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Health care during pregnancy - Discussion of care during pregnancy - Monitor your pregnancy with clear advice

  Health care during pregnancy - Discussion of care during pregnancy - Monitor your pregnancy with clear advice Things to remember When cho...

Health care during pregnancy - Discussion of care during pregnancy - Monitor your pregnancy with clear advice

Things to remember

  • When choosing your health care provider, you will need to consider the level of risk in your pregnancy, how much you want to have a say in your decision making, and how much you want to think about "natural" births and pain medications.
  • Proper nutrition and moderate exercise are critical to a healthy pregnancy.
  • Eliminate or reduce your exposure to potentially harmful substances called teratogens.
  • If you are over the age of 35, you may wish to see a geneticist to assess the risks to your fetus.

Health Care during pregnancy is many and varied and includes medical visits, antenatal screening, nutrition, exercise, screening for infections and certain genetic diseases (if applicable), and the control of any potential maternal disease or other factors to consider. The first step to receiving good health care during pregnancy is choosing a health care provider.

Nowadays, in developed countries, most women can decide whether an obstetrician, family doctor or midwife will care for them throughout their pregnancy, during delivery and a few weeks after their baby is born. When choosing a health care provider, you will need to consider a variety of factors. Is your pregnancy low or high risk? What role do you want to play in decisions about your pregnancy? How do you feel about "natural" births and painkillers?

Balanced nutrition and healthy eating practices can contribute to a good pregnancy. Pregnant women should maintain a diet consisting of foods from the four major food groups: milk and milk products, meat and meat alternatives, fruits and vegetables, and grain products. They should also take folic acid because this vitamin protects the baby from birth defects such as neural tube defects.

Regular exercise is very helpful during pregnancy. Women who don't exercise are at higher risk of gaining too much weight and may develop gestational diabetes, gestational hypertension, varicose veins and lower back pain.
If you or your partner have a family history of certain diseases, both of you should be screened to determine if you are a carrier of those diseases. Carrier screening is done for couples with a family history of cystic fibrosis or congenital hearing loss and for those at high risk for genetically determined diseases such as sickle cell disease or thalassemia.

Some infections put the unborn baby at risk. All pregnant women should be tested for HIV because if the disease is detected early, transmission to the baby can be reduced. High-risk women should be tested for syphilis and hepatitis B, and be aware that the hepatitis B vaccine can be given during pregnancy. Screening can also be used to check if you have ever had the 5th disease of the child (parvovirus), in which case you would be immunized. In addition, if you have never had rubella or chickenpox, keep away from people infected with these diseases because infection could seriously harm your baby. Although there are vaccines against rubella and chickenpox, they can only be given before or after pregnancy, not during pregnancy.
Try to avoid or minimize your exposure to potentially harmful substances called teratogens. These substances can interfere with the development of your developing baby, usually in the early months of pregnancy. Potential teratogens include some medications, workplace hazardous substances, pesticides, thinners, tobacco, alcohol, cocaine, marijuana and heroin.

In addition, if the mother suffers from certain chronic diseases, this can complicate her pregnancy and pose a threat to her and her unborn baby. It is important that you control these conditions, preferably before you become pregnant, or as soon as you know it. Your treatment may need to be changed because some medications are harmful to the fetus.

Considerations for women over 35 years of age

Many women wait until they are over 35 years old to have a child, which puts the mother and baby at greater risk. If you are over 35, it would be best to consult a geneticist to inform you of all the potential risks you are facing. At this stage, the risks are minimal, but they tend to increase with age. Here are a few of them.

  • Infertility: the risk of infertility increases with age and reaches nearly 20% in couples over 35 years of age.
  • Maternal conditions: High blood pressure, diabetes and cardiovascular disease occur more often in women over 35 years of age.
  • Complications during pregnancy: the risk of miscarriage, premature delivery and postpartum hemorrhage are slightly higher in older women.
  • Down syndrome and other chromosomal abnormalities: the risk of giving birth to a baby with Down syndrome is about one in 10,000 for women in their 20s, three in 1,000 for women in their 30s, and one in 100 for women in their 40s. Antenatal screening assesses the risk of these abnormalities for a given pregnancy. If the risk is significant, ultrasound, amniocentesis and chorionic villi sampling may be used.

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