WHAT TO EXPECT AT ANTENATAL CARE VISIT?

Dear momma's,the gift of  children is a huge blessing.Motherhood is beautiful;it teaches you about things you may not know about yourself.It brings out the best you.First pregnancies are mostly the memorable ones.You wake up and put your hands on our belly to feel your baby moving.You may tend to read a lot(if you have the access to) to know about every little thing happening to you.Though beautiful,the journey isn't easy.As such,it is imperative to know about your body,the changes it undergoes in pregnancy and the need to go for regular antenatal care visits.Most women may go for regular antenatal care visits,but may not understand what is being done for them.

Antenatal care is the health care and education given to all pregnant woman from the period of conception to just before labour.This health care and education is very key in protecting yourself and the life growing inside of you.There are so many negative effects when you do not go for antenatal visits.Such effects contributes to maternal and neonatal morbidity and mortality.

Immediately you notice you're pregnant either by noticing some changes in your body or having a positive urinary pregnancy test,please go to the clinic or hospital.

At the clinic,an ultrasound of your abdomen will be taken.This is known as the first trimester scan.It is taken in the first 13 weeks of pregnancy but it is best if taken early.This scan helps your doctor or midwife to know or confirm if indeed there is a pregnancy.There is something called pseudocyesis.This is where a woman may have all the pregnancy symptoms yet there is no baby in the belly.So the first trimester scan helps your doctor to confirm if indeed there is a baby in your uterus.Again,this scan helps to know the site of implantation,that is,where in the uterus is your baby at.This helps in the early diagnosis and management of ectopic pregnancy.

In ectopic pregnancy,instead of your baby to be in the uterine cavity,your baby may be in the tubes which connect the uterine cavity to the ovaries,or even inside the abdomen in rare cases.If your baby is found in the tubes,you may have  an unusually severe abdominal pain and vaginal bleeding which if urgent emergency inteventions are not done,you may loose your life.Again,this first scan helps your doctor or midwife to know the number of weeks you've been pregnant.This is known as the gestational age where you may be told you're 12 weeks or 8 weeks pregnant.

At your first antenatal visit,there are some baseline investigations necessary to be done.Every mama wants a healthy baby, hence the need for your blood sample to be taken.Your blood group is checked,rhesus too is checked,HIV status checked,hepatitis B and syphillis checked.If you are rhesus negative,you will be given the antibody D immunoglobulin.If you are positive for HIV,syphillis or hepatitis B,you will be managed with drugs accordingly.Syphillis in particular will lead to your baby being born with severe eye infection called ophthalmic neonatorium.Your urine will be taken to check for proteins,bacteria,white blood cells which may indicate a urinary tract infection or a  hypertensive disorder in pregnancy.Again,your hemoglobin level is assessed to look for anemia in pregnancy.Anemia in pregnancy can cause your baby to die or you may give birth to a baby who is too small.

There are some routine drugs pregnant women are given:iron tablets and folic acid to prevent anemia in pregnancy.

Your blood glucose is checked to rule out diabetes which can lead to giving birth to a baby who is dead or your baby having neonatal jaundice where the skin becomes yellow.A sample of your stool is taken to check for hookworm ova which can also cause anemia in pregnancy.As such,most pregnant women are given de-wormers like albendazole.Since Ghana is a malaria endemic country,measures are put in place to protect you and your baby from malaria.Pregnant women are encouraged to sleep in insecticide treated nets.From 16 to 20 weeks of pregnancy,most pregnant women are given sulphadoxine pyrimethamine which is an antimalaria drug.It is taken in the hospital in the presence of your doctor or the midwife.If you have never taken tetanus vaccine or have not completed it,you will be the injection at your upper arm.

In your second trimester which is from 13 weeks to 26 weeks,your doctor may request for second trimester scan.This scan is best taken between 18 and 22 weeks.It is basically to assess for chromosal anomalies.Some of the anomalies detected include down syndrome,Edward syndrome,turner syndrome,etc.This scan is very important and if missed may result in unfavourable outcomes.If it is detected that our baby has a chromosal anomaly,the option will be given to you if you want to abort the pregnancy legally or you may want to carry the pregnancy to term and give birth.

The third trimester scan is taken around week 26 to week 40.This is done to look for the location of the placenta,the weight of your baby,how far your baby's head has descended into the pelvis,the lie and presentation of your baby,amount of fluid around your baby and in some cases the dilation or opening of the cervix.This scan is very very important.Women who didn't undergo management for diabetes may end up having big babies and in such cases,surgery must be done.If your placenta is situated very low in the uterus,you may have to undergo a ceasarean section because you may bleed uncontrollably and loose your life and that of the baby if allowed to deliver via vagina.Ideally,your baby must come with the head.If your baby is coming with the shoulder,surgery must be done.If it is the leg,you may be allowed to deliver vaginally but keenly observed if the need arises  for a surgery to be quckly done.The fluid around your baby is called amniotic fluid.It is this fluid which protects y.our baby from so many infections.If the fluid becomes very small,an emergency ceasarean  section must be done to deliver the baby.

In Ghana,antenatal care visits are every one month till the pregnancy is 28 weeks,then every 2 weeks till you're 36 weeks,then every week till you deliver.At every visit,the midwife or doctor will assess the lie and position of the baby.Ideally,the head should be down and the legs up.He or she will listen to your baby's heart beat and check the heart rate.This gives information as to if your baby is fine or not.

Your blood pressure is very important and is checked at every visit.Having hypertension or a high blood pressure in pregnancy is very dangerous.It can lead to vaginal bleeding,death of the baby,seizures in the mother and death of the mother.Anytime,you notice persistent headache around your forehead,dizziness and double vision,please do not hesitate to go to the hospital promptly.

Antenatal care is very key.Always make it a point to go.Ask questions and tell your doctor or midwife about any unusual symptoms you may experience.It saves you and your baby.