The word 'prenatal' means before birth. When we talk about 'prenatal care', we are referring to the care you receive before the birth of your baby. One of the best ways to give your baby a healthy start in life is to get early - and ongoing - prenatal care. Prenatal care is essential for the health of both mother and baby.

Ideally, prenatal care begins even before you become pregnant. If you are planning to become pregnant, it is wise to discuss your plans with your health care providers and to have a complete medical check-up. This allows for:

• the identification of any genetic concerns in your family history
• the treatment and stabilization of any medical conditions that you have
• diagnosis of conditions such as heart disease, diabetes or sexually transmitted diseases that you weren't aware that you had
• early counselling about the things you can do to prepare for a healthy pregnancy.

Prenatal caregivers

In Alberta, three groups of caregivers offer prenatal care and help with the births of babies -- midwives, family doctors and obstetricians (specialists).

If you haven't chosen a caregiver, here are some tips to help you find one:

• Ask your friends
• Ask your family doctor or other health care providers
• Contact the College of Physicians and Surgeons of Alberta for a list of doctors who are taking new maternity patients (1-800-561-3899)

To find a caregiver who matches your needs, you may want to meet before your first examination. Some questions you may want to ask:

• Where will my baby be born (which birth centre)?
• What are the basic routines and procedures that I can expect during my pregnancy? For example, you may want to discuss routines for office visits, phone consults, usual tests and procedures.
• Will you be attending the birth of my baby? (If not, who will?)
• What are my choices during pregnancy and labour? Some tests and procedures are optional and will depend on the situation and your caregiver. You may want to discuss topics such as positions in labour and birth, labour support, medications, induction of labour and episiotomy.What support will I have for breastfeeding?
• Are there extra charges for your service that Alberta Health Care does not cover?

You need to be able to talk to and trust you caregiver throughout your pregnancy. If you feel uncomfortable or hurried during your appointment or if you have questions or concerns, say so.

Prenatal Checkups

Guidelines for Prenatal Checkups

• First prenatal checkup should be after you have missed your second period (during week 12-13 of pregnancy)
• Month 2-7 of pregnancy - once a month
• Month 8 of pregnancy - once every 2 weeksMonth 9 of pregnancy - once a week

Your first prenatal check up

The first appointment is often one of the longest. You'll be asked about your health history and have some tests done. This information is needed for future assessments of you and your growing baby. A complete physical exam may be done including:

• a pelvic exam (internal exam) - to check your cervix and uterus
• a pap smear - to check for problems in your cervix (the opening of the uterus)
• blood pressure - to check for high blood pressure which can cause difficulties during pregnancy
• routine blood tests - to check for conditions such as anemia (low iron), diabetes, RH factor, syphilis, HIV and hepatitis B. Also to show if you have protection against rubella (German measles).

NOTE: If you have never had the German measles, a German measle vaccine is one of the things you need to consider well in advance of getting pregnant. The German measles vaccine is not recommended when you are already pregnant. After having the vaccine, you will be advised not to become pregnant for three months. If you not had German measles or the German measles vaccine, and you come into contact with someone who has German measles, within the first 20 weeks of your pregnancy, get in touch with your doctor or health unit immediately (German measles can have a serious effect on your baby).

• urine test - to check for infection and problems with your kidneys or blood pressure
• breast exam - to check for changes in your breasts
• weight - to assess your health and your baby's growth
• a general assessment of your health (for example, lifestyle, nutrition, smoking, alcohol).

Your followup prenatal checkups

During these visits you can expect the following:

• Weight, blood pressure and urine sample checks at each visit
• At 16 to 18 weeks, your caregiver may listen for your baby's heartbeat
• Opportunities to ask questions about diet, activity during pregnancy and any of your concerns
• At about 28 weeks, a blood test may be done to measure the sugar level in your blood
• Between 32 to 36 weeks, a vaginal exam may be done to test for bacteria
• When you're close to your due date, a vaginal exam may be done to check for changes in your cervix that may indicate that labour is getting closer.

Sometimes women who have already had a baby feel they know all about the prenatal routine and they postpone prenatal care until close to delivery. This is unwise -- problems may develop with any pregnancy. 

In addition to early prenatal care, especially if this is your first pregnancy, it is recommended that you attend childbirth education classes. Refresher classes are also available for women who have attended prenatal classes before.

Remember that each birth is unique and no one can predict your experience. Discussing your hopes and plans for labour and birth with your caregiver, before labour begins, will help you have the best birth experience possible.