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Antenal Care

What is antenatal care?

  • It is a periodic health check up once you are confirmed pregnant.
  • One of the purpose is to ensure good relationship between you and your health care providers.
  • Both your psychological and medical needs will be addressed.
  • This service is provided by trained personnel and available at all government health clinics.

What is booking visit?

Booking visit is the first visit made to a clinic for antenatal care.

  • It is the most important visit to identify and manage your medical complications (if any) and to screen for risk factors that may have a bearing on the progress of the pregnancy and its outcome.
  • It should be done as soon as you are confirmed pregnant.
  • The recommended time is when you are less than 12 weeks pregnant.
  • The first visit may be late in your pregnancy but is still regarded as the booking visit.

During the booking, the nurses will ask you several questions pertaining to :

  • Your period pattern
  • Personal history
  • Family history
  • Medical and surgical history
  • Your previous pregnancy (if any)
  • Socio-economic background

After the interview session, the nurse will carry out a physical examination. Then, the nurse will ask you to go for some tests at the laboratory. Once you have completed the process, depending on your condition and findings from the interview, examination and lab tests, appropriate treatment will be given accordingly. Before you leave, your next follow-up date will be given once you agree. Your nurse will give you a copy of your antenatal card to be kept by you and to bring along during any health visit. The whole process lasts for 1-2 hours depending on workload at the clinic during your visit.

What happens during subsequent antenatal visit

  • During the visit, your general health status and progress of your pregnancy will be assessed and monitored.
  • Your spouse or partner and family involvement are encouraged:
    • this will provide emotional support in time of need
    • help to encourage adherence to advice and programme of antenatal care.
    • help to identify the mother’s needs and wants
    • partner/spouse is encouraged to do HIV testing
    • discuss the plan for delivery.
  • The following activities are carried out during subsequent visits :
    • Short history since the last antenatal visit recorded.
    • Weight and blood pressure taken
    • Urine tests for protein and glucose
    • Fundal height – plotted on a standard chart to alert the observer for possible growth retardation
    • Position of the fetus
      • assessed after 32 weeks
      • If the fetus position is not appropriate, an ultrasound will be done to scan for placenta location.
    • Fetal heart rate recorded.
    • Immunization(when due)
    • Routine blood investigations or other investigations indicated

How frequent is the antenatal visit

Suggested antenatal visit and follow-up :

  • below 28 weeks – once a month
  • 28-35 weeks – every 2 weeks
  • 36 weeks and above – every week

Home visits at least 4 times during the pregnancy period. More visits may be necessary depending on your condition and needs.

How do I know that my baby is growing well

During antenatal visits both you and your baby are being assessed and monitored. Here are a list of activities that help your health care providers monitor your baby’s well being :

  • measuring your fundal height (size of your tummy)
  • monitoring your weight gain during each visit
  • ultrasound scanning to measure your baby’s growth and position
  • fetal movement charting – you will need to count frequency of your baby’s kicking within 12 hours.
  • Heart rate of your baby – using a machine called Doppler will enable you to hear your baby’s heart rate.
  • Cardiotocography (CTG) – a machine used to assess your baby’s condition if it is suspected that your baby is not growing well.

Where can I get help?

  • At all government health clinics (known as Poliklinik komuniti, Klinik Kesihatan, Klinik Desa)
  • Private Clinics
  • Private hospitals

FAQs

Am I pregnant ?

If you miss your period, you can do Urine Pregnancy Test (UPT) to know if you are pregnant.

  • UPT result is reliable if you miss your periods for at least 6 weeks from your first day of the last period (also known as LMP)

If you are anxious, Ultrasound scanning (through your vagina) can be done within 5th week. Presence of gestational sac confirms your pregnancy. Your body changes too can indicate that you are pregnant.

What is LMP ?

LMP or last menstrual period. It is the date of your first day of last menstrual period. Usually confusion arises when you give the last day of your period. E.g.:

  • if your period on 1 January 2005 lasts for 7 days.
  • you will tell the nurses your LMP is 1/1/2005 and NOT 7/1/2005

Why is it important to give correct date?

  • correct LMP will help the health care provider to calculate your expected date of delivery (EDD)
  • help in providing appropriate management

What are signs and symptoms of pregnancy ?

Common body changes that take place when you are pregnant :

  • No period
  • pulse / heart rate faster than usual
  • heartburn
  • nausea with or without vomiting
  • body weight increases
  • appetite increases
  • feeling thirsty
  • breasts
    • enlarge and painful
    • skin around the nipples darken
  • passing urine more frequent

skin changes – some women experience darkened skin at body fold, itchiness

  • tummy increasing in size

What is morning sickness ?

Some pregnant women experience episodes of nausea/ vomiting during early pregnancy state. However, there are cases where this condition persists through out pregnancy. Even though described as morning sickness, nausea and vomiting can occur at any time of the day. Most women cope with this readily and the problem disappears spontaneously by the end of 12 weeks. What should I do if morning sickness persist?

  • If you cannot tolerate food or fluid at all, you should seek early treatment. Delay in seeking treatment may lead to dehydration and starvation even death.
  • There are medications that can control your vomiting episodes and improve your oral intake.
  • If your condition is severe, you may need to be warded.

Reference

  1. KKM (2003). Garispanduan Senarai Semak Mengikut Sistem Kod Warna Penjagaan Kesihatan Ibu Dan Bayi Edisi 3 (Versi Semakan)
  2. KKM (2002). Perinatal Care Manual.
Last Reviewed : 26 April 2012
Writer : Dr. Nor Filzatun Borhan
Reviewer : Dr. Sri Wahyu Taher