Do You Need Prenatal Care?

1. Does Prenatal Care Contribute to Safe Pregnancies?

Prenatal care is one of the most effective and financially efficient public health interventions ever developed. A widely cited report from the Institute of Medicine (1988) found that for every dollar invested in prenatal care, approximately $3.38 is saved in future healthcare costs.

2. Is prenatal care preventive medicine?

Prenatal care is the foundational of preventive health. It safeguards mothers and infants by identifying and mitigating complications before they become emergencies. Among the most critical of these is preeclampsia, a hypertensive disorder that can endanger the lives of both the mother and baby.

3. In pregnancy, what is the importance of that first elevated blood pressure?

In more than forty years of clinical experience, I have found that the first elevated blood pressure reading is often the “canary in the coal mine” for preeclampsia. However, healthcare providers are sometimes taught to disregard an initial high reading if subsequent measurements are lower. In practice, these patients frequently return a week later with higher pressures that are more resistant to control. For this reason, I take the first elevated pressure seriously and adopt early management strategies. I recommend modified activity-such as reducing a 12-hour workday to six or eight hours-rather than strict bed rest, alongside twice-daily home blood pressure checks. Each patient is counseled about her individual target pressures, since “normal” values differ among individuals.

4. What women are at high risk for developing pre-eclampsia?

If a woman in your family such as your mother had preeclampsia, you are at risk for developing it as well. If you developed preeclampsia in a previous pregnancy, you are at risk for developing preeclampsia in your current pregnancy.

5. If I am at risk for developing preeclampsia in my pregnancy, what precautions can I take?

Maintaining a healthy diet, staying active, and managing weight prior to and during pregnancy is important during pregnancy, but especially so with the risk of preeclampsia.

Low-dose aspirin (81 mg), started between the 12th and 15th week of pregnancy, can reduce the risk of developing preeclampsia. Calcium supplementation (1.5 to 2.0 g) by mouth per day is also recommended, especially in populations where the dietary intake of calcium for women is low.

6. How is preeclampsia managed once it is diagnosed?

Women should be taught how to monitor their blood pressure at home. Frquent prenatal visits with tests for protein in the urine and fetal monitoring with ultrasounds and non-stress tests. If these efforts to keep blood pressure low fail, medication for hypertension such as labetalol, nifedipine, or methyldopa may be used to keep blood pressure in a safe range.

In severe cases of preeclampsia, at the time of delivery, magnesium sulfate may be given to prevent seizures.

7. What is the cure for preeclampsia?

The primary cure for preeclampsia is delivery. If the preeclampsia is severe, early delivery of the baby (preterm) may be necessary.

8. Is prenatal care preventive care?

There is much talk today of providing preventive care to patients. Ultimately, prenatal care and in particular blood pressure monitoring, demonstrates the power of prevention in public health. By investing early in maternal health—through monitoring, education, and early treatment—we can prevent complications, reduce healthcare spending, and improve the wellbeing of families and communities. The benefits of prenatal care extend beyond pregnancy, forming the foundation of healthier generations.