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Be an Active Participant in Your Prenatal Care

Every book you read will tell you about the importance of getting prenatal care. Most women go to obstetricians, some go to midwives and some do their own prenatal care. But what exactly does it entail?

Most care givers do a schedule of visits beginning with once a month until you are approximately 28 weeks pregnant, then the visits increase to every two weeks, and finally, in the last month of pregnancy, you see your care giver once a week.

At the OB's office, you'll be weighed at each visit. They'll ask you to pee in a cup so they can do a urine test to see if you are spilling sugar or protein and they'll check your blood pressure. As your pregnancy progresses, they'll measure your fundal height (how large your belly is from the pubic bone to the top of the uterus) and listen to the baby's heart rate with a Doppler. They may also do a vaginal exam occasionally, especially towards the end of pregnancy to check your dilation. (Just for the record, knowing how far you're dilated before labor begins means nothing. You could be all the way closed one day and be in labor the next. Or, you could be walking around for a couple weeks while you're dilated to 6 centimeters. It does not predict when labor will begin.)You'll see the doctor for about five or ten minutes and you'll be done until next month. You may be scheduled for screening tests, ultrasounds and other procedures that the obstetrician feels are routinely needed. The doctor will make the decisions about what is needed or not, and you are expected in most cases to be passive and compliant.

An appointment with a certified nurse-midwife (CNM) is very similar to having an appointment with an obstetrician. You may get to take a little more of an active part in your care with a CNM. In some offices, they expect you to weigh yourself and dip your own urine and let them know what the strip says.

An appointment with a certified professional midwife (CPM) has some similarities, but the midwife will usually stay with you at least an hour each visit, getting to know you, your habits and your preferences. Visits may be at her office or at your home. Many of these midwives want to get to know you, your family, and be available to answer questions and concerns. Towards the end of pregnancy, she'll visit your home if she hasn't been there before, and she'll want to plan with you what you expect from your labor.

Learn more about the stages of birth here!

During the course of your pregnancy, she should talk to you about nutrition, concerns, and how to cope with contractions. She will listen to the baby's heartbeat with a Doppler or a fetoscope, measure your fundal height, and maybe require you to step on a scale and take a urine strip test. She may discuss tests with you and let you know the pros and cons of having them done. The decision of whether to go ahead with these tests will be up to you. She may do vaginal exams if you request them. You are expected to take a proactive role in your prenatal care. You will probably need to go over your diet with the midwife and make decisions about the birth. Having a homebirth requires that you take responsibility for your decisions and their outcomes.

If you choose a traditional, or lay midwife, appointments will probably be at your home, for at least an hour each visit. She may tell you about the various tests you can have done, but you'll need to schedule them with your doctor. At each visit, your midwife will listen for the baby's heart beat with a Doppler or fetoscope, measure your fundal height, and maybe have you weigh yourself or do a urine test if you are interested in it. Vaginal exams are usually at your request. With a traditional midwife, you are more of a partner in your prenatal care, since you may be expected to do some things for yourself. All decisions about your pregnancy and birth as well as the responsibility lies with you.

If you choose to do your own prenatal care because you want an unassisted birth, this is also possible. Keeping a record of when your baby kicks is an easy way to gauge the baby's health. You can learn to hear the baby's heartbeat with a fetoscope (a special stethoscope) and you can weigh yourself if you wish and take your own blood pressure. Keeping records of these things is a good idea if you or the baby needs medical attention after the birth. Doing your own prenatal care and birthing unassisted definitely puts all the eggs in your basket. You are doing all the research, making all the decisions and taking responsibility for you and your baby.

Whatever you decide for your prenatal care, remember that to have an organic pregnancy and birth, you must be an active participant. Decisions and responsibility lie with you and your partner. If you sign over all your decisions to someone else, you may end up with a birth you never dreamed of. By being an active participant, you learn a lot about what is happening during pregnancy, what will happen at the birth, and how to plan accordingly.

Medical Disclaimer

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