Prenatal care is caring for the mother & baby from conception to birth, which last till around 38 or 40 weeks gestation. Prenatal care is necessary to help promote good physical and mental health, and to also educate the parents for labor, delivery and breastfeeding. Knowledge is often a means of eliminating unnecessary problems.
Early care can help detect problems that could possibly be turned around, and may also aid in ruling out high risk conditions that could endanger the mother and the baby. Oftentimes, a mother doesn't even realize she is pregnant until 8 weeks-the most critical time.
First of all, we check the mother's medical and O.B. history. We want to know how many pregnancies she has had, any miscarriages, C-sections, problems, etc. We like to do some blood work to make sure that the mother's hemoglobin (hgb) isn't too low. We need to know the blood type. A prenatal panel is recommended (especially for first time moms). Then at every visit we check weight, B.P., pulse, edema, urinalysis, fetal movement, uterus size or fundal height, palpation and fetal heart tones. (See my book for more info.)
Edema simply means swelling brought on by an accumulation of fluid in the intercellular spaces of tissues. This puffiness will be seen usually on ankles, feet, hands and sometimes the face. (See my book for more info.)
This is a very important tool that we use. Palpating is done with our hands to feel the baby in the uterus to determine the position and the size. We also listen for fetal heart tones (FHT) while palpating.
Emotional support also plays a role. She may have fears that she needs to express or share. I find a lot of fear arises simply from not being informed.
I put together a "Birthing 8 Laws of Health" tract for pregnant moms to go by. Let's look at the acronym, 'BIRTHING'. Bodily exercise, Inhale pure air, Rest, Temperance, Hydrotherapy, In the sunshine, Nutrition, and God's Word.
BIRTHING: EIGHT LAWS Of HEALTH:
Bodily exercise: Gardening, walking. - Genesis 2:15, Proverbs 3 1:16,17. Inhale pure air: Breathe deep. - Genesis 2:7, Job 27:3. Rest: Go to bed early. - Exodus 23:12, Psalm 127:2, Proverbs 3:24. Temperance: Self discipline. - 2 Peter 1:6; Proverbs 23:1,2. Hydrotherapy: Drink plenty and bathe often. - Proverbs 25:21, Isaiah 1:16. In the sunshine: Bask in the sun. - Ecciesiastes 11:7, Psalm 74:16. Nutrition: Eat for strength. - Genesis 1:29, Ecciesiastes 10:17, 1 Corinthians 10:3 1. God's Word: Trust Him! - Proverbs 4:22, 31:30; Psalm 119:105.
"Perceive the evidences of God's love... Instead of looking upon an observance of the laws of health as a matter of sacrifice or self-denial... regard it as it really is. as an inestimable blessing."-MINISTRY OF HEALING, pg. 147.
Of course exercise will help tone up muscles to get prepared for birth. It helps blood circulation, which is good for mother and baby. Exercise is needed for proper elimination. It helps reduce stress and reduces indigestion. A pregnant mother needs to be in good physical condition in order to have the stamina she needs to give birth. The more exercise she gets the better she will stimulate the production of endorphins, which is a hormone that acts as a natural pain killer. Exercise may increase endorphin level in the blood by 60%. It is also interesting that prolactin, which stimulates the breast to make milk, may be increased by 40%. There are many types of exercises you can do, but the best is walking and/or gardening. Outdoor exercise in fresh air is healthiest.
Inhaling pure air increases oxygen supply to mother and baby. It purifies the blood and improves sleep. We encourage our mothers to get fresh air in their houses and bedrooms. As for labor, I recommend the slow relaxed breathing from the diaphragm instead of breathing fast, to avoid hyperventilation. Slow relaxed breathing will expend less energy so the mother won't be so tired. This also helps ease the pain that comes with contractions.
Of course! We tell our mothers that every hour before midnight is worth two hours after. If they maintain regular hours and establish a schedule now, it will help establish regular sleeping patterns for their newborn. If you stay up almost all night, your baby probably will as well.
Temperance in all things is essential. Don't over exert, don't sleep too much, don't over-eat. We also encourage our mothers to abstain from tobacco and alcohol. And what many people do not realize is that caffeine can be damaging.
We encourage our ladies to drink at least 8 glasses of water a day. This will promote good circulation, elimination, blood building, and supplies water for the amniotic fluid, which provides protection for the baby. Much of the fluid is being replaced every 3 hours.
Sunshine increases white blood cells, which strengthen the immune system. It destroys bacteria and helps lower high blood pressure as it brightens the disposition and soothes nerves. We also use it for treatment of jaundice in newborns.
The pregnant mother does need to be concerned that she gets enough vitamins and minerals and protein for herself and her baby. The best source is what God has provided in good natural food. Mothers should choose their foods from principle rather than cravings. We encourage lots of fresh fruits and vegetables. (See my book for more info.)
