Prenatal Care (Check‑ups during Pregnancy)

This content is from
pages 76 to 77 of Where Women Have No Doctor

Prenatal check-ups save lives by finding and taking care of problems early—before they are dangerous. Good care is not difficult to give and does not require expensive equipment. Get check-ups:

Minimum (3 check-ups)	Best (10 to 15 check-ups)
As soon as you think you are pregnant	Every month up to 6 months
Around the 6th month of pregnancy	Twice each month during months 6, 7, and 8
A month before the baby is due	Each week for the last month

Prenatal check-ups can help you decide the best place to have your baby: at home, or at a health center or hospital.

A midwife or health worker will ask about past pregnancies and births, including any problems, such as a lot of bleeding or babies that died. This information can help you both prepare for similar problems in this pregnancy. A midwife may also be able to:

make sure you are eating well enough and suggest ways for you to eat better food, if necessary.
give iron, which helps prevent anemia, and folic acid, which helps prevent disabilities in your baby.
examine you to make sure you are healthy, physically and emotionally, and that the baby is growing well.
give vaccinations to prevent tetanus.
give medicine to prevent malaria if it is common in the area.
give tests for HIV and syphilis, along with other sexually transmitted infections.
give medicines so HIV does not infect your baby.

What to expect at a prenatal check-up

A birth attendant or midwife should do these things at a prenatal check-up:

Check the eyelids and finger nails for signs of anemia.

Check the hands and face for swelling.

Check weight, urine, and blood pressure.

Check the growth of the baby. Normally the womb grows 2 finger widths each month. At 4½ months it reaches the level of the navel. If the womb seems too small or too big, it may mean there is a problem.

9 months

8 months

7 months

6 months

5 months

4 months

3 months

fetoscope

To check whether the baby is healthy, a midwife may listen for the baby’s heartbeat. It may be possible to hear it by putting one ear against the pregnant person’s abdomen, but it is often difficult to tell the baby’s heartbeat apart from the pregnant person’s. It is easier with a fetoscope. Another sign the baby is healthy is if the pregnant person feels the baby move every day during the second half of the pregnancy, including the day of the check-up.

How to check the baby's position
During pregnancy, it is common for a baby to change position several times in the womb. By the end of the pregnancy, the baby should be lying in the womb with its head down, toward the opening of the womb. This is the best position for birth. To check if the baby is head down, feel for the head like this:
1. Have the pregnant person breathe out all the way. Using both hands, feel the baby.	With the thumb and 2 fingers, push in here, just above the pubic bone. With the other hand, feel the top of the womb.
The baby’s bottom is larger and wider... ...and its head is harder and more round.	So bottom up feels larger high up...	...and bottom down feels larger low down.
2. Push gently from side to side, first with one hand, then with the other. At the same time, feel what happens to the baby's body with the other hand as you push.		3. Just before birth, a baby will move lower in the womb to get ready for birth. So, late in pregnancy, you may not be able to feel the baby's head move.
If the baby's buttocks are pushed gently sideways, the baby's whole body will also move. But if the head is pushed gently sideways, it will bend at the neck and the back will not move.		If the baby is still high in the womb, you can move the head a little. But if it has already moved lower, you cannot move it. A person’s first baby may move lower about 2 weeks before labor begins. Second or later babies often do not do this until labor starts.