due date

Why Prenatal Care Matters during Your Pregnancy

It is important that pregnant women see a physician more often than just to confirm their pregnancies and to have their babies delivered. Quality prenatal care by an established OB/GYN or nurse practitioner throughout the entirety of the pregnancy is the best way to monitor a baby's growth and to identify any problems or complications early on, before they become a health threat to the future mother or her unborn child. During these prenatal visits, a mother-to-be is also educated on how to care for herself during a healthy pregnancy, and also how to manage unique circumstances-such as gestational diabetes-that can emerge during pregnancy. Statistics show that women who make regular visits to health care providers during their pregnancy have healthier babies, are less likely to give birth prematurely, and are less likely to have other serious pregnancy-related issues. A pregnant woman's OB/GYN will often refer her and her partner to helpful support groups or Lamaze classes. These health care practitioners also connect low-income pregnant women with referrals to much-needed government services, such as WIC.

During a normal, low-risk pregnancy, it is recommended that a woman make prenatal visits about once a month during her first 28 weeks; twice a month from week 28 to week 36; and up to once a week after week 36, according to helpful information compiled by the March of Dimes. Those with higher-risk pregnancies may need to make more frequent visits with their doctor.

Knowing the approximate due date is another reason prenatal visits are useful because this helps women determine how much time they will have to prepare for a new baby. Prenatal visits also provide an opportunity to receive an ultrasound to determine the sex of the baby after it has reached the appropriate point of development.

The education a woman receives about pregnancy and childbirth during prenatal visits is invaluable. Women will learn the important role prenatal vitamins play in the healthy development of the baby, how to manage their weight during pregnancy, and answer any tricky questions they may have about their pregnancy. Topics a pregnant woman may want to discuss with a health care practitioner during a prenatal visit might include: sexual activity during pregnancy, exercise during pregnancy, the risk factors associated with being pregnant as a teen or older adult, what changes to expect in your body during pregnancy, and how to manage discomfort during pregnancy.

This guest post is contributed by Jennifer Johnson, who writes on the topics of NP Schools. She welcomes your comments at her email Id: j.johnson19june@gmail.com.

Birth planning leads to surprising increase in premature births

The rising trend of expectant mothers being involved in every aspect of planning their births has had an unintended consequence - a rise in pre-term deliveries.

"It never would have occurred to me or anyone I knew to think you had any kind of control over when the baby would come out," said Laura Crawford, who gave birth more than a decade ago.

Crawford, producer of the Kentucky Educational Television documentary "Born too Soon," said the increasing incidence of what is called late pre-term births is among the topics explored in the film.

Prematurity rates in the nation have increased quietly over the past two decades, according to public health officials. The premature-birth rate in Kentucky is 15.2 percent, and it's rising faster than the national rate, which is 12.7 percent. Kentucky has one of the highest rates of pre-term births, trailing only Louisiana, Alabama, Mississippi and South Carolina.

Some of Kentucky's rise is related to some not-so surprising subjects, including the rate of maternal smoking (more than twice the national average), poverty and environment.

Other reasons are more surprising. They include the rise in scheduling births.

It's just within the last three or four years that the scope of the problem of late pre-term births - babies born between 34 and 36 weeks' gestation - has become apparent, said Dr. Ruth Shepherd, division director for maternal and child health in Kentucky's Department of Public Health. Roughly 10 percent of all babies born in Kentucky fall into the late pre-term category.

Ideally, she said, babies shouldn't be delivered before 39 weeks.

Often, there are legitimate reasons for early delivery, especially if the health of mother or child is at risk.

Increasingly, choices are made for reasons other than health. Delivery might be scheduled to coincide with grandparents' dates of arrival from out of town, or before Dad must ship out for Iraq.

There are several complicating factors, Crawford said. The documentary states that people tend to underestimate the impact of premature births, especially late pre-term births. They tend to overestimate how accurately a due date can be determined.

Shepherd said there can be real consequences. They can include immediate physical challenges, including underdeveloped lungs and long-term problems involving learning and behavioral disabilities, for example.

And even if a mother gets an ultrasound within the first 16 weeks - the best way to accurately determine the due date - the date can be off by two weeks either way.

Those two weeks can be crucial, she said.

"It's an issue of planning and control," she said. Planning is good. The Centers for Disease Control and Prevention recommends that mothers have a birth plan. But, Shepherd said, "you can take it too far if you don't pay attention to the science."

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