Obstetrics

Prenatal Care

Prenatal care refers to the medical care recommended for women before and during pregnancy. The aim of good prenatal care is to detect any potential problems early, to prevent them if possible (through recommendations on adequate nutrition, exercise, vitamin intake etc). The availability of routine prenatal care has played a part in reducing

maternal death rates and miscarriages as well as birth defects, low birth weight, and other preventable infant problems in the developed world

While availability of prenatal care has considerable personal health and social benefits, socioeconomic problems prevent its universal adoption in many developed as well as developing nations.

One prenatal practice is for the expecting mother to consume vitamins with at least 400 mcg of folic acid to help prevent neural tube defects. Prenatal care generally consists of:

monthly visits during the first two trimesters (from week 1-28)
biweekly from 28 to week 36 of pregnancy
weekly after week 36 (delivery at week 38-40)

Delivery

Labor and delivery are the final phases of a pregnancy , which end with the birth of the baby. Labor begins with physiological changes in the mother’s body that indicate the imminent birth of the child. These changes include:

Dilation (widening) and effacement (thinning) of the cervix
Rhythmic contractions of the uterus that become more frequent and intense as delivery nears

Once a woman has gone into labor, a prolonged, three-stage process begins in which the baby moves down into the pelvis in preparation for birth. Labor often lasts between 12 and 14 hours – or longer – for first-time mothers, but is usually shorter in subsequent births.

In most cases, labor and delivery occur between the 37th and 42nd weeks of a pregnancy. The typical U.S. pregnancy is about 39 weeks, according to new analysis by the March of Dimes. In other situations, labor may begin before the 37th week of pregnancy, a condition known as preterm labor that is potentially dangerous to the health of the fetus. In still other cases, natural labor may be delayed or is not strong enough to produce adequate contractions. In such instances, a physician may need to induce or augment labor to help the birth process advance.

Cesarean Section

A cesarean section is a surgical procedure in which incisions are made through a woman's abdomen and uterus to deliver her baby.

Cesarean sections, also called c-sections or cesarean deliveries, are performed whenever abnormal conditions complicate labor and vaginal delivery, threatening the life or health of the mother or the baby. Dystocia, or difficult labor, is the other common cause of c-sections. The procedure is performed in the United States on nearly one of every four babies delivered—more than 900,000 babies each year. The procedure is often used in cases where the mother has had a previous c-section.

Postpartum Care

Postpartum care encompasses management of the mother, newborn, and infant during the postpartal period. This period usually is considered to be the first few days after delivery, but technically it includes the six-week period after childbirth up to the mother's postpartum checkup with her health care provider.

Immediately following childbirth, a new mother experiences profound physical and emotional changes. She may stay in the hospital or birthing center a very short time, even as little as 24–48 hours after delivery. The physical and emotional care a woman receives during the postpartum period can influence her for the remainder of her life.

During the postpartum period the mother is at risk for such problems as infection, hemorrhage, pregnancyinduced hypertension, blood clot formation, the opening up of incisions, breast problems, and postpartum depression.