It's not uncommon to see campaigns pushing for every woman to have prenatal care. Health officials say prenatal care saves lives and improves pregnancy outcomes. But does it really help that much? Why are we seeing higher rates of complication like prematurity, emergency c-sections, and even maternal and infant deaths? Most women in developed countries do get prenatal care. Is it really prenatal appointments that make the difference? That's what I'll explore today.
I won't argue the fact that prenatal care does have an impact for many mamababy pairs. Public health campaigns that have championed prenatal care have usually seen a positive impact from the project.
Any program that believes that mothers and babies are worth attention, especially special attention and care, is beneficial to the community it exists in. Moms and babies are a core part of a healthy society and should be supported. When campaigns help bring them to light and help them get the support they need, the entire society benefits.
And there are times when prenatal care really does catch something that could have turned into a big problem. A mother and her baby are safer because of careful monitoring or quick intervention. Sometimes prenatal care can highlight an emerging problem and bring it to a mother's awareness.
Prenatal care is an excellent time for education, which is vitally important in a world that doesn't truly understand how to keep mamas and babies healthy. The chance to really guide a mamababy along a path to health is a wonderful part of prenatal appointments!
Having said that, healthy pregnancy is not a random thing. It doesn't just happen to those mamas who are “lucky enough” to skate through without complications. And, in general, pregnancy complications don't just randomly happen to healthy women with no indication whatsoever. In other words, the mentality that prenatal care is there “just in case” one of these things suddenly springs up is flawed.
While I agree that now and then something is caught during a prenatal appointment that nobody saw coming, I think that tends to be really rare. The reality is, driving to the doctor or midwife's office and peeing in a cup does not make your pregnancy any healthier!
Simply going through the motions of prenatal appointments doesn't make you any healthier than a mother who didn't drive to her prenatal care appointment.
We forget that simple truth in our zeal to get women to their prenatals. And we actually do women a disservice. We perpetuate the myth that the mere act of going to your appointments is what's going to keep you and your baby safe. And that's not true.
Sure it's good to catch that rare problem a prenatal appointment may identify. But because we emphasize that “making the appointments” is what matters, there is little emphasis on how to keep yourself and your baby healthy during pregnancy.
The dangerous perception is that it's the doctor or midwife's job to keep you and baby healthy. And that's not true.
A typical pregnancy is roughly around 280 days. If you're having a typical pregnancy, you'll have roughly 12 – 15 appointments. That means you're pregnancy for 265 days where you do not see a care provider. Who's taking care of you and your baby on those days?
Midwives Jan Tritten and Carol Gautschi put it this way: “Prenatal care is what you do between the visits to your midwife!”
That's the truth about prenatal care – it's really and truly what you do between your appointments. It's your daily self-care. And it makes a huge difference.
I won't say that taking good care of yourself will prevent every possible problem – accidents still happen, sometimes genetics still impact pregnancies, and sometimes things just don't go smoothly. But aside from that, and aside from some of the discomforts of pregnancy that we just grin and bear… what you do really does make a huge difference.
Don't ever let anyone else tell you otherwise. I can't figure out why it became taboo to let a mama know you really make a difference in your baby's health. I don't actually think it's because doctors or midwives are on some ridiculous power trip. I think the reality probably has to do with trying to protect mothers from guilt – mother guilt is real and it's not fair to create a culture of blaming moms for everything. There's a fine line to walk, and I want to acknowledge that. But understanding, and doing everything you know you can do to have a healthy pregnancy and a healthy baby, is a good thing. It's not something we should keep from mamas.
So just what does it take to do 265 days of your own prenatal care?
Did you know you can actually do just about all of your prenatal care? I'll talk more about how you can keep track of your well-being and prenatal health (and even do stuff like test your own urine, if that tickles your fancy :p) next week – and I'll also tackle the intimidating and anxiety-provoking world of prenatal tests on next week's podcast.
Today I want you to rest assured that the basics of good self-care at any time in life are what it takes to keep you and baby healthy:
That's really simplistic. I know. I talk to students every week who could ask a hundred questions just within those three areas (and thousands beyond). It's true that “good pregnancy diet” and “sensible pregnancy exercise” are hard to define. And stress relief is elusive… even for me! That's why I think education is an important part of prenatal care. Having someone on your team to help you understand. It goes back to the concept of “if you teach a (wo)man to fish…” from the great Teacher himself… If you discover how to care for yourself, and feel supported by your care provider, you're likely to feel confident and enjoy a great pregnancy outcome.
I'm not advocating giving up your prenatal appointments. I spend my life eating, breathing, and living pregnancy, birth, and baby… but I still love my midwife's support during my pregnancies. I know how to care for myself, but her emotional support is important.
And even with six healthy pregnancy and six healthy babies, I had questions for my midwife during my seventh pregnancy. I greatly appreciate her listening ear, her wisdom, and her ability to objectively see things that I don't notice with myself (like “Kristen, I think you should make a point to drink more water” – and she was right!). It's invaluable to have somebody to call when you're new at this pregnancy thing, or when you're an old hat but still need a listening ear.
Care providers can see warning signs developing over the course of regular appointments. They can point those out and help you change lifestyle or diet factors, avoiding a complication because you realized you need to change something. And if there is an unavoidable complication their assistance is invaluable!
But care providers should focus on education. Helping you understand that this is your pregnancy, and you're in charge. The choices you make every day impact your baby (so indulge in that square of dark chocolate after a dinner full of protein, veggies, and salt to taste 😉 ). A good care provider will listen to your questions, help you find answers, make you feel empowered, and respect your choices.
Prenatal care does save lives – and the best thing about is that it's the care mamas do every day that makes the biggest difference. Take a look at what you can do for your little one – your hands are the best hands for your baby to be in 🙂