Pre-conception / Inter-conception Care
Training Curriculum 2
Inter-conceptional Care -Prenatal care
Definition of Prenatal Care
Regularly scheduled obstetric care beginning in early pregnancy and continuing through post-partum. Prenatal care involves the management of medical, nutritional. Psycho-social, and educational needs of the patient and her family. This is reevaluated at regular intervals, and revised in accordance with the progress of the pregnancy.
Rationale for Prenatal Care:
Access to prenatal care has long been associated with reduction in infant and maternal mortality and morbidity. Encounters between pregnant women and health care providers, afford opportunities for teaching when a foundation can be laid for learning good health habits which will benefit both mother and infant Women who receive prenatal care during the first trimester have better pregnancy outcomes than women who have little or no prenatal care.
Goals of Prenatal Care:
To maintain and improve maternal/ infant health and well-being through education including nutrition, Periodic surveillance, laboratory testing, and risk assessment including risks of genetic disease and birth defects.
Objectives of Prenatal Care
- To reduce maternal mortality, morbidity, fetal
- To reduce pre-term births, intrauterine growth retardation, congenital anomalies, and failure to thrive
- To promote health supervision, and healthy fetal growth and Development
Major Recommendations for quality Prenatal Care- All pregnant women:
- Should be assessed for peri-partum depression.
- Should be given folic acid supplementation prior to conception.
- The first prenatal visit should occur during the first trimester.
- Gestational age must be accurately established by 20 weeks, either by the last menstrual period correlating with exam the first trimester, or an ultrasound preferably at 18-20 weeks gestation, to allow for fetal survey.
- Should be screened for HbsAg before delivery.
Components of Prenatal Care.
Prenatal care involves the management of medical, nutritional. Psycho-social, and educational needs of the patient and her family. This is reevaluated at regularly scheduled intervals, and revised in accordance with the progress of the pregnancy. In 1989 the US Public Health Service identified three basic components of prenatal care, they are:
- Early and continuing risk assessment, including laboratory testing
- Health promotion, including patient education
- Medical and psycho-social assessment, intervention and follow-up care.
Early and Continuing Risk Assessment
Prenatal care is more effective when the first visit takes place at 6-8 weeks gestation, and not delayed until the second or third trimester. The prenatal visit is a comprehensive process of assessing historical data, laboratory findings, medical, social and obstetrical risk indicators.
One important goal of the prenatal visit is to prevent pre-term births which is the chief cause of infant mortality. Prenatal visits are designed:
- To provide primary health care
- Identify risks to fetal health and safety
- To prevent and or control disease
- To assure delivery of a healthy baby of appropriate weight.