The first Antenatal care clinic visit is one of the most important visits during your pregnancy. It is during the first visit that your health care provider will conduct a comprehensive health assessment to identify your individual needs. Usually, there is much to be done on this visit, therefore, I recommend that you go to the clinic early in the morning for you to have adequate time with your health care provider.
Remember to make the first visit before the 12th week of your pregnancy. In my previous article, I focused on why it is important to make the first visit as early as possible. The benefits of initiating your antenatal care clinic visits are:
- You will have adequate time to complete the four recommended visits or more if your pregnancy has any complications
- Prevention of diseases such as tetanus
- Treatment of preexisting medical conditions such as diabetes, hypertension, urinary tract infections
- Early detection and treatment of pregnancy complications
The first visit may take much time as there is so much to be done. Among the things to be done during the first visit are:
- History taking
- Health education
- Physical examination
- Laboratory investigations
- Preventive services
- Prepare a birth preparedness plan
First, your health care provider will ask you questions to obtain your background information. He/she will ask you about:
- Your personal details: Name, age, marital status, level of education, place of residence, occupation, next of kin details and contacts
- Your menstruation history: you will be asked about your Last Monthly Period date. This date will be used to calculate your Expected Date of Delivery. If you are not sure of your date, your healthcare provider might request you to take an obstetric scan to know the gestation and approximate date of delivery.
- Your birth history: your healthcare provider will seek to know whether you have been pregnant before, the year of pregnancy, place of delivery, type of delivery( vaginal delivery or caesarian section) outcome of pregnancy(whether the child is alive or not), birth weight of the baby
- Medical and surgical history: you will be asked whether you have any illness such as diabetes, hypertension and tuberculosis, history of surgical operations,blood transfusion, drug or food allergies.
- Family history, whether there are any hereditary diseases in the family or twin births.
Second, your health care provider will carefully examine you from head to toe to identify any signs of underlying conditions. Your weight and height measurements will be taken on every visit. You should gain 0.4-05kgs per week or 1.6kgs monthly. Your blood pressure will also be monitored.
Third, the following Laboratory investigations will be done:
- Blood grouping and Rhesus factor tests. In case you are rhesus negative, you will need special care.
- Hemoglobin level, if it is low, it is a sign of anemia, your health care provider will give you blood builders and will be advise you to improve your nutrition by including green vegetables, fruits, liver, eggs, beans in your diet.
- Syphilis test
- HIV counselling and testing. It is important that you go for HIV counselling and testing with your partner.
Fourth, will be educated on:
- Nutrition: eat a balanced diet, include plenty of vegetables, fruits and water in your diet. Avoid unhealthy feeding habits such as eating stones. Breastfeed your child exclusively for the first six months. Do not give anything to your baby other than breast milk, not even water.
- Danger signs in pregnancy: You will be advised on danger signs in pregnancy. In case you experience any of these signs, you should go back to your health care provider as soon as possible; vaginal bleeding, fits, reduced or no fetal movements, severe headache, severe abdominal pain, breaking of water, severe pallor.
Fifth, your health care provider will:
- Give you tetanus vaccine to prevent tetanus disease
- Give you Iron and folic acid tablets. Iron and Folic acid prevent and treat anemia. Folic acid also prevents neural tube defects.
- Give you a treated mosquito net or your healthcare provider will advise you to buy one.
Fifth, the health care provider will help you come up with a plan for delivery. Among the things to plan for are:
- The health facility that you would like to deliver in.
- The person who will accompany you on the due date of delivery to the health facility.
- Method of transport that you will use on the due date to the health care facility
- How to meet the cost of delivery if your health facility of choice is a private facility.
- Have a bag that has: gloves, string, razor blade and clothes to cover the baby. You should have this bag at all times in case your child comes earlier than expected or in an unexpected place.
In conclusion, the first visit is one of the most important and longest visits that you will make for antenatal care. During this visit, your health care provider will ask questions to obtain your background information, conduct a comprehensive head to toe examination, send you for laboratory investigations, educate you on various issues during pregnancy and birth, provide preventive services and help you have a plan for delivery. All these are vital for your health and the health of your baby.