For the expectant mothers

03 Dec, 2022

For the expectant mothers

“Before you were conceived I wanted you. Before you were born, I loved you. Before you were here an hour I would die for you. This is the miracle of Mother's Love.” -Maureen Hawkins

So you are the miracle called mother, aspiring for another miracle-your baby. It is only natural that you would want only the best! Here is a comprehensive list you must be aware of. But it is on no way exhaustive as your needs may be a little different from the routine. I am sure your obstetrician will be able to take care of that.

Here is a Checklist for expectant mothers:

Time-When? What should be done? Why it needs to be done... How is it done?
Before you get pregnant Pre-pregnancy counseling To assess your health status before pregnancy.
To ensure you embark on pregnancy in optimal health.
  • 1. Folic acid supplements for 3 months prior.
  • 2. Rubella immunization
  • 3. Weight reduction (if obese).
  • 4. Optimize medical conditions (asthma, epilepsy, hypertension, diabetes, Thyroid disorders etc.) which may have been existing before
  • 5. Stop smoking and alcohol
First visit:
Immediately after a missed period.
Diagnosis of pregnancy Confirmation that the missed period is because of pregnancy and not just an over-due period.
  • 1. Urine pregnancy test
  • 2. Trans-vaginal ultrasound
  • 3. Internal examination
First trimester (up to 13 weeks)
  • Period of formation of fetal organs.
  • Avoid medications other than those prescribed.
  • Frequency of clinical examination: Once in 4-6 weeks
6-8 weeks History and examination
  • 1. Risk assessment-Categorization as high risk or low risk pregnancy.
  • 2. Calculating the expected date of delivery.(EDD)
  • 3. Preliminary examination of blood pressure, height and weight. General systemic examination.
  • 4. Assessment of early pregnancy
  • 5. Testing for HIV, hepatitis, syphilis, blood group and type, hemoglobin and blood sugars. Rubella and chicken pox susceptibility may also be tested
  • 1. Detailed family history of diabetes, twins, hypertension, thyroid, autoimmune and other disorders.
  • 2. Personal history of any pre-existing medical or surgical conditions, or allergies along with the treatment details
  • 3. General and Internal examination
  • 4. Blood and urine tests
  • 5. Medication: Folic acid supplementation.
8-14 weeks Screening for abnormalities like Down Syndrome and others. This is optional. Your doctor will discuss your age related risk for Down syndrome and will offer the screening test.
  • 1. Trans-vaginal scan for Nuchal translucency (NT) and other subtle markers for Down Syndrome.
  • 2. Blood tests (free beta hCG and PAPP-A hormones)
Second trimester (13 to 28 weeks)
  • Period when the formed organs begin to function.
  • During clinical examination, you are serially assessed for blood pressure, anemia, feet/facial swelling, and weight gain. Baby is assessed for growth, position, movement and heartbeats.
  • Frequency of examination: once in 4 weeks.
  • Medications- Iron and Calcium supplements. Tetanus toxoid injection (TT)-Two shots at an interval of at least 4 weeks in-between.
18-22 weeks
  • 1. Detailed look at the growing baby to see if all organs appear normal
  • 2. Screening for high risk cases
  • 1. As all the major organs are formed now, it is possible to pick up most anomalies.
  • 2. Termination of pregnancy may be offered for potentially uncorrectable/ lethal deformities.
  • 3. In high-risk cases (hypertension in pregnancy, previous bad outcomes etc.) the blood flow pattern to the uterus and from placenta to the baby is assessed. It is of predictive value.
  • 1. Detailed anomaly scan.
  • 2. Uterine and umbilical artery Doppler studies. May be done at the same sitting as an anomaly scan.
26-30 weeks To look for diabetes in pregnancy Some women may manifest diabetes in pregnancy for the first time now Oral glucose challenge test-Blood sugar estimation on empty stomach and 2 hours after drinking 75 gms of glucose mixed in water.
Third trimester (29 to 40 weeks)
  • Period when the functioning organs continue to mature
  • During clinical examination, you are serially assessed for blood pressure, anemia, feet/facial swelling, and weight gain. Baby is assessed for growth, position, movement, descent into the pelvis (at advanced stages), heartbeats and also the amount of fluid around it.
  • Frequency of examination: once in 2-3 weeks, or as per your doctor’s advice.
36 weeks Relook at the well-being of the baby.
Monitoring the baby’s environment in high-risk cases.
Gastro intestinal anomalies may manifest for the first time. Some high risk babies need supervision frequently
  • 1. Abdominal Obstetric scan
  • 2. Bio-physical scoring-same sitting as the scan
  • 3. Non-stress test(NST)
38 weeks Assessment of the birth passage, especially for the first time mothers. To evaluate if the descent of head has begun (By 36 weeks in first pregnancies) and if labor is likely to start earlier Internal examination.
Term (40 weeks) Reassess for delay Is there any harm waiting for another week?
What tests must be done to ensure that the baby is safe inside?
  • 1. Clinical examination
  • 2. Ultrasound and biophysical score
  • 3. NST

*At times, it happens that there is only a pregnancy sac growing inside the uterus, without any evidence of a baby within or even if there is one, there may be no heartbeat. This is called missed miscarriage.

Remember that pregnancy is not a pathology or a disease. It is a natural phenomenon and most women sail through it with a little help. Modern day obstetrics is far more advanced than what it was decades ago. So bearing and delivering a baby must be an enjoyable and not a fearful or complaining affair!

“Life is a flame that is always burning itself out, but it catches fire again every time a child is born.” - George Bernard Shaw

For more info, Follow :

Previous Post Next Post