. Your health care provider will
check at each visit to make sure that you and the
baby are healthy. If there are any problems,
action can be taken right away to help you and the
baby.
    *

      Eat a healthy diet that includes fruits,
vegetables, grains and calcium - rich foods.
Choose foods low in saturated fat.
    *

      Unless your health care provider tells you
not to, try to be physically active for 30
minutes, most days of the week. If you are pressed
for time, you can get your activity in through 10
minute segments, three times a day.
    *

      If you smoke, drink alcohol, or use drugs,
STOP. These can cause long-term damage to your
baby. Talk with your health care provider about
steps to take to stop smoking. Talk with a member
of your faith community, a counselor, a trusted
friend, or your health care provider if you are
concerned about your alcohol or drug use.
    *

      Ask your health care provider before taking
any medicine, even over-the-counter medicines.
Some medicines are not safe to take during
pregnancy.
    *

      Avoid hot tubs or saunas and x-rays during
pregnancy.
    *

      Do not empty the cat litter when you are
pregnant. It may contain a parasite that causes an
infection called toxoplasmosis, which can cause
birth defects. Also, use gloves when working in
garden areas used by cats.
    *

      Don't eat uncooked or undercooked meats or
fish.
    *

      Stay away from toxic chemicals like
insecticides, solvents (like some cleaners or
paint thinners), lead, and mercury. Most dangerous
household products will have pregnancy warnings on
their labels. Ask your health care provider about
products if you are unsure.
    *

      Limit or eliminate your caffeine intake from
coffee, tea, sodas, medications, and chocolate.
    *

      Many women continue working through
pregnancy. Staying active might help you stay
healthier. If you have a question about the safety
of your particular job, talk with your health care
provider.
    *

      Get informed. Read books, watch videos, go
to a childbirth class, and talk with experienced
moms.
    *

      Ask your health care provider about
childbirth education classes for you and your
partner. Classes can help you prepare for the
birth of your baby.

I am not thinking about getting pregnant right
now, but heard that all women should take folic
acid every day?

All women of childbearing age, with even a remote
chance of getting pregnant, should try to make
sure they get enough folic acid. The reason is
that many pregnancies are not planned. Many women
don't know they are actually pregnant early in
their pregnancies, and certain birth defects
happen in the very early part of pregnancy. Taking
400 micrograms (mcg) of folic acid every day will
help prevent certain birth defects that happen in
the early part of pregnancy. If a woman begins
taking vitamin pills in the second or third month
of pregnancy, it may be too late to prevent birth
defects. Folic acid may also have other health
benefits for women besides preventing birth
defects.
How often should I see my doctor during
pregnancy?

Your health care provider will give you a schedule
for your prenatal visits. You will have visits
more often as you get closer to the end of your
pregnancy. An average pregnancy lasts about 40
weeks. A typical schedule includes visiting your
health care provider:

    *

      about once each month during your first six
months of pregnancy, then
    *

      every two weeks during the next two months,
and then
    *

      weekly until the delivery date.

If you are over 35 or your pregnancy is high risk
because you have certain health problems (like
diabetes or high blood pressure), your health care
provider will probably want to see you more
often.
What happens during prenatal visits?

At your first prenatal visit, your health care
provider will talk to you about your health
history and your family health history and do a
physical exam. The physical exam will include
checks of your blood pressure, height and weight,
and an exam of your pelvic organs. There will be
tests of your blood and urine. Your health care
provider will be able to tell you when to expect
that your baby will be born. This visit is also a
chance for you to learn about staying healthy
during pregnancy.

At your later prenatal visits, your health care
provider will check how you are doing and how the
baby is developing. You may have a number of tests
done as your pregnancy progresses. Ultrasound
exams are often used to check on the baby's
growth and health. You may have more urine and
blood tests as well as special tests if needed.
Visit our "Healthy Pregnancy" pages on the NWHIC
web site http://www.womenshealth.gov for more
information on prenatal care and pregnancy.
I am in my late thirties and I want to have a
child now. Should I do anything special?

As you get older, there is more chance of having a
baby born with a birth defect. However, most women
in their late thirties and early forties have
healthy babies. See your health care provider on a
regular basis before you get pregnant and be sure
to go for exams throughout your pregnancy. Your
health care provider probably will want to do some
special tests to check on your baby's health.

