- Pre-pregnancy Counselling
- Antenatal Care
- Normal Delivery
- Caesarean Section
- High Risk Pregnancy
- Postpartum services
There are many important steps that a couple needs to take when getting ready to conceive a child. It is very important that both partners are prepared both physically and emotionally for this life-enhancing event.
Caring for your health before you become pregnant is good for you and your baby. This is called Pre-Pregnancy care. The first step is to inform your regular Obstetrician/Gynaecologist that you are ready to talk about getting pregnant and you would like to schedule an appointment for pre-pregnancy counselling. At the appointment, your doctor will probably have a routine set of questions and tests that they give to a couple preparing for pregnancy. Which may include:
The clinical examination includes blood pressure, weight, auscultation of heart sounds, and where relevant breast examination and pap smear.
An assessment of any medical problems and a discussion of how they may affect a pregnancy.
Past obstetric history
An assessment of the outcomes of any previous pregnancies (e.g. pregnancy loss, preterm birth, birth defects, gestational diabetes) to determine whether any measures could reduce the recurrence risk.
Genetic / Family history
If there high risk of a chromosomal or genetic disorder based on the family history or ethnic, pre-pregnancy genetic testing and counselling is recommended
To review all current medications including over the counter medicines, with regard to their appropriateness and teratogenic potential.
Women considering a pregnancy should be aware of her vaccination status
- Healthy weight / nutrition / exercise
A healthy, well balanced diet is strongly recommended before, during and after pregnancy.
- Folic acid
Folic acid should be taken for a minimum of three month before conception and for the first 3 months of pregnancy
- Smoking, alcohol and illegal drug cessation
Cigarette smoking and illegal drug use during pregnancy can have serious consequences for an unborn child and should be stopped before conception
Assessment of the risk of exposure to toxins or radiation in the household, work place or at recreational activity and discussion to minimise the exposure is worthwhile.
The goal is to check for any potential risks to you and your baby during pregnancy — and to address any medical issues you may have before you get pregnant. It’s about becoming your healthiest self — physically and emotionally — before you take that next step into pregnancy.
A large number of pregnancies are unplanned which means that many opportunities for pre-pregnancy counselling are missed. Pre-pregnancy counselling is also relevant to men. Their lifestyle and health may also affect pregnancy outcome. Any couple being referred for infertility assessment should have had a full pre-conception assessment prior to further investigation or treatment. Pre-Pregnancy care is distinct from antenatal care. It should include:
Informed choice, which helps women and men to understand health issues that may affect conception and pregnancy.
Women and their partners being encouraged to prepare actively for pregnancy and be as healthy as possible.
Identifying couples who are at increased risk of having babies with a genetic malformation. Provide them with sufficient knowledge to make informed decisions
When a woman is pregnant, it is important to have regular check-ups with the doctor. These check-ups are called antenatal care or antenatal visits. Antenatal means before birth. Regular medical care, knowledge of her choices, and understanding the unknown events during pregnancy can make childbirth an extremely enriching and joyful event. A series of appointments is usually offered with a doctor who specialises in pregnancy and birth (an obstetrician).
About AnteNatal Care
For most women, pregnancy is a simple, joyful and hale and hearty time. Having regular antenatal check-ups is an important part of staying healthy and making sure baby is healthy too. Regular checks during pregnancy can help in finding and decreasing risks to mother or baby. Although expecting mother may be feeling fine, it is still important to get regular antenatal check-ups. This gives a chance to ask any questions and to talk about any issues that one is unsure about. Before each visit, one can plan and think about the things one wants to talk about from the gynaecologist.
When to start antenatal care ?
As soon as a lady thinks that she is pregnant, it’s important to discuss with the gynaecologist for
- What type of care one would like to have, and
- When and where one should have next visit
Before the first antenatal visit, what all requirements and arrangement need to be done for necessary tests (blood tests, scans). After first antenatal visit, the later visits are then every 4 weeks until expecting mother is near her Expected Due Date (EDD) when visits become more frequent.
First Antenatal care visit
At the first antenatal visit, expecting mother will be asked lots of questions about her health, any other pregnancies, herself, her partner, and her family. This will assist the doctor to plan her care. At the first visit, she may also undergo some diagnostic test like blood group, viral markers, Hb electrophoresis, thyroid panel& urine test as well.
Gynaecologist will need medical history, including information about illnesses, operations, and allergic reactions to drugs, heart or kidney problems. Also, doctor will need gynaecological and obstetric history and any other health issues and information about any family medical problems such as diabetes, chronic diseases, genetic disorders or a history of twins.
