2011-03-07 Last revised in March 2011 Back to top Antenatal care - uncomplicated pregnancy - Summary. A woman with an uncomplicated pregnancy is usually managed in the community by a midwife, with or without a GP. The mission of the WHO Department of Reproductive Health and Research (RHR) is to help people to lead healthy sexual and reproductive lives.
Early and frequent antenatal care attendance during pregnancy is important to identify and mitigate risk factors in pregnancy and to encourage women to have a skilled attendant at childbirth. However, many pregnant women in. Guidance, advice and information services for health, public health and social care professionals. Obstetrics is the field of study concentrated on pregnancy, childbirth, and the postpartum period. As a medical specialty, obstetrics is combined with gynaecology under the discipline known as obstetrics and gynaecology (OB/GYN). International Confederation of Midwives La Confédération internationale des sages-femmes Confederación Internacional de Matronas Laan van Meerdervoort 70 2517 AN The Hague – The Netherlands Tel: + 31 70 3060520 Fax. Www.health.gov.au All information in this publication is correct as at October 2014 10848 October 2014 CliniCAl PrACtiCe Guidelines Antenatal Care — Module ii Clini C al Pra C ti C e Guidelines a ntenatal care — Module ii.
National Guideline Clearinghouse | Antenatal care. Routine care for the healthy pregnant woman. Note from the National Guideline Clearinghouse (NGC): This guideline was developed by the National Collaborating Centre for Women's and Children's Health (NCC- WCH) on behalf of the National Institute for Health and Clinical Excellence (NICE). See the "Availability of Companion Documents" field for the full version of this guidance. In this update, the recommendations on antenatal information, gestational age assessment, vitamin D supplementation, alcohol consumption, screening for haemoglobinopathies, screening for structural anomalies, screening for Down's syndrome, screening for chlamydia, gestational diabetes, preeclampsia, asymptomatic bacteriuria, placenta praevia, preterm birth, and fetal growth and well- being, as well as the schedule of antenatal appointments, have changed.
Definition of primary health care nursing APNA’s definition of primary health care nursing has a number of components, outlined below. What is ‘health’? Primary health care nurses adopt the definition of health in the. Prenatal care, also known as antenatal care is a type of preventive healthcare with the goal of providing regular check-ups that allow doctors or midwives to treat and prevent potential health problems throughout the course of.
In addition, some recommendations on smoking cessation and mental health have changed because NICE has produced public health guidance on smoking cessation (see the NICE public health guidance, 'Smoking cessation services in primary care, pharmacies, local authorities and workplaces, particularly for manual working groups, pregnant women and hard to reach communities') and a clinical guideline on antenatal and postnatal mental health (NICE clinical guideline 4. Following NICE protocol, the developers have incorporated the relevant recommendations verbatim into this guideline and have marked them clearly. No other recommendations are affected. New and updated recommendations are marked "New."Woman- Centred Care and Informed Decision Making.
The principles outlined in this section apply to all aspects of the Antenatal Care guideline. Antenatal Information. New. Antenatal information should be given to pregnant women according to the following schedule.
At the first contact with a healthcare professional: Folic acid supplementation Food hygiene, including how to reduce the risk of a food- acquired infection Lifestyle advice, including smoking cessation, and the implications of recreational drug use and alcohol consumption in pregnancy All antenatal screening, including screening for haemoglobinopathies, the anomaly scan and screening for Down's syndrome, as well as risks and benefits of the screening tests. At booking (ideally by 1. Before or at 3. 6 weeks: At 3. This can be supported by information such as 'The pregnancy book' (Department of Health 2.
United Kingdom (UK) National Screening Committee publications and the Midwives Information and Resource Service (MIDIRS) information leaflets (www. New. Information should be given in a form that is easy to understand and accessible to pregnant women with additional needs, such as physical, sensory or learning disabilities, and to pregnant women who do not speak or read English. New. Information can also be given in other forms such as audiovisual or touch- screen technology; this should be supported by written information. New. Pregnant women should be offered information based on the current available evidence together with support to enable them to make informed decisions about their care. This information should include where they will be seen and who will undertake their care. New. At each antenatal appointment, healthcare professionals should offer consistent information and clear explanations, and should provide pregnant women with an opportunity to discuss issues and ask questions.
New. Pregnant women should be offered opportunities to attend participant- led antenatal classes, including breastfeeding workshops. New. Women's decisions should be respected, even when this is contrary to the views of the healthcare professional. New. Pregnant women should be informed about the purpose of any test before it is performed. The healthcare professional should ensure the woman has understood this information and has sufficient time to make an informed decision. The right of a woman to accept or decline a test should be made clear.
