What are the types of prenatal care?

Judging from the actual clinical implementation, the current core of routine prenatal care can be classified into three categories: physiological monitoring care, lifestyle adaptation guidance, and psychological state adjustment support. Many specialized hospitals will also expand into subdivided care branches such as genetic counseling and exercise intervention based on the needs of the patients.

The 30-week-old expectant mother I followed up last week has a family history of high blood pressure and is at high risk for preeclampsia. Every time she comes for a prenatal check-up, we will pay extra attention to her urine protein and blood pressure values. We will also ask her to report her blood pressure values to the follow-up group twice a day after she goes home. If she feels dizzy or has swollen feet, she should press down half of the pressure. Contact us at any time if there is no chance of recovery. This kind of personalized monitoring for high-risk pregnant women is the core part of physiological care. For ordinary low-risk pregnant women, regular reminders to count fetal movements, regular prenatal check-ups to check fetal development indicators, and pay attention to signals such as abnormal bleeding and abdominal pain will suffice.

Just looking at physical indicators is not enough. Many first-time pregnant mothers are most likely to fall into misunderstandings in life, such as "you need to take more supplements during pregnancy or the baby will not be strong enough" and "you cannot move during pregnancy and it is best to lie down to raise the fetus". If these rumors are taken seriously, problems such as gestational diabetes and macrosomia will easily arise. Therefore, life guidance care also accounts for a large part of our daily work, such as customizing dietary reference for expectant mothers with different weight gain rates, when and how much to take supplements such as folic acid, calcium, and iron, and how to adjust daily walking, sitting and lying postures to relieve backache and pubic bone pain. These are all included. I just want to mention here that there are now different voices in the industry. Some specialized hospitals feel that the demand for maternal exercise and nutritional guidance is getting higher and higher. They should be divided into independent nursing categories, with specialized nutritionists and maternal rehabilitation specialists to connect them. They do not need to be mixed with regular life guidance, and the services can be more precise. However, many general hospitals have limited obstetrics staff. For the time being, these contents are included in regular life guidance and have not been separated.

In addition to these visible care contents, psychological adjustment that many people tend to overlook is actually a particularly important part of prenatal care. I have met several expectant mothers in the third trimester. Their physical indicators are normal, but they are worried every day about whether there will be problems during delivery and whether the children will have congenital defects. , so severe that they can't even eat or sleep well. At this time, we will talk to them more about past successful childbirth cases. If necessary, we will contact the psychologist in the hospital for evaluation. We will also bring them into a group of pregnant mothers with the same due date. We chat with each other and complain, which can alleviate a lot of anxiety. Not long ago, there was a mother who had a second child. Her first child was a cesarean. She wanted to have a normal delivery this time, but she was particularly worried about the risk of uterine rupture. We specially compiled the scar assessment data for her previous cesarean section, as well as the successful cases of natural births with scarred uteruses in our department in the past six months. We followed up on her fetal size and lower uterine segment thickness every week. When she finally had a successful delivery, she even gave us wedding candy, saying that if she hadn't been given reassurance pills at every prenatal check-up, she would have given up on the cesarean section long ago.

In fact, the types of prenatal care are not fixed now. They are adjusted according to the actual needs of pregnant mothers. There may be more subdivided categories in the future. The core is to allow pregnant mothers and fetuses to spend the entire pregnancy more smoothly.