Prenatal care issues and measures

Judging from the clinical admission data and follow-up status of our obstetrics department in the past five years, the three most prominent common problems in prenatal care are erroneous behaviors caused by cognitive biases, irregular responses to physiological discomfort, and lack of psychological support. The core of the corresponding solutions has never been to apply a unified nursing template, but to combine individual conditions with layered intervention + physician collaboration. There is no absolutely correct standard answer, and the one that suits you is the right one.

Let’s talk about a case we just encountered last week. Sister Zhang, a mother of her second child who was 28 weeks pregnant, came to the clinic with leg cramps for three days. She said at the beginning that she drank three bowls of bone soup and took two calcium tablets every day. The elderly at home also asked her to lie down and not move around every day, for fear of premature birth if she moved too much. In fact, her bone density report was normal. The cramps were caused by poor circulation in her lower limbs after lying down for a long time. In addition, she turned on the air conditioner at night without covering her legs and caught cold. Half of the calcium she added became unnecessary metabolic burden. When it comes to exercise during pregnancy, the academic community has always had different trends: Traditional obstetrics tends to be more cautious, and it is recommended that pregnant women with a history of premature birth, placenta previa, and cervical insufficiency reduce their activities as much as possible. ； The modern obstetrics and gynecology rehabilitation school advocates that pregnant women without contraindications should maintain low-intensity exercise for about 30 minutes every day. Pregnant women’s yoga, brisk walking, and Kegel exercises can both control weight and reduce the risk of tearing during natural delivery. There is no right or wrong in either view. It all depends on the fitness of the individual’s physical condition. There is really no need to force it on yourself after hearing a certain statement.

Many people's impression of prenatal care is still "eat well, drink well and don't run around". In fact, the hardest hit area is dealing with physical discomfort. Let’s just talk about morning sickness. The older generation always said, “vomiting is normal, and it will pass if you tolerate it. Taking medicine is not good for the child.” There are two reasons for this: If it is only mild nausea and does not affect normal eating, there is really no need to intervene. Just eat smaller meals and avoid greasy food. ； But if you vomit to the point where you can’t even drink water, and your urine is positive for ketones, and you still insist on not taking medicine or rehydration, it will lead to electrolyte imbalance and affect fetal development. Clinical guidelines have long made it clear that vitamin B6 is safe for moderate to severe morning sickness. There is no need to hold on to the old concept of "the medicine is only three parts poisonous". Oh, by the way, there is also a saying of "eating goose eggs to remove fetal toxins" that has been spread for I don't know how many years. In the past six months, I have met three pregnant mothers who ate goose eggs and had excessive cholesterol. There is no concept of "fetal toxins" in medicine. The so-called neonatal eczema and jaundice are normal physiological phenomena and have little to do with what you eat during pregnancy. Don't make up for it.

Let’s talk about a point that is easily overlooked by everyone, which is the prenatal psychological state. Last month, a pregnant mother who was 32 weeks pregnant came for a routine prenatal check-up. She cried after sitting down without saying a few words. She said that everyone in the family was focused on her belly and asked her every day, "Is the baby moving a lot?" There are now different directions for prenatal psychological intervention: some hospitals mainly promote prenatal psychological clinics and use professional scales to evaluate the intervention. ； Some institutions encourage family members to participate in delivery rehearsals so that expectant fathers can understand the key points of care in advance. ； Other experience is that pregnant mothers are advised to join social groups with the same due date and complain and communicate with people who share the same due date. Each of the three methods has its own advantages and disadvantages. As long as it can relieve the mood, it is always more useful than family members who just say "don't think too much".

I have been working in the obstetrics department for almost 8 years, and I have seen too many pregnant mothers who posted the "Perfect Prenatal Care Checklist" on the Internet on the refrigerator and clocked in the list, and struggled for a long time just to eat more rice and less vegetables. In fact, it is really unnecessary. Those uniform templates are like the one-size-fits-all clothes in the mall. Some people fit them just right, while others just don't fit. If you are really unsure about something, don't scare yourself by searching online for a long time. Just ask your bedside doctor casually during your next prenatal check-up, which will be more effective than searching Xiaohongshu for three hours.

To put it bluntly, the core of prenatal care has never been "doing everything right." As long as the prenatal check-up indicators are normal and you feel comfortable, that is better than anything else. Don't be bound by the so-called "standards of a perfect pregnant woman."