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Antenatal care is undertaken during pregnancy with a range of checks and tests being used to ensure that the baby is growing correctly and developing in the right way. These tests are designed to help make the pregnancy safer and protect the wellbeing of both mother and baby.
Weight and height checks
When pregnant, a woman will undergo a number of tests to assess her weight and height. These are used to calculate your BMI (body mass index) and it may be that a new mother is told to be careful with their diet or try to lose a little weight during the early stages of pregnancy should a doctor have reason to believe that a person’s diet is unhealthy.
These types of checks will often be to establish the health of the mother and will be used to ensure a woman is in good condition during the early stages of carrying a baby.
During antenatal appointments women will be asked to undergo a urine test. This will be checked for a number of things including protein and albumin which, if found, can indicate an infection and may need to be treated.
Blood pressure tests
A mother’s blood pressure will also be tested when first pregnant and will be taken during almost every visit to the doctor during pregnancy. A rise in blood pressure could be a sign of pregnancy-induced hypertension and pregnant women should avoid stress as much as possible which will put pressure on their unborn child.
Blood tests are very common when pregnant and, despite not being to everyone’s taste, are performed fairly regularly. These tests are used to look for a whole range of conditions and will also help to ensure the health and safety of the baby. Blood tests will help to screen for:
- HIV, Syphilis and Hepatitis b
- Rhesus disease
Blood tests will also be used to determine the blood type of the mum-to-be which is vital information for when they are giving birth should a blood transfusion be required.
Amniocentesis tests are carried out during pregnancy which will assess if any abnormalities have occurred, or may occur later in pregnancy. This procedure is typically carried out between 15 and 20 weeks into pregnancy and requires a needle to extract a sample of amniotic fluid which is used to test for abnormalities. Before the procedure is undertaken, a consent form must be signed and the test can detect a number of conditions in a fetus such as:
- Down’s syndrome
- Spina bifida
- Sickle cell anaemia
There are a number of things which can increase the risk of an abnormality during pregnancy including the age of the mother and their medical history as well as if there are any genetic conditions within the family history.
Once a baby is born a series of checks will be undertaken to ensure that both the child and mother are happy and healthy. Usually a check will be scheduled for around 6 weeks from the date of birth to make sure that everyone is recovering and progressing correctly. This is a great opportunity for the mother to ask questions or get help with any early issues relating to their newborn and tackle these. During a postnatal check there will be a number of things which are tested such as:
- The weight and length of the baby as well as height and weight of mum.
- Should any stitches have been required during birth, these may be checked or removed if needed.
During these checks a mother should tell their doctor if they have any issues at all. These may relate to:
- Any vaginal discharges or pain.
- If the mother is feeling particularly tired, low or depressed.
- If the mother is having trouble with wind or incontinence.
- Any worries or concerns at all after the birth of the child.
Checks undertaken on a newborn
When taking a child to a postnatal check the doctor will check for a number things and ensure that the baby is generally healthy. A personal health record is often started where the weight of the baby can be monitored. The doctor will also check the baby’s heart, lungs, spine and genitals have developed as they should and that there are no abnormalities. A baby may be tested to ensure that they can follow objects with their eyes and to make sure they are happy and well-fed.
Right after a baby has been born, the very first test that is carried out is known as the Apgar score. This test will look at the condition of the newborn and quickly evaluate if any attention is required. Apgar tests look at:
- Appearance (the colour of skin)
- Pulse (heart rate)
- Grimace (reflexes and responses)
- Activity (muscle tone and movement)
- Respiration (breathing rate and effort)
Each of the above categories will give a score with 2 being the best and 0 being a cause for concern. If a category seems healthy and normal (such as the baby being active, with a normal respiratory rate and pulse) then a score of 2 is given. Should the baby seem to be struggling with any factors such as having little amounts of movement or a slow pulse then they will score 1 and attention may be required. A score of 0 will indicate no pulse, responses, breathing or a bluish colour to the baby all over and will be a major concern requiring medical attention immediately.
Blood spot tests
A blood spot (also known as a heel prick test) is normally offered for newborns at around 5 days old. This procedure involves taking a small blood sample from the baby and is used to test for any illnesses that may be present. A special device is used to prick the heel of the baby to collect four drops of blood on a special card and this is done quickly and is not invasive in any way. This test will then be used to test for illnesses such as:
- Sickle cell disease
- Cystic fibrosis
- Congenital hypothyroidism
- Metabolic diseases
The heel prick test is not compulsory and mothers can decide not to undergo this treatment. However, it is a very good way of screening for many illnesses and could end up saving a babies life.
Checks during the first year of life
After a baby is born, mothers are given a Personal Child Health Record (PCHR) which is a small red book. This is a really handy way of keeping track of a child’s progress throughout their early life. Sections will be filled in by GPs, health professionals and parents to show a record of weight and height as well as all vaccinations which have been given.
During baby reviews a health visitor may make an appointment to come and see a child or a child may be taken to a local GP. During this time the weight of the baby will be measured and any issues can be spotted early. Advice and help can be given to mothers on a range of different issues including:
- Bathing and cleanliness of the baby
- Health and nutrition
- Breast feeding
- Postnatal depression
- Physical examinations
- Bonding and parenting skills
Regular visits will often be made to see parents and assess the environment that the baby is being brought up in. This is a great opportunity for parents to ask for advice and ensure that they understand the needs of the child including safety, diet and normal behaviour.
Checks on mothers
Checks will be undertaken on mothers shortly after they give birth to ensure that they are happy and healthy. Typically, mothers will have tests and scheduled doctors appointments to check for postnatal depression as this is a common problem and can affect how a mother bonds with their baby. Around 1 in 10 mothers go through postnatal depression which can manifest itself through a number of symptoms such as:
- A persistent feeling of sadness
- Poor sleeping patterns and not being able to sleep even when very tired
- Lack of energy and enjoyment from the world
- Difficulty bonding with the new born
- Withdrawing from contact with other people
- Poor concentration and decision making
- Very frightening thoughts (such as harming your baby)
Any of the above can be a cause for concern and mothers are likely to discuss their feelings with a mental health professional should they require. A range of support is available for new mums who should never struggle alone or be embarrassed about postnatal depression. Counselling, psychological therapy and antidepressants can be used to combat postnatal depression.
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