What is Antenatal Care?
Today we will explore what we mean when we talk about antenatal care, what it includes and why, helping you to understand its significance and the Midwives role in providing good antenatal care.
What Does ‘Antenatal’ Mean?
The word ‘antenatal’ refers to the duration of pregnancy from conception until labour begins and is synonymous with other terms such as ‘prenatal’ or ‘antepartum’.
Who Provides Antenatal care?
Antenatal care is provided by appropriately trained health care professionals relating to your needs during pregnancy. In the UK you are most likely to see Midwives, with some contribution from your GP or an Obstetrician if required. In Ireland you are likely to see Midwives and your GP but may opt for consultant led care with an Obstetrician.
Midwives are experts in physiological pregnancy, birth and postnatal care. If you have any medical issues or a complication arises with your pregnancy, we usually recommend an appropriate health care professional work with you. At Private Midwives, our experienced and dedicated Midwives can provide all your Midwifery care in the comfort of your own home, unhurried and at times convenient to your lifestyle. We offer a variety of relevant screening tests and are passionate about empowering you to make decision around which are right for you and your family.
Usually, your GP can review any medication regarding its suitability for you while pregnant and may be the best person to see if you suspect a minor ailment such as a urinary tract infection or any other illness that you would usually see your GP about.
An Obstetrician is a specialist Doctor who has completed training in the areas of medical disorders affecting pregnancy or other complex pregnancies.
What does Antenatal care include?
Midwifery centred antenatal care incudes the comprehensive and holistic assessment of your well-being and the progress of your pregnancy, through which a trusting partnership in care is built between you. It includes education and preparation as you journey towards birth and welcoming your new baby into your family.
At your first appointment your Midwife should complete a booking visit which includes:
- Discussing your medical, surgical, pregnancy, birth, and family history so that we can work with you to plan appropriate and supportive pregnancy care.
- A social assessment to ensure that we are aware of the quality of available support that you have as you embark on this journey towards becoming a parent.
- A sensitive enquiry as to your emotional and psychology well-being and a discussion around any concerns, questions, or anxieties you may be experiencing, allowing her to direct you to further sources of support if needed.
- A discussion around healthy nutrition and exercise, food safety, your practices regarding alcohol, medications, drug use, or any other potential environmental concerns, to help optimise your healthy pregnancy.
- Offering screening tests identify any increased chance of disease or conditions that may affect you or your baby, thus reducing the likelihood of complications.
At your antenatal appointments your Midwife should:
- Monitor your health and your pregnancy for any concerning signs or symptoms.
- Provide ongoing support for you should any aspect of your life or circumstances cause issues for you and your pregnancy.
- Answer any questions you might have regarding your care, and advocate for you during your pregnancy if required.
- Help with birth preparation and planning, signposting you towards available classes, helpful books, and websites.
- Discuss your preferences including place of birth, comfort measures, signs and stages of labour, ensuring you understand the process and are prepared for what you may experience.
- Undertake a physical examination at each appointment including taking your blood pressure, pulse, testing a urine sample (primarily for protein, glucose or signs of infection), an abdominal palpation (to assess your baby’s growth, in later stages of pregnancy, your baby’s position and presentation), and listen to your baby’s heartbeat.
Screening Tests in Pregnancy
There are several routine tests that are offered to every pregnant woman, and some that are only offered if indicated by your personal history or symptoms. Your Midwife should discuss each with you enabling your informed choice around accepting or declining.
Blood tests including:
- Screening for blood type, rhesus and antibodies, Hepatitis B, Syphilis and HIV. A full blood count to check your iron levels and platelet levels.
- Depending on your ethnicity and history you may be offered screening for thalassaemia, or sickle cell anaemia.
- At 28 weeks and 36 weeks, you should be offered a repeat full blood count.
You should be offered the following ultrasound scans:
- A dating scan between 18 and 14 weeks
- An anatomy scan between 18 and 20 weeks
- Further scans may be recommended depending on your history, current pregnancy events or any concerns regarding your baby’s health.
- In the UK, screening tests for chromosome-related conditions are offered routinely, while in Ireland this screening is usually undertaken privately if you wish to avail of it.
- Further screening tests may be offered depending on your family, medical or pregnancy/birth history, including screening for Gestational Diabetes or Group B Streptococcus.
What is the Benefit of Antenatal Care?
Antenatal care is strongly recommended as it aims to promote optimal health during pregnancy, to support you to in any appropriate lifestyle changes, reassure you that all is progressing well with your pregnancy, and to detect and act upon any concerns or complications allowing for safely monitoring and management. Serious conditions are rare, however detection, appropriate referral and a multidisciplinary approach when needed can positively impact your pregnancy outcome.
Our role as Midwives encompasses holistic, physiological care and support, and referral should any complications arise. As autonomous practitioners, the Midwives’ role is to provide knowledgeable and compassionate care, supporting you on your individual maternity journey and enabling you to make informed decisions with the benefit of accurate assessment and balanced information.