Prenatal care plans and measures

The core logic of prenatal care is never to apply a unified template. Instead, it is based on the individual pregnancy cycle, maternal and childbirth history, basic health status, and psychological state of the pregnant woman, and develops a personalized plan focusing on the three directions of risk prevention and control, comfort improvement, and delivery preparation, and ultimately achieves the goal of reducing pregnancy risks, ensuring mother and child safety, and optimizing the delivery experience.

I have been in the obstetrics clinic for almost 11 years, and I have met too many pregnant mothers who followed the "standard labor guide" on the Internet but had problems - Sister Lin, a 32-year-old pregnant mother with a second child who was treated last week, had a cesarean section for her first child. This time she was pregnant with twins and had a complicated pregnancy. As for diabetes, all the strategies I searched for before were "dietary recommendations for a single birth," "climb more stairs in late pregnancy to aid delivery." When I came for a prenatal check-up, my fasting blood sugar was 6.8mmol/L, and I could have false contractions more than a dozen times a day, which was really scary. After we adjusted her nursing plan, the blood sugar level has stabilized within 5.3mmol/L this week, and the uterine contractions have basically returned to normal.

In fact, there have always been two mainstream voices in the industry regarding prenatal care: one is the traditional "prenatal care school", which believes that pregnant women should move less, take more supplements, and rest as much as possible to avoid risks; the other is the evidence-based "activity school" that has become popular in recent years, advocating that pregnant women without high-risk factors should maintain normal activities or even moderate exercise to increase productivity and reduce discomfort. There is actually nothing wrong with both statements. The key is to match your personal situation - if you have high-risk factors such as habitual miscarriage, cervical insufficiency, and placenta previa, then "lying more and moving less" is the most suitable plan for you. ； If you are a 25-30-year-old pregnant mother of a single child with no underlying diseases, taking a walk every day and doing a few sets of pregnancy yoga can relieve common discomforts such as edema and constipation, and can also help control weight and reduce the risk of macrosomia.

Many pregnant mothers think that prenatal care means going to the hospital for prenatal check-ups every week. In fact, daily monitoring at home can detect problems in time. Let’s just talk about weight measurement. Many people remember the saying that “it is best to gain 25 pounds during the entire pregnancy.” In fact, this is not the case at all: a pregnant mother with a thin pre-pregnancy BMI can gain 25-30 pounds during the entire pregnancy, and a pregnant mother who is overweight before pregnancy can gain 10-15 pounds during the entire pregnancy. Oh, by the way, it is best to measure your weight on an empty stomach in the morning, after going to the toilet, and when you are wearing the same home clothes. Otherwise, if you eat too much today and wear thick clothes tomorrow, the value will be different by two or three pounds, which is purely to scare yourself. Two years ago, I met a pregnant mother who ate only boiled vegetables every day in order to achieve a "standard weight." Finally, she fainted at home due to hypoglycemia at the 28th week of pregnancy. When she was sent to the hospital, the fetus was suffering from intrauterine hypoxia. It was really unnecessary.

Besides, there is no "miraculous method" for intervention during pregnancy, which is the most troublesome thing for everyone. What suits you is the best. Let’s talk about morning sickness. The elders all told them to eat soda crackers and drink soda water. However, I have met many pregnant mothers who said that eating soda crackers made their acid reflux worse. Now many evidence-based obstetricians also recommend that if you can’t eat light food, you can occasionally eat iced yogurt and suckle. It’s okay to eat plums, or even take two bites of the hot and sour noodles you’ve been craving for a long time. The fetus in the first trimester requires very little nutrition, and your mother’s previous reserves are completely sufficient. There’s no need to force yourself to eat tasteless “nutritious foods.” Being able to eat is more important than what you eat. There is also edema in the third trimester. If your ankles are only swollen and there is a pit when you press it, but it disappears after you sleep, then just raise your feet when you sit. If your calves or even your face are swollen, don't just think about raising your legs. You must go to the hospital quickly to have your blood pressure and urine protein measured. This is likely to be a sign of pregnancy-induced hypertension, so don't take it seriously.

Oh, by the way, there is also psychological care that many people ignore. The detection rate of prenatal anxiety and prenatal depression has really been getting higher and higher in the past two years. It is not that pregnant mothers are "hypocritical". Last month, a 1998 mother who was pregnant for the first time came to talk to me. She said that everyone in the family was focused on her belly. Every day when she opened the door, her first words were, "Did the baby move today?" There are actually different opinions on this point. Many older generations think that "pregnancy is not hard, and it will be over if you endure it." However, from our clinical perspective, the emotional state of pregnant mothers directly affects hormone levels, and severe anxiety can even induce uterine contractions and lead to premature birth. If you feel that your emotions are wrong, don't force yourself to do so. You can either talk to the obstetric psychology clinic of the hospital, chat with pregnant mothers who are on the same due date, or even occasionally lose your temper with your husband. Don't keep your emotions in your heart.

Finally, I would like to talk about the preparation for childbirth that everyone is most concerned about. You really don’t need to buy a lot of things according to the “most complete list of childbirth packages” on the Internet. There are many things that you won’t use at all. I have seen pregnant mothers who gave birth in the summer and bought thick maternity hats and velvet postpartum shoes. They covered their heads with sweat when they entered the delivery room. They also had disposable maternity soft-bristled toothbrushes that were so soft that they couldn't clean away tartar at all. Just use the ordinary soft-bristled toothbrush you usually use. There are also many pregnant mothers who memorize the Lamaze breathing method months in advance, saying that they are afraid that it will hurt so much that they won’t be able to exert force. In fact, there is really no need to worry. Many people can’t remember the breathing rhythm when the contractions start to hurt. They just listen to the midwives’ instructions. People have taught them for decades, and they are much more effective than the mantras you memorize.

In fact, after doing obstetric care for so many years, my biggest feeling is that there has never been a "standard answer" for prenatal care, nor is there any standard for "perfect pregnant mothers". You don’t need to feel guilty because you are greedy for ice cream occasionally, and you don’t need to feel anxious because you are too lazy to exercise. As long as you have regular prenatal check-ups, tell the doctor if you feel uncomfortable as soon as possible, and give birth to the baby safely, you have done a good job.