Women today are often delaying having children
until later in life, when they are in their
thirties and forties. While many women in their
thirties and forties have no difficulty getting
pregnant, fertility does decline with age. For
women over 40 who cannot get pregnant after six
months of trying, it is recommended that they see
their health care provider for a fertility
evaluation. It is not uncommon to have trouble
becoming pregnant or experience infertility
(inability to become pregnant after trying for one
year). If you think that you or your partner may
be infertile, you can discuss this with your
health care provider who can recommend treatments
such as drugs, surgery, or assisted reproductive
technology.

For more information…

You can find out more about prenatal care by
contacting the National Women's Health
Information Center (NWHIC) at (800) 994-WOMAN
(9662) or the following organizations:

Centers for Disease Control and Prevention
National Center on Birth Defects and Developmental
Disabilities
Phone Number(s): (770) 488-7150, (888) 232-6789
Internet Address: http://www.cdc.gov/ncbddd/

Smart Moms, Healthy Babies
Phone Numbers(s): (734) 936-4000
Internet Address: http://www.smartmoms.org/

March of Dimes
Phone Number(s): (914) 428-7100, (888) 663-4637
Internet Address: http://www.modimes.org/

American College of Obstetricians and
Gynecologists
Phone Number(s): (800) 762-2264 x 192 (for
publications requests only)
Internet Address: http://www.acog.org/

American Academy of Family Physicians
Phone Number(s): (913) 906-6000
Internet Address: http://www.aafp.org/

The Nemours Foundation
Phone Number(s): (302) 651-4046
Internet Address: http://www.nemours.org/no/

All material contained in the FAQs is free of
copyright restrictions, and may be copied,
reproduced, or duplicated without permission of
the Office on Women's Health in the Department of
Health and Human Services; citation of the source
is appreciated. Getting early and regular prenatal care is one of
the best ways to promote a healthy pregnancy.
Prenatal care is more than just health care; it
often includes education and counseling about how
to handle different aspects of pregnancy, such as
nutrition and physical activity, what to expect
from the birth itself, and basic skills for caring
for your infant.

Prenatal visits also give you and your family a
chance to talk to your health care provider about
any questions or concerns you have related to your
pregnancy, birth, or parenthood.

Many health care providers recommend that a woman
who is only thinking about getting pregnant see a
health care provider about preconception health.
There are steps she can take to reduce the risk of
certain problems.

Folic Acid and Prenatal/Preconception Vitamins
Proper Immunizations for the Mother
Healthy Behaviors
 
Folic Acid and Prenatal/Preconception Vitamins

The U.S. Public Health Service recommends that
women of childbearing age get at least 400
micrograms of folic acid each day, through food
sources and/or supplements. For women who are
thinking about getting pregnant, health care
providers recommend supplementing the diet with
folic acid for three months before pregnancy, and
then for at least the first three months of
pregnancy. Prenatal vitamins are a good way to get
extra folic acid into the diet. Prenatal
supplements often contain high amounts of folic
acid and other compounds, such as iron and vitamin
A. (But, women should take care in choosing a
supplement, to make sure that no more than 5,000
IU of vitamin A is included.) Findings from
research supported by the NICHD and other agencies
indicate that the right amount of folic acid can
help prevent certain types of birth defects and
other problems during pregnancy. 

Even though many foods available in the United
States are fortified with folic acid, women who
are thinking about pregnancy benefit from an extra
boost of this important compound. It can be hard
to get the full amount of folic acid from food
sources alone, so preconception supplements are
important. For more information about
NICHD-supported research on this topic, read the
news releases on folic acid research.

Proper Immunizations for the Mother

Women who are thinking about getting pregnant
should make sure that they have been properly
vaccinated and are immune to certain diseases,
such as rubella (also called German measles). If a
woman gets rubella while she is pregnant, the
fetus is at increased risk for a variety of
problems, including deafness, heart problems,
cataracts of the eyes, and mental retardation,
just to name a few. These problems, which together
are called congenital rubella (kon-JENN-it-ul
roo-BELL-uh) are much more severe than the effects
of getting rubella as a child.

