prenatal care

There is no one-size-fits-all standard answer to prenatal care. The core is not to copy the Internet celebrity's delivery package list, collect all optional prenatal check-up items, and strictly implement the so-called "pregnancy taboo list." It is to combine one's own basic physical conditions and changes in gestational age, and give priority to personalized care within a safe range that takes into account comfort. Compared with "achieving perfect scores", "adapting yourself" is the first priority.

Last week, I met a 32-week pregnant mother in the clinic. She had Hashimoto's thyroiditis before she became pregnant. She read several maternal and child posts saying that she should drink more coconut water to replenish amniotic fluid. With the mentality of "I would rather believe it", I drank 2 freshly opened coconuts every day. I drank it for two weeks in a row for routine prenatal check-ups. Her abdominal blood sugar soared to 5.7mmol/L, and her ankles were so swollen that she couldn't even fit into her previous slippers. Looking at her food records, she found that in addition to coconut water, she also had to eat a bowl of fish maw stewed by her mother-in-law every day. The amount of carbohydrates and hidden sugars alone exceeded the standard by more than double.

Having said this, I have to mention the question that has been asked the most recently: Is the more comprehensive the prenatal check-up, the better? There are actually two voices in the industry that make sense: One group is doctors who strictly follow evidence-based medicine. It is recommended that ordinary low-risk pregnant mothers follow the 2022 version of the "Pre-Pregnancy and Pregnancy Health Care Guidelines" of the National Health Commission. There is no need to perform additional frequent B-ultrasounds, unnecessary non-invasive PLUS or even sheep transpiration to avoid the additional anxiety and costs caused by excessive medical treatment. ； The other group prefers individualized considerations, especially for pregnant mothers who are over 35 years old, have had a history of adverse pregnancy, and have underlying diseases such as hypertension, diabetes, and autoimmune diseases. They will increase the frequency and items of examinations based on the patient's needs based on the guidelines. I met a 38-year-old pregnant mother last year who had had two miscarriages before. She took the initiative to ask for an amniotomy in advance after the NT at 12 weeks. Although the doctor said that her indicators could actually be treated with non-invasive surgery first, she felt that "I can sleep well only after I check it clearly." The final results were all normal. Her condition was particularly stable throughout the third trimester of pregnancy, and even the frequent false contractions that had occurred before were much less common. To put it bluntly, the purpose of the examination is not only to check risks, but also to stabilize her mentality. There is no need to set rigid standards, just follow a rhythm that suits you.

Compared with the controversy over prenatal check-ups, there are more misunderstandings about daily eating, drinking and moving. When my best friend was pregnant with her first child, the whole family raised her like a porcelain doll, eating bird's nests and sea cucumbers, and even refused to let her down the stairs. She gained 40 pounds during the entire pregnancy, and the baby was born at 8 pounds and 7 taels. She was born with two births. ； When she was pregnant with her second child, she simply moved back to her own home and went to work as usual. In addition to drinking an extra box of pure milk, eating an extra plate of green leafy vegetables, eating hot pot when she wanted, and occasionally drinking iced milk tea when she wanted. She also took a 20-minute detour home from get off work every day. She only gained 22 pounds during the entire pregnancy. It was over in half an hour. The baby weighed 6 pounds and 2 taels, and all indicators were good. Oh, by the way, there is also the saying that "you should not use skin care products or make-up during pregnancy" that has been passed down for many years. You really don't believe it. As long as it is a mild product from a regular brand and does not contain clearly taboo ingredients such as retinol and salicylic acid, it can be used normally. I once had a patient who was a bride and a makeup artist. She was doing light makeup throughout her pregnancy. The baby was born fair and fat, and there were no problems.

Of course, this does not mean that everyone should move more. I once had a pregnant mother with placenta previa. I heard others say that walking more will help her survive, so she walked 10,000 steps a day. In the end, she suffered bleeding and was hospitalized. The pregnancy lasted for half a month before it stabilized. For example, pregnant mothers with cervical insufficiency, placenta previa, and signs of premature labor should lie down when they should. Don't force yourself to torment yourself with the rule of "exercise more and have a better life".

There is another point that many people ignore. Prenatal care does not only take care of the body. The importance of mental state is no less important than the physical state. There was a 28-year-old first-time pregnant mother who had all her prenatal check-ups at one time. She had insomnia every day and kept thinking about "what if the baby is defective" and "will I have a difficult delivery". She failed the fetal monitor for one month in a row. Then I told her, you should set aside one afternoon a week, don't post about mother and baby, don't think about pregnancy, go to the movies when you want, eat barbecue with friends when you want, just pretend that you are not pregnant. She tried for two weeks and went to the fetal monitor again and said she finally slept through it. According to current academic statistics, about 20% of pregnant mothers will experience varying degrees of prenatal anxiety. It is really not hypocritical. Family members should not just stare at the belly every day and ask "Is the baby moving?", ask her more "Do you want to eat anything today?", which is more useful than any supplement.

I have been in the obstetrics department for almost 8 years, and I have seen too many pregnant mothers who put themselves into the mold of the "perfect pregnant woman". Today they are anxious about having one less test than others, and tomorrow they are anxious about gaining 2 taels of weight. They feel guilty for half a day even eating an ice cream. In fact, it’s really not necessary. Pregnancy itself is a natural physiological process. Prenatal care is just to help you go through this journey more comfortably, not to ask you to get perfect scores. Even if you occasionally get greedy and eat some "taboo food", even if you occasionally feel lazy and don't want to move, as long as you don't feel uncomfortable and your prenatal check-up indicators are normal, there will be no problem. After all, a happy pregnant mother is more likely to give birth to a happy baby.