New. Information about antenatal screening should be provided in a setting where discussion can take place; this may be in a group setting or on a one- to- one basis. This should be done before the booking appointment. New. Information about antenatal screening should include balanced and accurate information about the condition being screened for. Provision and Organisation of Care.
Who Provides Care? Midwife- and general practitioner (GP)- led models of care should be offered for women with an uncomplicated pregnancy. Routine involvement of obstetricians in the care of women with an uncomplicated pregnancy at scheduled times does not appear to improve perinatal outcomes compared with involving obstetricians when complications arise. Continuity of Care. Antenatal care should be provided by a small group of healthcare professionals with whom the woman feels comfortable.
There should be continuity of care throughout the antenatal period. A system of clear referral paths should be established so that pregnant women who require additional care are managed and treated by the appropriate specialist teams when problems are identified. Where Should Antenatal Appointments Take Place? Antenatal care should be readily and easily accessible to all women and should be sensitive to the needs of individual women and the local community. The environment in which antenatal appointments take place should enable women to discuss sensitive issues such as domestic violence, sexual abuse, psychiatric illness, and recreational drug use. Documentation of Care.
Structured maternity records should be used for antenatal care. Maternity services should have a system in place whereby women carry their own case notes. A standardised, national maternity record with an agreed minimum data set should be developed and used. This will help healthcare professionals to provide the recommended evidence- based care to pregnant women.
Frequency of Antenatal Appointments. A schedule of antenatal appointments should be determined by the function of the appointments.
For a woman who is nulliparous with an uncomplicated pregnancy, a schedule of 1. For a woman who is parous with an uncomplicated pregnancy, a schedule of 7 appointments should be adequate.
Early in pregnancy all women should receive appropriate written information about the likely number, timing and content of antenatal appointments associated with different options of care and be given an opportunity to discuss this schedule with their midwife or doctor. Each antenatal appointment should be structured and have focused content. Longer appointments are needed early in pregnancy to allow comprehensive assessment and discussion.
Wherever possible, appointments should incorporate routine tests and investigations to minimize inconvenience to women. Gestational Age Assessment. New. Pregnant women should be offered an early ultrasound scan between 1.
This will ensure consistency of gestational age assessment and reduce the incidence of induction of labour for prolonged pregnancy. New. Crown–rump length measurement should be used to determine gestational age. If the crown–rump length is above 8. Lifestyle Considerations. Working During Pregnancy. Pregnant women should be informed of their maternity rights and benefits. The majority of women can be reassured that it is safe to continue working during pregnancy.
Further information about possible occupational hazards during pregnancy is available from the Health and Safety Executive (www. A woman's occupation during pregnancy should be ascertained to identify those at increased risk through occupational exposure. Nutritional Supplements. Pregnant women (and those intending to become pregnant) should be informed that dietary supplementation with folic acid, before conception and up to 1. The recommended dose is 4. Iron supplementation should not be offered routinely to all pregnant women.
It does not benefit the mother's or the baby's health and may have unpleasant maternal side effects. Pregnant women should be informed that vitamin A supplementation (intake above 7. Pregnant women should be informed that liver and liver products may also contain high levels of vitamin A, and therefore consumption of these products should also be avoided. New. All women should be informed at the booking appointment about the importance for their own and their baby's health of maintaining adequate vitamin D stores during pregnancy and whilst breastfeeding. In order to achieve this, women may choose to take 1. D per day, as found in the Healthy Start multivitamin supplement. Particular care should be taken to enquire as to whether women at greatest risk are following advice to take this daily supplement.
These include: Women of South Asian, African, Caribbean or Middle Eastern family origin Women who have limited exposure to sunlight, such as women who are predominantly housebound, or usually remain covered when outdoors Women who eat a diet particularly low in vitamin D, such as women who consume no oily fish, eggs, meat, vitamin D- fortified margarine or breakfast cereal Women with a pre- pregnancy body mass index above 3. Food- Acquired Infections. Pregnant women should be offered information on how to reduce the risk of listeriosis by: Drinking only pasteurised or ultra- high- temperature processed (UHT) milk Not eating ripened soft cheese such as Camembert, Brie and blue- veined cheese (there is no risk with hard cheeses such as Cheddar, or cottage cheese and processed cheese) Not eating pâté (of any sort, including vegetable) Not eating uncooked or undercooked ready- prepared meals Pregnant women should be offered information on how to reduce the risk of salmonella infection by: Avoiding raw or partially cooked eggs or food that may contain them (such as mayonnaise) Avoiding raw or partially cooked meat, especially poultry Prescribed Medicines.
Few medicines have been established as safe to use in pregnancy.