Care for the pregnant woman and her baby Care for the pregnant woman and her baby
By Dr. Gailyn Thomas
It is estimated by the World Health Organization that 600,000 women die each year as a result of pregnancy, yet most of these deaths are preventable with proper health care. Ninety-nine percent of maternal deaths occur in countries where women do not have access to care for themselves and their babies before birth and during the birthing process.
In Vermont, we are fortunate to have a non-profit health system open to all, affordable care options and up-to-date birthing practices. There is always more women can do, however, to improve their chances of welcoming a healthy newborn.
Care for the pregnant woman and her baby should begin even before pregnancy occurs. Starting a daily prenatal vitamin about six weeks before trying to conceive reduces the risk of spinal cord problems in the baby by as much as two-thirds.
For a woman with health problems such as high blood pressure, diabetes or other conditions requiring medication, a visit to a health care provider should occur several months before pregnancy to make sure her medicines are the safest ones for pregnancy and that her medical condition is as well-managed as possible for the safety of herself and her baby.
Some problems affecting pregnancy cannot be avoided, but some can. Of the ones we can change, smoking and alcohol use are the two most important. Quitting smoking can prevent one in 10 stillbirths and deaths of newborns. Alcohol use can cause birth defects and mental retardation. Health officials in the United States, Canada, Great Britain, France and many other countries agree that there is no amount of alcohol that can be considered safe during pregnancy. This is because every woman’s body deals with alcohol differently. What is safe for one woman may not be safe for another.
These are among the things a health care provider discusses during prenatal care. Prenatal care is a series of regular visits to a health care provider during pregnancy. The major goal is to ensure the birth of a healthy baby with minimal risk to the mother.
Prenatal care can be provided by doctors or midwives. Midwives can be trained by attending nursing school, followed by an additional three years of intensive training in pregnancy and birth. These certified nurse midwives (CNMs) usually work in a partnership or collaboration with doctors. Lay midwives are those who train by apprenticeship with another midwife and often attend home births. The length of apprenticeship may vary. Lay midwives usually practice without a formal relationship with a doctor or hospital.
Prenatal care usually starts within one to two months after the first missed menstrual period. Early prenatal care allows the most accurate estimate of a due date and allows time to build a relationship between the woman and her provider. Studies have compared prenatal care provided by obstetricians (doctors who specialize in the care of pregnant women) and midwives. While both groups provided the same quality of care, women repeatedly said they favored the care provided by midwives.
In recent years, a new type of prenatal care has emerged – group prenatal care. In this type of care, small groups of women with similar due dates meet once or twice monthly for a period of two hours. Each session begins with a private physical assessment of each woman. After some time for snacks and socializing, the group discusses topics of importance to the participants. Women have opportunities to discuss their experiences and challenges and to work together with their health care provider to find solutions.
Studies comparing group prenatal care to traditional prenatal care have shown a decrease in premature delivery as well as higher satisfaction among participants. Group prenatal care can also eliminate the need for extra birthing classes and waiting for appointments to start.
While group prenatal care offers a new option for women, every woman will make a different choice about the type of care she wishes to receive. Whatever type of care she chooses, the importance of taking good care of herself and her baby cannot be overstated.
Dr. Gailyn Thomas is an obstetrician/gynecologist at Gifford Medical Center in Randolph, where group prenatal care will soon begin. Pregnant women interested in this type of prenatal care should contact Gifford Ob/Gyn and Midwifery at 728-2401 to sign-up.
Past health columns
Read about the preventing flu in children >>
Read about ACL tears in women and girls >>
Read about childhood immunizations >>