Ideally, when you’re trying to conceive, a visit to your health practitioner is strongly advised, says Dr Abigail Lukhaimane, an obstetrician and gynaecologist at Life Fourways Hospital. “This is important in order to discuss your general state of health, optimise your wellbeing and see if there are any risk factors such as chronic conditions that could affect, or be worsened by, pregnancy. These conditions include high blood pressure or diabetes. Lifestyle modifications such as alcohol intake, smoking and drug abuse should also be addressed and you’ll probably be advised to start taking a folic-acid supplement, which helps to prevent neural-tube defects such as spina bifida. If a visit before conception isn’t possible, you should see your doctor as soon as your pregnancy has been confirmed – whether by a home pregnancy test or a lab test.”
Your first visit
The first pregnancy consultation normally happens between six and eight weeks, and varies according to whether you’re seeing a midwife, GP or obstetrician, says Dr Lukhaimane. Appointments for low-risk first pregnancies usually involve the following:
- Medical and surgical history
- Social and family history
- A general examination, including measuring blood pressure, height, weight, body mass index and middle upper-arm circumference (which is a good screening tool for assessing a pregnant woman’s nutrition)
- Abdominal-pelvic assessment
- Urine spot test for bladder or urinary tract infections, preeclampsia and gestational diabetes
- Dating ultrasound to confirm that the pregnancy is viable and the estimated due date of delivery (this is not on offer at all midwife or GP practices, so make sure it’s available before making an appointment)
- Taking blood, which includes:
– a full blood count (haemoglobin) to get your baseline iron levels to prevent pregnancy-related anaemia
– testing glucose
– testing for the rhesus factor, which highlights if your blood type is compatible with your baby’s
– testing for HIV and syphilis
– checking your rubella and hepatitis immune status and thyroid function. These are not always included in your check-up, but can provide important information to healthcare providers.
Once these tests have been done, your doctor will advise you on supplements, exercise and future antenatal visits. It’s also important to discuss the two scans you need to have at about 12 weeks and 20 weeks for congenital abnormalities and foetal anomalies. These scans should be performed by a foetal medicine specialist or a certified practitioner such as an obstetrician.
Your doctor should schedule an appointment between the 12 and 20-week scans to review how you’re coping, discuss the results of your last scan and what to expect during the second trimester. You are also screened for preeclampsia and preterm delivery risk factors.
From 20 weeks onwards, you should book an appointment every four weeks. At each visit, your overall wellbeing is assessed, along with your weight gain and blood pressure. Your urine is checked and your doctor should do an abdominal examination, with or without ultrasound. If you are planning to have a 4D scan, it should be done between 28 and 32 weeks.
What about antenatal classes?
In today’s technology-driven world, parents-to-be are able to find answers to all their pregnancy-related questions at the click of a button. “However, the information provided by ‘Dr Google’, or any of the readily available apps, can be overwhelming and cause unnecessary stress. The best way to deal with this is to get back to basics, and to cover each aspect of pregnancy, birth and parenthood systematically,” says Sister Ros Allman, childbirth educator at Netcare Park Lane Hospital. “This is where antenatal classes come in. They help expectant parents focus on pregnancy and to prepare for birth and parenthood. These classes answer many questions and concerns, assist moms and dads in making more informed decisions regarding their birth plan, and guide them to make the most of the birthing experience. The days of classes mainly teaching women how to breathe during labour are long gone. Today, the antenatal class involves qualified professionals providing evidence-based information, and covering the role of the birth partner, birth plans, neonatal intensive care, vaccinations and the importance of stimulation for your baby.”
Sister Alison Horn, coordinator at Netcare Stork’s Nest Mother and Baby Wellness Clinic at Netcare Mulbarton Hospital, says that the classes are not exclusively for first-time moms, as every pregnancy is different. “I advise every pregnant woman to attend antenatal classes in order to keep abreast of developments, including different pain control options and delivery methods. Antenatal classes will guide you as to what’s best and safest for you and your baby and we recommend attending them from about 20 weeks.
“Make sure you do your homework when choosing an educator,” she adds, “as there are various options, many of which most medical aids cover.”