Journal Article: Evidence-Based Prenatal Care by Kirkham, Colleen, Susan Harris, and Grzybowski - Essay Example

Upon pregnancy confirmation, plans for prenatal care must be discussed, among them being the choice of caregiver. The initial prenatal visit should take place during the first trimester, and for coverage of all pertinent information, more than one visit is necessary. Additionally, accurate dating is imperative for timing screening tests and interventions, as well as for optimum management of complications. The first three months of pregnancy are a time of formation of fetal organs and fetal vulnerability to teratogens is very high.

For this reason, there is a need for counseling about risk behaviors. Other issues for discussion in early pregnancy include air travel, breastfeeding, exercise, hair treatments, hot tubs, saunas, labor, and delivery; medications including prescription over-the-counter and herbal remedies; substance use including alcohol, illicit drugs, and smoking; sex, and workplace. The performance of history and directed physical examination are also necessary to detect conditions linked to increased maternal and perinatal mortality and morbidity.

The prenatal examination also allows for cervical cancer screening, ectopic pregnancy, and spontaneous pregnancy loss – ectopic pregnancy should be a consideration with the presence of risk factors, bleeding, or abdominal pain. The clinical components of routine prenatal visits that the majority of guidelines recommend include routine assessment with fundal height and maternal weight as well as blood pressure measurements, protein and glucose urine tests, fetal heart auscultation, and questions about fetal movement. Other aspects of prenatal care include genetic screening, ultrasonography, blood typing, prenatal education, domestic violence, and nutrition and food safety.