Prenatal Care

Prenatal (antenatal) care is the medical care a woman gets during pregnancy. Good antenatal care prevents many complications and catches others early. Every woman in India is entitled to free antenatal care at government hospitals, PHCs, sub-centres and Anganwadi centres, through ASHAs and ANMs.

How many visits, and what happens

• At least 4-8 antenatal visits — more if any complications.
• Every visit: blood pressure, weight, urine check, abdominal exam, baby's heartbeat (later), specific questions about symptoms.
• Blood tests: haemoglobin, blood group, HIV, syphilis, Hepatitis B, thyroid, blood sugar; glucose tolerance test between 24-28 weeks.
• Ultrasounds — typically first trimester, 18-22 weeks, and sometimes third trimester.
• Two doses of tetanus toxoid (Td) vaccine during pregnancy as per schedule.
• Iron-folic acid from second month, calcium from second trimester — daily.

What to discuss with the Health Expert

• Existing illnesses — diabetes, thyroid, BP, epilepsy, heart/kidney/liver disease.
• All medicines, including ayurvedic and herbal products — some can harm the baby.
• Family history of inherited conditions.
• Previous pregnancy problems.
• Mental health.
• Work, travel, exercise plans.
• Vaccines: flu vaccine in pregnancy, Tdap in some situations, COVID vaccine as advised.
• Birth preparedness — where you will deliver, transport, finances, support at home.
• Breastfeeding and contraception plans.

Nutrition and lifestyle

• Balanced diet; an extra 300-450 kcal/day in second and third trimesters.
• Adequate protein — dal, eggs, milk, curd, paneer, nuts, chicken/fish (well-cooked).
• Plenty of iron-rich foods and vitamin C to help absorption.
• Calcium — dairy, ragi, green leaves, small fish with bones.
• No alcohol, no tobacco (any form), no recreational drugs.
• Stay active — walking, swimming, prenatal yoga, unless advised otherwise.
• Sleep 7-9 hours; left-side sleeping in later pregnancy.

Warning signs — dial 112 or go to hospital

• Severe headache, blurred vision, swelling, sudden weight gain.
• Convulsions.
• Vaginal bleeding.
• Severe abdominal pain.
• Reduced baby movements after 24 weeks.
• Water breaking.
• High fever.
• Severe vomiting preventing eating/drinking.
• Breathlessness, chest pain, fainting.

Navigating the public system

ASHA workers are a valuable first contact — they link you to the nearest ANM/PHC, make sure entitlements (free antenatal care, transport, conditional cash transfers, free delivery) reach you. Use them.