Services you Should Expect and Get During Antenatal Care 

The antenatal clinic provides the avenue for a lot of services to be rendered to pregnant women. [4] 

These include:

• Assessment of the health of the mother and baby

• Health education and counselling

• Administration of supplements

• Screening and treatment of infections

• Vaccination

• Early detection and management of complications

• Birth planning

Your doctor and other health workers will provide these services throughout pregnancy, though some of the services are delivered at some definite points in pregnancy.

Initial Assessment/ Booking Visit

The first visit should take place between 8-12 weeks. This is called the booking visit.

At the initial consultation your doctor and other healthcare workers would:

• Take a history from you: This would include the history of your present and past pregnancies, and also ask relevant questions about any concurrent illnesses, past surgeries, family history of hereditary diseases and social history.

• Examine you:  This will include measurement of your height, weight, blood pressure and the baby’s condition.

• Request for routine booking investigations/tests 

These tests include:

• Packed cell volume/Haemoglobin concentration: To check the quantity of red blood cells in your blood.

• Blood group: To check your blood group(A. B, AB, O) and Rhesus group(Rhesus negative or Rhesus positive)

• Genotype: To check your genotype (AA, AS, SS, SC, SBthal)

• Urinalysis: To check for protein, glucose or any sign of infection in your urine

• Infection screening:
  • Human Immunodeficiency Virus (HIV) screening
  • Syphilis screening
  • Hepatitis B screening

• Ultrasound scan: To check the number of babies, how your baby is lying, the location of the placenta and the general well-being of the baby.

These tests are important because anaemia (low blood percentage), abnormal blood group (rhesus negative) and abnormal genotypes (like SS, SC, SBthal) can negatively affect pregnancy. 

In addition, the presence of protein, and glucose in your urine may indicate diabetes, hypertension or the presence of infection in your urine.

HIV and Hepatitis B can be transferred to the baby if the necessary interventions are not put in place. Syphilis can affect the development of the baby if not treated.

• Conduct Special tests

Special tests may be done for you if you have certain risk factors. These include:

• Oral Glucose Tolerance Test (OGTT) is done between 24-28 weeks if you are at risk of gestational diabetes (Diabetes in pregnancy)

• Screening for congenital problems can be done if you are at high risk of having babies with abnormalities. These may include a special ultrasound or blood test using the mother's blood.

Health Education 

Health education is a very important component of antenatal care. [5, 6] It involves educating the women on:

• Diet and exercise during pregnancy

• The expected  body changes during pregnancy

• The danger signs in pregnancy and how to respond to them

• The signs of labour and when to come to the labour ward

• Family planning, post-delivery care and newborn care

• Birth preparedness and complication readiness. This involves buying the needed delivery items, setting aside money for delivery, making transport arrangements and alternative arrangements for the care of the home front while in labour.

Related: How to Boost Positive Childbirth Experience in African Women

Medications

 Your doctor will prescribe these medications

• Daily Iron tablets and folic acid

• Sulfadoxine/pyrimethamine tablets for the prevention of malaria. The WHO recommends that the drug should be given in multiple doses with the first dose given early in the second trimester of pregnancy

• Vaccination includes Tetanus toxoid vaccination and other relevant vaccines. Vaccines made from live viruses are not safe in pregnancy and should not be given.

• Calcium tablets, if you have calcium deficiency and you are at risk of having preeclampsia

• Low-dose Aspirin from 12 weeks of pregnancy if you are at risk of having preeclampsia. This helps to reduce the risk.

Follow-up Visits

After the initial visit, your doctor will determine the schedule for your subsequent visits.

Care at the subsequent visits would involve:

• History: Listening to and addressing any complaints you have

• Examination: Monitoring of your blood pressure, and weight. It also includes the assessment of the growth of the baby by measuring the size of the womb (fundal height), the baby’s heart rate, and also checking the position of the baby in the womb

• Blood tests: Doing urine and blood tests when indicated. Urine tests are done on each visit, while blood percentage is checked every month. Your doctor may also request special blood tests to check for conditions such as gestational diabetes, anaemia, and infections

• Ultrasound Scans: The WHO recommends that a pregnant woman should have at least one scan before 24 weeks. Any other scan may be done if needed

• Health Education: This continues through antenatal care

• Birth planning: At 36 weeks, your doctor will make a birth plan. This depends on your condition and the condition of the baby. Delivery may be either by vaginal delivery or caesarean section. 

If you are to have a vaginal delivery, labour is usually expected to start from around 37 weeks, though it may be earlier in some patients. If it fails to start by 41 weeks, induction of labour would be done to make labour start. '

Induction of labour may be done earlier if you have a medical condition like diabetes or any other similar disease or if there is a problem with your baby that requires delivery before the due date

Resources

Published: August 17, 2024

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