The Importance of Prenatal Care
Preventing Low Birth Weight
Prenatal care is a way to identify mothers who are at high risk of giving birth to low birth weight infants by providing services such as medical, nutritional, and educational interventions in an effort to reduce the risk of low birth weight and other adverse pregnancy outcomes. Both the United States and Europe have realized the benefits of prenatal care from its conception until now. Trying to find ways to measure the adequacy of prenatal care accurately has been difficult. For years, it has been based on the number of prenatal visits, the stage of pregnancy when care was provided, and the type of services that was provided, as well as blood and urine analysis screening and health education.
When to Start Prenatal Care
Studies suggested that the relationship between low birth weight and the trimester in which prenatal care is initiated, or the number of prenatal visits, could very well be confounded by gestational age. Mothers who wait to receive prenatal care until their third trimester are more likely to be at a lesser risk of giving birth to a low birth weight infant as she approaches full term when prenatal care is initiated. On the other hand, the more prenatal visits she makes, the greater her chances will be for increasing the infant birth weight because birth weight and the total amount of scheduled prenatal visits increase with gestational age.
Taking Responsibility
Research suggests that women who are more health conscious are more likely to initiate prenatal care early during pregnancy and make every attempt to make their scheduled prenatal care visits. These same women are more likely to demonstrate other responsible acts such as planning their pregnancies; maintaining a proper nutritional diet; and abstaining from using drugs, tobacco, or alcohol. These women also seek out information from health care providers about other positive aspects that they can implement during pregnancy. This type of behavior helps to decrease the risk of low birth weight deliveries. In addition, prenatal care can be used to improve women’s maternal attitude toward pregnancy and also serve as a way to measure the type of care they receive.
In an effort to prevent low birth weight, prenatal interventions should include programs that target smoking reduction and cessation in an effort to help women stop smoking; nutrition that target prepregnancy weight gain or sufficient weight gain during pregnancy; and medical care that target overall infant mortality. Although certain medical conditions do have an impact on birth weight, many affect only a fraction of pregnant women and consequently attribute very little to the impact on the overall birth weight rate. Illnesses such as hypertension, diabetes, infections, and transmitted diseases all increase the risk of low birth weight.
Socioeconomic Conditions
The relationship between the utilization of prenatal care and the low birth weight rates could reflect the individual’s socioeconomic conditions that determine how early and frequent prenatal care is provided. A crucial area to explore is what the maternal and social factors attribute to the use of prenatal care. If women believe in the benefits of prenatal care, they are more likely to use it in a way that will be beneficial for not only themselves but also for their children. The reasons why a number of women do not get an adequate amount of prenatal care could be due not only to the healthcare system but also to the practices of their health care providers and their own socioeconomic conditions. In a recent study, barriers that included financial; cultural; and system-related issues were identified. Low-income women who participated in a national study indicated that 71% had problems receiving prenatal care due to financial reasons; multiple reasons were given for not receiving prenatal care earlier and other reasons included transportation and not having quality child care.
Research also revealed that it is important to have a positive attitude during pregnancy. Women who have a negative attitude during pregnancy and who did not intend to get pregnant in the first place are more likely to miss prenatal care appointments. Also, women who decide not to receive prenatal care are more likely to contemplate aborting their babies. It was reported in a recent study that before abortions were approved, women who were unhappy with their marriage and whose husbands did not want the babies were two times more likely to experience fetal death because of stress.
Studies of the relationship between prenatal care and low birth weight have yielded uncertain results because there has been little done in the standard package of prenatal care to affect the rate of low birth weight. However, from an individual standpoint, three areas need to be targeted: smoking cessation; the undernourished; and medical care. These are the areas where medical care has the most impact in reducing low birth weight and small-for-gestational-age deliveries. Health promotion, social services, and case management interventions offer further benefit.