To help gynaecologist to find out if she need any special antenatal need care, it’s important to share if expecting mother:
- Had any complications in a previous pregnancy or birth, such as pre-eclampsia or a premature baby
- Are being treated for a long-term condition, such as diabetes or high blood pressure
- Have previously had a baby with a birth defect (or anyone in your family has), for example spina bifida
- Have a family history of an inherited disease, for example sickle cell anaemia or cystic fibrosis
Next successive antenatal visits till expected due date (EDD) will be a great way to learn about how the baby is growing and what is happening to expecting mother’s body. Many women and their partners enrol for antenatal classes to learn more about pregnancy and birth, partner’s role etc.
Every delivery is different, and some women need extra help. It’s good to know ahead of time about the medical interventions that may be offered, and how doctor may assist labour.
- Normal Delivery – is Natural (vaginal) childbirth
- Caesarean Delivery (also called a C-section) is childbirth through an cut in the mother’s abdomen
- Painless Delivery – Epidural Analgesia helps in reducing the discomfort of childbirth. The goal of an epidural is to provide pain relief, rather than anaesthesia which leads to total lack of feeling which allow women to remain alert and be an active participant in your birth.
- Assisted Delivery – Assisting baby’s birth with vacuum or forceps is a safe, well-practiced procedure.
A Caesarean is an operation where an incision (a cut) is made through the abdomen to deliver the baby. It is also called a caesarean delivery.
Some Caesareans are planned, and some are emergencies. At times a C-section is safer for mother or baby than is a normal (vaginal delivery). In addition, several women request C-sections with their first babies to avoid labour or the possible complications of vaginal birth, or to take advantage of the convenience of a planned delivery.
If a Caesarean is planned, doctor will share all the information necessary to make the decision. A planned Caesarean will not be done before 38 weeks of the pregnancy, unless there are concerns about mother or baby’s. Some of the reasons for planned Caesarean include,
Painless Delivery and postnatal counselling
Painless delivery : Each woman during labour, experiences and tolerates pain. In some cases, the labour may be short i.e. 4 to 8 hours, but in other cases it may go on up to 24 hours, especially in first pregnancy. The perception of pain during labour and delivery differs between individuals.
Many expecting mothers would like to experience a normal delivery but without the labour pain. Painless delivery using epidural analgesia is an advance in pain management during labour, which ensures that a pregnant woman has a comfortable labour.
Postal Natal Counselling
Baby is finally here! The joys and challenges of motherhood are about to begin. It is important to remember to take care of yourself as well as your new baby. Post Natal care is of due importance. Make sure to rest when you can and don’t try to do too much. You need to understand that changes in your body post-delivery will continue for next couple of months as you decide whether or not to breastfeed and as your body starts to recover from having the baby. As we all know, breast milk is the best form of food for the babies. Your will start breastfeeding your baby as soon as possible after the delivery, if you need assistance with breastfeeding, your doctor will help you to guide to take a right way.
Postnatal visit to doctor is an important part of the pregnancy care. Post Natal visit to your gynaecologist is required for abdomen check-up. It is important to discuss about contraception as well, as there is a high risk of pregnancy immediately postpartum,
A pregnancy is “high risk” or “complicated” when the life or health of the mother or baby may be at risk. Health problems that occur before a woman becomes pregnant or during pregnancy may also increase the likelihood for a high-risk pregnancy.
Some factors that may lead to a high-risk pregnancy include:
- 35 years old or older at the time of conception
- Multiple pregnancy
- History of poor pregnancy outcomes (recurrent miscarriage, stillbirth, premature delivery)
- History of pregnancy-related complications (premature delivery, preeclampsia, gestational diabetes)
- Have a serious medical condition (high blood pressure, diabetes, heart disease, autoimmune disorders, etc.)
- Have an infection, such as HIV or hepatitis C. Other infections that can cause a problem include cytomegalovirus (CMV), chickenpox, rubella, toxoplasmosis, and syphilis.
- Use of alcohol or illegal drugs, or you smoke.
- Family history or previous child with birth defects
- Family history of a genetic disorder
In case of high risk pregnancy, one will have more visits to the doctor than in a normal one. One may have more diagnostics test to have a regular check on mother and baby, frequent ultrasound tests to make sure that baby is growing well.
No one who conceives a pregnancy expects to have to end it – terminate it – for medical reasons, or for a normally happy event to become one of sadness. The decision to terminate or to continue with a pregnancy can be a very difficult time for both of the parents.
Before any process of termination of pregnancy, one should receive a thorough consultation with the gynaecologist For uninvited pregnancy or pregnancy complications, based on stage of pregnancy there are different types. They are –
This is for women seeking abortion in early pregnancy. In medical abortion, use of a medicine or combination of medicines causes the pregnancy to terminate and the uterus to expel the products of conception.
SUCTION ASPIRATION / DILATION & EVACUATION (D&E)
Postnatal visit to doctor is an important part of the pregnancy care. Post Natal visit to your gynaecologist is required for abdomen check-up. It is important to discuss about contraception as well, as there is a high risk of pregnancy immediately postpartum