Prenatal Care: What To Expect

Let’s be honest. If you are experiencing your first pregnancy—or even if this isn’t your first rodeo, but you have changed providers or are in a different life stage since last time—we know questions are brewing. Maybe a few concerns. Some serious wonderings. A few odd cravings. Along with lots (and lots) of planning.

Dr. Derek Beyer, an OB/GYN physician at Grand Itasca since 2014, has guided women and couples through all stages of pregnancy. Read what he says to expect during your prenatal care journey:

In the initial stages of pregnancy, we first identify how many fetuses there are, and identify any risk factors for the mom. This helps us to determine if it's just a routine pregnancy or a high-risk pregnancy. 

Early on, it's useful to discuss lifestyle modification such as quitting smoking or avoiding drugs and alcohol, do routine screenings for genetic disorders, and discuss appropriate weight gain and safety issues in pregnancy.

The second part of pregnancy is basically watching for preterm labor and establishing that the baby is growing as it should. Providers typically perform an ultrasound in the middle of the pregnancy, at about 20 weeks, to look for any congenital problems that the baby could possibly have. 

Toward the end of pregnancy, prenatal care visits are focused on watching for things like gestational diabetes, to make sure that the mother is not glucose intolerant (which can increase some risks for the baby and the mom). We also watch mom's blood pressure, monitoring for things like preeclampsia (a pregnancy complication characterized by high blood pressure and signs of damage to another organ system) or hypertension (high blood pressure) that could be more problematic for mom if it's not addressed.

The initial visit is usually established around eight weeks of pregnancy. After that, we see patients on a monthly basis, up through about 32 weeks. Then, typically, we see patients every other week until 36 weeks, and usually every week after that until the baby's born. 

The timing of prenatal care is important so that we are able to watch for any complications that could occur. Sometimes those complications can happen quickly, so regular check-ups keep us on top of things.

Things that the mother can do to impact the pregnancy include being careful what you put in your body, and including avoiding drugs, alcohol and tobacco. 

Staying active is also important. Exercise during pregnancy is actually a good thing, as it helps limit weight gain and reduces mom's risk for high blood pressure and diabetes during the pregnancy. Moms who are physically fit will also tend to do well with labor.

Prenatal vitamins are helpful in preventing things like anemia during pregnancy, and can actually prevent spina bifida (a condition where the spinal cord fails to develop properly) if you're taking folic acid. DHA is an important supplement also for fetal brain development and can also be involved in helping keep mom's mood healthy.

When planning outings during your pregnancy, you should avoid risky activities that could harm the baby or your abdomen. While you’re in the car, proper positioning of your seatbelt is important so that the belt is over your hips and the shoulder harness goes down between the breasts and off to the side (so there's no belt or harness over the abdomen). Some activities that are probably best skipped during pregnancy include water skiing, and riding horses or motorcycles, just to prevent the possibility of trauma.

Things in the first part of pregnancy that you may want to let your doctor know about include:

• Bleeding and cramping, due to the possibility of a miscarriage or even very early labor. 
• Fever, chest pain, or shortness of breath. In this day and age of COVID, you’ll especially want to report if you're experiencing these symptoms. Bring that to your provider's attention and get screened appropriately. 

In the middle of pregnancy, watch for signs of preterm labor, such as:

• Regular contractions
• Bleeding
• Leaking of vaginal fluid

As the pregnancy advances, watch for: 

• A decrease in fetal movement 

Talk to your provider right away if you experience any of these symptoms.