Antenatal Care
Antenatal care aims to make the expecting woman the focus. Its main purpose is to optimize pregnancy outcomes for women and babies by early detection and management of any factor that can adversely affect the health of the mother and baby. It also helps to relieve the anxiety of the new parents regarding the health of their baby. It allows for general health screening and management of minor ailments of pregnancy. It also provides an opportunity to the health care team to provide advice and education to the woman and her family. Women are provided high quality, culturally appropriate information which helps them to make their choices and decisions.
Providing Antenatal care can never be a one man show. From confirmation of pregnancy till delivery many people are involved including the midwife, an obstetrician, an anesthetist, a pediatrician, a neonatal nurse, a sonographer and finally a health visitor.
Midwife
A Midwife is a trained health care worker who provides support and care to the women throughout pregnancy. They not only work at hospitals, maternity units but also provide care at the mother’s own home mainly during labour. They work with the rest of the team and share the work load with them. They are expert on childbirth and are the ones monitoring progress of labour by doing repetitive vaginal examinations of the mother and hence identify slow progress. They also provide one to one care and support throughout pregnancy. Their job also includes providing reassurance and emotional support to the parents.
Obstetrician
An obstetrician is a specialized doctor who deals with pregnancy, child birth and postpartum. Their main role is to manage the pregnancy, deal with any factor that can affect the health of the mother and the baby. They manage all the medical issues that a woman might have like hypertension, diabetes Mellitus and also specialize in managing obstetric emergencies like placenta previa (low lying placenta), hemorrhage(blood loss) and shoulder dystocia. An obstetrician identifies high risk cases early in pregnancy and keeps them under close supervision to prevent any adverse outcome. They assess the maternal and fetal conditions and help you decide mode and place of delivery. They are the ones who perform caesarian section if required. They also provide education early in pregnancy about breastfeeding and its advantages to the mother and the baby.
Anesthetist
Pregnancy can be daunting for many women. We have all heard how painful the delivery can be or just the thought of the possibility of a caesarian section can cause goose bumps. The anesthetist is involved in relieving pain associated with normal labour and also to make caesarian section possible (if required).
Anesthetists do so much more than just making you sleep so another doctor can operate on you. Pain relief (Analgesia) is one of the main divisions of anesthesia. They make sure delivery is a pleasant experience for you by giving you various options to make child birth painless. Epidural anesthesia is one of the most reliable and effective analgesia given in labour. For C-section, spinal anesthesia or epidural anesthesia is used, which means the woman is awake and can experience a PAIN-FREE delivery. However, occasionally general anesthesia is required where the prior methods are contraindicated. So an anesthetist evaluates and provides you with various options for making delivery wether normal vaginal or a C-section pain free. They are also responsible for maintaining all the vitals (temperature, blood pressure, heart rate) during the C-section.
Pediatrician
A pediatrician is a doctor who specializes in dealing with children commonly known as child specialist. After birth of the baby, it is very important to have a competent pediatrician on board (usually a neonatologist) who can examine and screen the baby for any anatomical or metabolic abnormality. The common problems that a neonate can have are breathing problems, infections, seizures, jaundice, hypoglycemia (low blood sugar) and feeding difficulty. Congenital abnormalities and prematurity are another important issues a pediatrician deals with. These can be due to a number of reasons and early detection is the key in managing these. A pediatrician decides wether the baby should be kept in nursery or not.
Neonatal Nurses
They are nurses specialized for neonatal care working in neonatal units. They are specifically trained for different aspects of neonatal care. They manage the major neonatal problems like prematurity. They also have a role in supporting the parents and keeping them informed about the baby’s health in order to alleviate their anxiety. They are responsible for preparing and giving the baby prescribed medications, maintaining the baby’s vitals and maintaining a record of everything. They are a crucial part of the health care team dealing with premature babies and are usually the ones to initiate resuscitation in emergency cases.
Health Visitor
They are nurses or midwives who work to raise the awareness about healthy lifestyle and disease prevention. They work with families mainly with children from birth up to five years of age to make sure they have a healthy start to life. They not only provide antenatal and post natal support but also assess a child’s growth and development to advice parents about feeding. They play an important part in encouraging breastfeeding and its continuation for the first two years of life. They are usually the first ones to identify cases of child neglect or abuse making them extremely important as part of the health care team. Their training in public health enables them to assess the health requirements of an individual and provide essential information to the people.
Sonographer
A Sonographer is a trained professional who specializes in the use of ultrasound machine and performs ultrasound of the mother various times during pregnancy. Since ultrasound is an operator dependent modality it is extremely important that the person performing it is an experienced person especially trained for it.
Ultrasound is required for confirmation of a single normal pregnancy, placental localization, diagnosis of fetal abnormalities and assessment of fetal wellbeing. It also allows screening of downs syndrome and hence lets parents decide termination of pregnancy. Ultrasound early in pregnancy helps in identifying high risk cases like multiple pregnancy (twins, triplets), placenta previa (low lying placenta) and allows the mother to be under close observation.
Fetal assessment by monitoring fetal heart rate and amniotic fluid volume can also be done by ultrasonography.
Dietician
A dietician is extremely important for a healthy pregnancy outcome. Since the expecting mother is receiving advices from everyone around on what to eat and what not to eat making her even more anxious and confused. Only a dietician can help that woman by busting all the myths and by providing a proper diet plan to follow.
The job of the dietician is to provide general pregnancy dietary advice ranging from the recommended weight gain to the number and size of portions to take in a day. Women need to understand that they DO NOT have to eat for two. Remember every woman’s weight gain is different and it depends on your pre-pregnancy BMI so a dietician is a person who would tell what your ideal weight gain should be. General exercise advise (aerobic and strength conditioning) is also given by the dietician. They encourage women to maintain walking, swimming but to avoid contact sports.