Health care providers often test a woman's blood
for immunity to this infection, or they try to
find proof of childhood immunizations from a
woman's health history. If a woman is not immune
to rubella, she should be vaccinated. The American
College of Obstetricians and Gynecologists (ACOG)
recommends that women wait at least one month
after getting vaccinated before trying to get
pregnant. ACOG also suggests that women take steps
to prevent pregnancy during this time. This time
period can protect against any lingering traces of
the vaccine/illness that may affect the fetus.

A woman who is already pregnant should not get a
rubella vaccination.

In addition, if a woman gets chickenpox while she
is pregnant, the fetus is at increased risk for a
number of problems, which together are called
congenital varicella (vair-i-SELL-uh). The name
varicella comes from the name of the virus that
causes chickenpox, called varicella zoster virus.
Congenital varicella is much more serious than the
effects of getting chickenpox as a child. It can
result in scarring of the skin, weakening or
withering of the arms and legs, called atrophy
(AT-row-fee), and eye abnormalities.

Just like they do for rubella, health care
providers will likely test a woman's blood for
immunity to varicella, or they will try to find
proof of childhood immunizations from her health
history. If a woman is not immune to varicella,
she should be vaccinated. The Advisory Committee
on Immunization Practices (ACIP), part of the
Centers for Disease Control and Prevention,
recommends that all non-pregnant women of
childbearing age be vaccinated against varicella.
ACIP and the American Academy of Pediatrics also
recommend that women wait at least one month after
getting vaccinated before trying to get pregnant.
This time can protect against any lingering traces
of the vaccine/illness that may affect the fetus.

A woman who is already pregnant should not get a
varicella vaccine.

For more information, visit the Medem™ Website,
and do a search for “Planning your Pregnancy” in
the medical library. 

Healthy Behaviors

Vitamins and immunizations aren't the only things
that can help promote a healthy pregnancy. Things
like diet, physical activity, medications,
smoking, alcohol or drug use, and environmental
factors can all affect pregnancy.

A healthy diet, weight level, and regular physical
activity level can help to reduce problems for
both mother and fetus during pregnancy. For this
reason, many health care providers suggest that
women who are thinking about getting pregnant take
steps to improve or maintain their own level of
health before they get pregnant. A healthy diet
helps to ensure that the fetus has all the
nutrients it needs to grow and develop normally.
Maintaining a healthy weight, both before and
during pregnancy, can help to reduce stress on the
mother's body and lower the risk of certain
disorders of pregnancy. Being active before and
during pregnancy, if approved by a health care
provider, can help women maintain their healthy
weight and can improve the function of the
circulatory, cardiovascular, and skeletal
systems.

Just as important is keeping things that can be
dangerous out of the mother's body. For instance,
medications used to treat various diseases and
conditions can affect the growth and development
of the fetus. Certain herbal supplements and high
amounts of vitamins can also make it harder for a
woman to get pregnant, and can impact the fetus'
health during pregnancy. Even being around certain
materials, such as paint and pesticides can put
the health of the fetus at risk. Women who are
thinking about getting pregnant should discuss all
of these factors with their health care providers.
Some changes in medication or supplement use, or
changes in environment may be recommended to
prevent problems during pregnancy.

Research shows that smoking, drinking alcohol, or
using drugs, even now and again or in small
amounts during pregnancy can cause health problems
for the fetus, some of them severe. Many of these
problems can have life-long effects. Alcohol and
drug use may also make it harder for some women to
get pregnant.

To reduce the risk of problems during pregnancy,
health care providers recommend that women stop
smoking, stop drinking alcohol, and stop using
drugs, completely, as early as possible before
they start trying to get pregnant. They should
maintain this tobacco-free, alcohol-free, and
drug-free lifestyle throughout their pregnancies
and after birth, as many of these substances can
get into the baby's system through breast milk. 


For more information, visit the Medem™ Website,
and do a search for “Planning your Pregnancy” in
the medical library. 

If you are thinking about getting pregnant, talk
to your health care provider about how best to
promote a healthy pregnancy, in a way that takes
your medical history and lifestyle into
consideration. 
 
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Source: National Institute of Child Health and Human Development
Source: Womenhealth.gov