Pregnancy Healthcare for Expat Women

Regardless of cultural background, there is one given in healthcare: pregnant women want to know what they can do to improve the likelihood of a trouble-free pregnancy and a healthy baby. For ex-pat women in Shanghai, the challenge is compounded by the fact that their extended family is overseas, meaning their support network is far away. The following general advice should ensure that a woman should deliver a healthy child, however.

Pregnancy health maintenance starts way before conception, and pre-conception counseling is part of standard healthcare services provided by hospitals.

A general physical examination of woman is recommended, and any chronic health conditions such as diabetes, thyroid or hypertension should be well controlled prior to conception. More importantly, pre-conception counseling starts with women taking Folic acid 0.4 mg (a higher dose may be necessary for high risk patient) daily for at least one month prior to conception.

During the pregnancy, smoking (including passive smoking) should cease, as this can lead to low birth-weight babies. Similarly the pregnant mother should stop drinking, to avoid Fetal Alcohol Syndrome that results in low birth-weight and mental retardation in babies.

Caffeine consumption should be limited to no more than two cups per day to avoid nervous and jittery baby at birth who may experience caffeine withdrawal.

A car seatbelt can prevent the baby from hitting the steering wheel or dashboard during a car accident. Seatbelts should be worn with the lap belt below the uterus on the pelvic bone and the shoulder belt across the top of the uterus.

Pregnant women should make sure to eat healthy nutritional meals that will allow mom to gain between 27 – 30 lbs (13-15 kg) for the whole pregnancy. Regular exercise is also important, and in general, a pregnant woman can carry on her normal activity and exercise that she is accustomed to prior to her pregnancy. Common sense would, however, suggest that a pregnant woman should avoid high impact activity or exercise that can place undue stress on the developing fetus.

Based on what we now know about prenatal learning-formative experiences that occur in the womb, pregnant women should consider the following.

– Strive for tranquility; establish the security and support one will need to cultivate peace of mind

– Listen to beautiful music (Mozart is especially good for the fetus’s early brain development)

– Avoid stress

– Lay a hand on the stomach – and encourage the father to do the same – and have a loving conversation with the baby, welcoming it and telling it how happy and proud you are to be bringing it into the world

Last but not least, early and regular prenatal care with the doctors is also vitally important.

Prenatal Testing

Expectant mothers feel excitement, anxiety, fear and wonder all at once.  One question they may be asking is, “What tests should I be receiving during my prenatal visits?”

Some medical offices may ask you to make your first prenatal appointment, six weeks after the first day of your last month’s period. The reason is that your period may simply be late. And secondly, doctors prefer to confirm a pregnancy by an internal exam and/ or an ultrasound scan. These may not be accurate until at least six weeks following your last menstrual.

The doctor may ask you to have an ultrasound exam during your regular visits to assist in ruling out some fetal malformations. Around 12-14 weeks, measuring the skin of the fetus neck (Nuchal Translucency) can screen for Downs Syndrome. Around 16-18 weeks, the doctor may ask you to have a primary ultrasound screen.  Around 24 weeks, they may ask you to do it again. During the last month, the amniotic fluid and placenta, as well as other parameters, will be monitored by the ultrasound. 

During your first physical examination, a cervical, or Pap smear will be obtained to check for gonorrhea, chlamydia, and bacterial vaginosis. This is standard for all pregnant woman. Treatment of these conditions, if present, will prevent complications for your newborn.

You may be asked to have some blood tests during your regular visits to your doctor. Initial tests will assess hemoglobin, blood-cell concentrations and, rule out sexually transmitted diseases such as syphilis, hepatitis, and HIV. Your blood will also be examined for anemia and to determine your blood type and Rh factor.

Other possible initial blood screening includes testing for immunity to varicella (the chicken pox virus) and to rubella (German measles). Exposure and infection or either of these illnesses during pregnancy can have profound effects on the developing fetus.

 Usually the doctors may ask you to have a prenatal visit once per month before 28 weeks pregnancy and twice per month between 28 to 36 weeks pregnancy. After 36 weeks, the doctor may ask you to have weekly prenatal tests. The doctors will monitor your blood pressure, weight gain, check uterine size and the baby’s heart, among other things.

Chromosomal disorders are probably the most common issue in pregnancies for women over the age of 35. Some chromosomal problems are inherited, but most are caused by an error that occurs at the union of sperm and egg. The risk of having a child with a chromosomal disorder is always present and it rises with the age of the mother.

To put it simply, no test is guaranteed 100 percent accurate. You should know that some birth defects can go undetected. Which tests are right for you should be discussed with you, your partner, and doctor while taking into consideration your individual family histories, risks, and desires.




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