We encourage our mothers to read God's word and meditate on His promises. This provides spiritual strength for the day and keeps the mind clearer. It also helps eliminate stress, worry and fear. I find that Christians have the most peaceable births.
Because hospitals can handle emergencies when a problem arises. They have medical equipment, they can perform surgery, and they have medications for pain relief, like epidurals. Also, hospital staff are available to wait on you, a luxury not always available at home.
Some couples want to have a natural birth without interventions in their home setting, with just the privacy of the family. The husbands can get more involved this way. There is less risk of infections for mom and baby, and the cost is much less.
Yes, the Mehl Study and the JAMA Study are perhaps the best known. Both basically concluded that low-risk home births are as safe or safer than hospital births.
In the hospital they have what they call Standard Operating Procedures (S.O.P.), which they must go by. As soon as the patient has been registered, the staff will obtain her OB history and do some additional blood work. Most women get IV's unless they refuse. Enemas are generally routine, although some doctors aren't doing that . They get hooked up to fetal monitors for monitoring contractions and FHT's. Labor is augmented by the use of Pitocin. Epidurals are freely given for pain, although the patient may choose to request a natural birth. Depending on the doctor, forcep deliveries or vacuum extractors may be used. Most doctors routinely give episiotomies (to create a bigger opening for delivery), and c-sections are becoming more common-place.
You should probably ask how many years of experience she has. Does she carry emergency and medical equipment (diagnostic instruments) like B.P. cuffs, stethoscopes, and chemstrips to the birth? Does she carry oxygen, an Ambu bag to administer a certain amount of oxygen by positive pressure to a severely depressed baby (this is very rarely needed at home)? Does she carry devices to listen to FHT's? How does she handle hemorrhages? Does she work with an assistant and is she trained as well in neonatal emergencies? Has she ever lost a baby or mother? Is she accessable (on call) all the time? Does she have a Doctor back-up that works with her? Does she do prenatals, labor and delivery, postpartum care?
Yes, certainly you should rule out complications and high risk situations during the prenatal period. Unless it is something that can be turned around, refer to OB care.
Yes, most of the uterine incisions are low and horizontal, making the risk of uterine rupture less than 1%. The Flamm Study (1994) documented 75% of women with previous C-sections were able to have successful vaginal births. Also, the American College of Obstetricians and Gynecologists (ACOG, 1994) recommended that the practice of routine repeat cesareans be abandoned.
Yes grand multips (a woman who has had 5 or more babies) will have a greater risk of uterine inertia or boggy uterus than one whose had less babies. When the uterus does not contract well, a major hemorrhage is possible. But it also depends on what kind of shape she is in. If she is in good health and follows a good diet and lifestyle, she may have no trouble. Also, there is greater risk if she is having one baby on top of another without sufficient time in between to give the uterus a break.
The effects of smoking are tremendous, but let us look at just a few. 5% of still births and neonatal deaths are attributed to smoking (British Medical Journal). 70% greater risk of miscarriage (Ibid.). Babies are stunted in growth (Ibid.).
Yes, let's look at some. Braxton Hicks contractions increase and become more regular. Mucus discharge will increase. The "bloody show" or pinkish glob of mucus may appear. Bowel movements (soft) will increase.
In the hospital it may be preferred due to the monitors that are hooked up to the patient. However, you will find in Exodus 1:15-18 that the Hebrew women delivered quicker and easier. They were using birthing stools. This is like squatting with support. It is less painful because of the upright position, and gravity is in the patient's favor. The cervix dilates quicker, and helps the pelvis open up wider.
No. Very rarely, if ever, are they necessary in a homebirth. By using (olive) oil massage on the perineum, combined with hydrotherapy and controlled pushing, tears can be generally avoided.
No anesthesia is generally available, but wonderful comfort measures may be employed, such as warm baths, hydrotherapy (the use of warm moist towels), massage, and walking. In addition, the patient may stay well hydrated and rest when she wants. That will help keep her energy level and pain tolerance up.
The pelvic joints are greatly influenced during pregnancy due to the hormones progesterone and relaxin which increase flexibility of the sacroiliac joints and the symphysis pubis to open greatly during labor. This allows the baby to pass through the birth canal.
There is the 3rd stage of labor, the expulsion of the placenta. By nursing her baby, a natural oxytocin is released which will cause the uterus to contract, which releases the placenta. The uterus will begin to go back to its normal size, a process called uterine involution.
After delivery, it is important to make sure the fundus is firm. This may be accomplished by massage. Bleeding needs to be under control. She should be able to void. She needs to be fed and well hydrated, and generally cared for. The baby needs to be examined and nursing well. She should have a two week and six week visit also. At 6 weeks the placental site should finally be healed.
We encourage them to have help at home, either the husband taking off work for a while to help or her mother. Often, church members will bring meals in for at least 2 weeks.
Frequently Asked Questions