Prenatal care is a preventive health service for pregnant women. It consists of preventive examinations and optional additional examinations for women in risk groups. Prenatal care begins from the time the pregnancy is diagnosed by a doctor and ends shortly before the baby is born, to be followed by postnatal care for the woman and child.
What is prenatal care?
Prenatal care is a preventive health service for pregnant women. It consists of preventive examinations and optional additional examinations for women in risk groups. Prenatal care is a voluntary but recommended preventive health care program for pregnant women. It is a routine examination that can be supplemented by optional additional examinations as needed. Pregnancy care is covered in full by health insurance – unless the woman requests further screening outside of the routine and voluntary offerings. Although there is no obligation to attend routine prenatal care examinations, if this endangers the child’s well-being, the pregnant woman can be held accountable afterwards for failing to do so. If the woman is employed, her employer must excuse her from work for the duration of each prenatal check-up. The size, growth and development of the child are examined, as well as its general state of health. Pregnancy check-ups for the woman include discussions with the doctor, weight and blood pressure measurements, as well as blood and urine samples. Within the framework of the voluntary examinations, tests are carried out in individual cases for hereditary diseases of the child. Furthermore, prenatal care serves as an opportunity for the expectant mother to ask individual questions of the attending gynecologist.
Function, effect, and goals
Most pregnancies proceed without major problems; minor difficulties are often easier to treat if detected early than if they were detected later. Therefore, prenatal care is mainly used for early detection of high-risk pregnancies, health problems of mother and child, and, of course, detection of hereditary diseases or congenital disorders of the child. The following procedures are used in routine prenatal care examinations:
- Ultrasound examination
- Urine sample
- Test for gestational diabetes
- Vaginal and cervical smear
- Palpation examination of the cervix
- Weight control of the mother
- Blood pressure measurement of the mother
- Examination of the fetal heart tones
As a rule, nothing more is required. Shortly before the birth, the gynecologist will talk to the woman about the birth, prepare her for it and, if necessary, make a recommendation for a cesarean section. In the presence of a high-risk pregnancy of the mother, for example, due to the age of the woman, gestational diabetes or previous difficult pregnancies, further examinations are considered to detect and exclude any risks that may occur as a result:
- First trimester screening with nuchal fold measurement.
- Triple test (blood test to detect hormones that indicate diseases in the child).
- Amniocentesis and examination.
- Toxoplasmosis screening test
- Test for streptococcus B, chickenpox antibodies, cytomegalovirus infection.
- Chorionic villus sampling
These tests are used for early detection of hereditary diseases such as trisomy 21 and are particularly recommended for women over 35 years. In exceptional cases, parents may still opt for a late abortion of a hereditary child, if this would massively reduce his and her quality of life or the child would not be viable at all. Such examinations as part of prenatal care enable detection and allow parents to make a decision in an emergency. Furthermore, it can be determined whether the mother needs vaccinations to build up antibodies against diseases that are dangerous for her and the child, if a previous vaccination no longer offers protection.
Risks, side effects and dangers
Most prenatal care examinations are completely safe for mother and child. This applies to all examination procedures of regular prenatal care without IGeL services (these include the optional services, such as prenatal diagnostics). Only some examinations can be unpleasant, such as the smear test or blood sampling – in this case it is important for the woman to visit a gynecologist with whom she has confidence. In the best case, the gynecologist can also accompany her through the birth, since he already knows her and has monitored her health over the past months. In the case of IGeL prenatal care services, on the other hand, there are risks for mother and child depending on the examination, about which the pregnant woman is informed in each individual case. Some prenatal diagnostic procedures, such as amniocentesis, are invasive. In this procedure, for example, a needle is used to puncture the uterus and amniotic fluid is removed from the amniotic sac; risks could include leakage of amniotic fluid, healing complications of the puncture site and, in extremely rare cases, injury to the child. Therefore, the benefits and risks of these prenatal care procedures are weighed, and the gynecologist then makes a recommendation that the woman can follow. Of course, the woman can also refuse any prenatal care examination, whether it is an additional service or part of the routine, if she does not want to undergo it at all. However, if there is no high-risk pregnancy or if the gynecologist does not explicitly advise a potentially high-risk examination, prenatal care is very low-risk for both mother and child. Furthermore, prenatal care can identify life-threatening situations such as gestational diabetes early so that treatment can be initiated and the health or life of mother and child are no longer at stake.
