Prenatal Care

The prenatal period refers to the time from before conception until the end of pregnancy. So, prenatal care refers to the care that is provided before and during pregnancy to evaluate maternal and fetal health, provide education to promote health, and to intervene when possible to ensure the birth of a healthy baby with minimal risk for the mother. For a successful pregnancy outcome, prenatal visits should continue every 4 weeks until week 28, every two weeks from week 28 to 36, and then weekly until delivery. 

Alright, now the first step in prenatal care is preconception counseling, which seeks to identify any potential risks to the client’s fertility and pregnancy outcome. The first prenatal visit typically occurs when a client suspects they are pregnant or because they wish to conceive in the near future. No matter the case, the main focus of the first prenatal visit should be obtaining a thorough personal and obstetrical history, as well as family history, to identify any medical conditions that could pose a risk to the pregnancy.

Now, in clients who suspect they are pregnant, pregnancy should be confirmed with a urine pregnancy test and an abdominal ultrasound. If pregnancy is confirmed, the estimated date of delivery, or EDD, should be calculated. It’s traditionally calculated using Naegele’s rule, which takes the first day of the last menstrual period, or LMP, subtracts 3 months, and then adds one year and seven days. So, if the LMP was September 10, 2021, counting back 3 months, adding 1 year and 7 days calculates the EDD as June 17, 2022.

The obstetrical history evaluates the gravidity, parity, and abortions. Gravidity, or G, refers to the number of times a client has been pregnant, including the current pregnancy. 

Parity, or P, refers to the number of times a client has carried the pregnancy to a viable gestational age, which is more than 20 weeks gestation. So, if a client is currently pregnant, has been pregnant once before, and has had one viable birth, you’d say that as Gravida 2, Para 1, or G2P1.

A more detailed evaluation evaluates Gravidity; as well as the number of Term births at 37 or more weeks of gestation; the number of Preterm births or infants born after 20 weeks of gestation but before completion of 37 weeks of gestation; the number of Abortions, either spontaneous or therapeutic; and the number of children that are currently Living. So, if a client is pregnant for the fifth time, and has 3 children currently alive who were born at term, and had a spontaneous abortion at 16 weeks, the clients GTPAL would be G5T3P0A1L3. 

Next, a family history can provide insight about any genetic conditions or disorders that may be passed on to a child. In clients with a family history of genetic disorders, like cystic fibrosis or sickle cell anemia, individuals may benefit from genetic testing to see if they or their partner have the mutation.