We are all familiar with the adage: ‘Be good to your baby before it is born’. This aphorism serves to emphasis the importance of medical care during pregnancy (known as antenatal care). However, in reality, the best time to start taking care of your unborn baby is even before you conceive! Such care is called pre-pregnancy or pre-conception care.
Why is this care so important? Remember, that the foetal organs are actively developing during first 12 weeks of pregnancy (this crucial period is called ‘organogenesis’.) The embryo is highly susceptible to external insults during this time, so that any damage can lead to crippling birth defects.
The beauty about pre-pregnancy care is that it is so simple: all that is involved is visiting your doctor before you are planning to get pregnant, rather than after you've missed your menstrual period! The doctor normally undertakes the following procedures: (1) takes a medical history; (2) carries out a physical examination; and (3) performs some simple laboratory tests. These procedures are inexpensive and easy to conduct and signify examples of preventive medicine at its best!
Pre-pregnancy care also leads to other benefits. For instance, it allows the doctor (duly assisted by you) to identify problems and rectify them. If, In other words,, these problems were to be spotted only after you became pregnant, detailed testing can become very difficult, because the very presence of the delicate embryo, can impede testing. The harsh reality is that not all problems are preventable, but you can, nevertheless, increase your chances of having a healthy baby by identifying the risks you face and trying to eliminate them, if possible. After all, most doctors go in for a battery of tests before performing major surgery, to make sure that the patient is healthy enough to withstand the stress generated by the operation and the anesthesia. Pregnancy can also stress the body, and it is important to screen the woman for potential problems before she embarks on one of the most important journeys she will ever make!
The most important precaution to be taken is to ensure a regular intake of a vitamin called folic acid. Folic acid greatly reduces the chances of your baby being born with spina bifida or anencephaly (without a brain) if taken before you become pregnant and during the first six weeks of pregnancy. This vitamin is now routinely prescribed in A lot of countries in the West to prevent A lot of birth defects.
Most women are aware of the importance of regular medical care during pregnancy and you should plan to register with a reliable obstetrician as soon as you find out that you are pregnant. This ensuing pre-natal care will then simply be an extension of your pre-pregnancy care. While modern obstetric care can ensure that pregnancy and childbirth are very safe for both mother and baby, unfortunately, today doctors have ‘medicalized’ pregnancy to such an extent that what is otherwise a normal event has been converted to one which needs rigorous and frequent medical assistance.
Every mother naturally wants a normal baby, and technology can be very useful in reassuring her that all is well. However, it is easy to misuse technology. One mainly disturbing trend stems from the fact that A lot of obstetricians nowadays overuse medical technology; such overuse can often prove detrimental to both the mother and the baby. Common tests which are misused include: blood tests for TORCH (Toxoplasmosis, Rubella, Cytomegalovirus; Herpes) infections; ultrasound scans; and foetal monitoring. Another area of misuse relates to the tests available for screening the baby for a possible birth defect. A lot of doctors routinely subject their patients to a ‘triple test’ during the pregnancy to screen for birth defects. While this is an easy test (it’s a simple blood test which measures the levels of 3 hormones in the blood) to carry out unfortunately, it has still not been standardized for Indian women. Such a drawback leads to a large number of tests yielding abnormal results, even though the babies are completely normal. An ‘abnormal’ result creates a lot of anxiety
- and then the doctor needs to perform a battery of other tests to
confirm that the baby is, in fact, normal to reassure the mother.The
second tier of tests can be expensive, and risky as well, because
some of them can cause the mother to miscarry. Thus, it is not
uncommon for a mother to lose a healthy baby because of a test
which was not really required in the first place!
The foetal monitoring procedure has also been overused over the past few years. While this procedure was initially designed to serve as a tool to monitor the well-being of the foetus and to help reduce the need for medical intervention, today it is often used to justify an LSCS (Caesarean section) in order to forcibly take out a baby ‘in foetal distress’! A much simpler alternative would be to opt for ‘kick counts’ — a baby which moves actively is sure to be healthy!
Antenatal classes conducted by medical or paramedical professionals can be very helpful. Here, you not only to learn a lot about pregnancy and childbirth, but also you get an opportunity to interact with other women in various stages of their pregnancy. The friendships developed during this period can be very supportive and helpful!
Despite tremendous advances in medical science, labour and childbirth are still events which A lot of women dread. Moreover, the rituals associated with childbirth in hospitals have unfortunately been designed for the doctor's convenience, rather than the patients'! In this context, the harmful practises include: forced induction of labour; routine use of enemas and intravenous drips, foetal monitoring, making the patient lie down (rather than allowing her to walk about) — it is a long list! Don't let the hospital/clinic staff patronize you — you need to assert your rights! it is very useful to draw up a birth plan (which includes things you will allow and those you won't ) and make sure your doctor agrees with the procedures. The presence of a doula has been proven to be your very helpful for women in labour. Also, should encourage your husband to participate in this adventure as actively as possible !
Yet another minus point pertains to the application of anaesthesia for pain relief, which has become the norm nowadays. We have mindlessly aped this Western ‘advance’, much to the detriment of both the mother and the child. While techniques for pain relief a valuable resource, can be they should be used only when absolutely necessary.
We are witnessing a virtual epidemic of Ceasarean sections today. Whereas a CS once used to be the method of last resort to deliver the baby, it has at present, tragically, become the norm in some hospitals, accounting for 50 per cent of all births. The reason, of course, is obvious: a CS is financially much more lucrative to the doctor than a normal delivery. As a senior obstetrician wryly put it: ‘The only indication for a normal delivery today seems to be if a patient delivers before the doctor reaches the hospital!’
The alarming spurt in CS has taken on the dimensions of a major scandal today, which needs to be tackled actively. What steps can you take if you don't want to end up as another statistic? It would be a prudent idea to find out the rates your doctor charges for a CS and for a normal birth. You can also ask him what proportion of his patients successfully delivers normally. Other patients in the clinic, as well as the hospital nursing staff, can prove to be valuable sources of information, which you should effectively tap to alert you to a "knife-happy" obstetrician, from whom you need to stay away!
