An illustration of the concept of prenatal care

From the clinical confirmation of pregnancy to the official start of delivery, the system covers five dimensions of systematic care: physiological monitoring of pregnant women, fetal health assessment, pregnancy risk intervention, psychological state adjustment, and lifestyle guidance. The ultimate goal is to reduce the probability of adverse pregnancy outcomes for mother and baby while improving the comfort of life throughout pregnancy. If you think this definition is too dry, I will break it down for you and give you a few real examples from clinical and daily life, and you will understand it immediately.

Last week, I met Xiao Wu, a 28-year-old pregnant mother of her first child, at the obstetrics clinic. She was just 6 weeks pregnant when she clutched a pregnancy test stick and asked, if she only needs to go for a B-ultrasound and draw blood on time every month, is it considered that prenatal care has been taken care of? This is actually the biggest misunderstanding that many people have about prenatal care - equating it with routine prenatal care. That day, her face turned pale from vomiting, and her urine ketone levels were 3+. In addition to prescribing her rehydration, we did not send her home directly. We specially asked her to make a half-page "private anti-vomiting list": choose soda crackers without added sucrose, take a small bite each time and wait 10 minutes before swallowing. Don't eat half a bag at a time. ； Replace the full-fat milk powder for pregnant women stored at home with low-fat room-temperature yogurt. Don’t freeze it too hard when drinking it. Just cool it to about 15 degrees. ； If you really want to eat something sour and spicy, you don’t have to bear it. As long as you don’t have stomach pain or diarrhea after eating it, it’s perfectly fine to eat hot pot and drink half a glass of iced Coke once in a while. These non-medical life guidance are essentially part of prenatal care, and they don’t count only by prescribing check-ups and medicines. Oh, by the way, when she came for NT last week, she specifically told me that after eating according to the list for half a month, her morning sickness was much better, and she also gained two pounds.

I have to mention here that when choosing a prenatal care plan, many families now struggle with whether to take the purely evidence-based Western medicine route or the traditional Chinese medicine plan that combines traditional conditioning. In fact, both directions have their own basis, and there is no absolute right or wrong. Sister Li, a 32-year-old second-pregnant mother I met, strictly followed overseas evidence-based guidelines when she was having her first child. She controlled her sugar levels throughout the pregnancy to the point where she could only eat less than half a bowl of rice and walked 8,000 steps a day. As a result, at 32 weeks, she was so anxious that she had insomnia for a week in a row and her blood pressure was a little high. This time, she went directly to the prenatal care clinic of our hospital that combines traditional Chinese and Western medicine. She received all the necessary examinations such as glucose tolerance, major ovarian abnormalities, and fetal heart rate monitoring. She also received acupoint massage once a week to relieve back pain. She occasionally drank a mild anti-abortion tea prescribed by the doctor. She no longer forced herself to walk enough steps every day and just lay down when she was tired. She said that this pregnancy was "more than twice as comfortable" and all indicators were within the normal range. The evidence-based view is that all nursing measures must be supported by large sample clinical data, and interventions without clear evidence of benefit are not recommended. ； Traditional Chinese medicine prenatal care focuses more on individual somatosensory differences, and the two are now slowly integrating. In our current routine nursing assessment, "pregnant women's subjective comfort" has long been regarded as an equally important reference item as blood items and B-ultrasound indicators.

Don’t think that all prenatal care must be done in the hospital. Many home operations that are easily overlooked are actually the most critical part. Last year, I met a 36-week pregnant mother. She had one week to go before her regular prenatal check-up. She counted the fetal movements at home and found that the fetal movement was half less than usual. She did not dare to delay and came to the hospital immediately. After a check, it was found that the umbilical cord was wrapped around the neck for 2 weeks and there was slight intrauterine hypoxia. An emergency cesarean section was arranged that day. The mother and baby were safe. This kind of operation of spending an hour at home every day to count fetal movements is an extension of prenatal care to the core part of the family. The cost is almost zero, but it can help many families avoid risks. Some pregnant mothers have asked me, are doing manicures and hair dyeing during pregnancy considered taboos in prenatal care? My answer has always been: as long as you use regular and qualified products, without irritating nail polish remover or hair bleach, and you feel particularly good after doing it, then this is meaningful - after all, the emotional state of a pregnant woman itself will affect hormone levels, and anything that makes you happy does not violate the nursing principles as long as it does not cause any clear harm.

There is another controversial point that everyone discusses the most: Does prenatal education count as part of prenatal care? Nowadays, two schools of thought are fiercely arguing. One school believes that listening to music to the fetus every day during pregnancy and talking to it through the belly can not only stimulate the fetus' sensory development, but also help pregnant women relax. It is an extension of routine care. ； The other group believes that there is currently no clear clinical evidence that prenatal education can improve the IQ or development level of the fetus. On the contrary, frequent belly touching may cause uterine contractions, and pregnant mothers at risk of premature birth should avoid it as much as possible. Our current advice to pregnant women is never one-size-fits-all: If you think prenatal education is a very enjoyable thing, then do it, regardless of whether it is useful or not. ； If you feel that listening to music and telling stories every day is a burden, you don’t have to do it at all. Just lie down and watch your favorite drama for half an hour. The effect may be better than prenatal education.

In fact, to put it bluntly, prenatal care is never a condescending medical terminology, nor is it a rigid implementation manual. It’s the cup of warm lemon water that the nurse handed you when you were just pregnant, it’s the reminder WeChat message you received before each prenatal check-up to “be fasting next time”, it’s the sense of security you feel holding your phone while counting fetal movements at home, and all the things you do around “making mother and baby safer and more comfortable” are all included.