Monday, March 16, 2009

How To: Performing Your Own Prenatal Checkups


I have been researching on the methods of prenatal care that are performed in both the hospital/clinic setting and by experienced midwives. I recently checked out the book Heart and Hands: A midwife's guide to pregnancy and childbirth by Elizabeth Davis from our local library. The book contains very accurate information that is medically reliable when learning about the process of pregnancy and childbirth. I have also read some of my husband's nursing books and study guides about maternity and childbirth. I do find that a lot of information is left out of the books....for the practical reason that nurses generally are not involved and responsible for checking the actual condition in certain circumstances regarding prenatal, labor and postpartum care. Heart and Hands book really informs a person when actual emergency situations arise in pregnancy, labor and child well being where an actual doctor will be needed. Rather than implicitly implying that the doctor will know all and we cannot make judgments regarding health and circumstances.

Honestly, whether a women chooses to give birth in a hospital, birth center or at home, reading Heart and Hands will give the women more knowledge about the process of labor. I have found that many of the mainstream pregnancy books are written in format's for 8th graders and really leave out a lot of important information that a women in the labor room needs to know in order to protect her self and her child from mistreatment and harm.


When you are doing your own pregnancy cares, it is an excellent idea to pick up some basic medical sheets to help you know that you are checking all the necessary components in a healthy pregnancy and labor. This is good in case reference and contact with medical personel is neccesary. If there are terms in the charts you don't understand...pick up a simple midwife book and learn some good things ;)

Also Cascase is an excellent site that offers excellent supplies for all the prenatal and birthing needs.

Any way.....thus far I have outlined basic techniques in prenatal care and they are as follows:

Physical Examination

LMP

EDD

Weight

Protein/Glucose in urine

Blood Pressure (130/80) and above is a concern

Pulse and Temp

Breast Exam

Cervical condition

At 16 weeks do bimanual exam (size of uterus with measurement in cm)

10 weeks fundus barely above pubic bone

12 weeks a few centimeter above pubic bone

16 weeks midway between pubic bone and umbilical

Pelvimietry (this is not practiced as redily because it has been replaced by ultrasound.....less acurate and more hospital control)

Size of pelvic inlet

Diagonal conjugate

Obstetrical conjugate

Ischial spines

Interspinous diameter

Pubic arch

Intertuberous diameter

True pelvis

False pelvis

Gynecoid

Anthropoid

Platypelloid

Android

Symphysis pubis joint

Sacrococcygeal joint

Sacroiliac joints

Leopold’s maneuvers

Presentation

Breech

ROP

LOP

ROA

LOA

Fetal Heart Tones

Audible with fetoscope at 20 weeks

Replaced by utrasounds (palpation, fundal height assessment, fetal heart auscultation)

Lab work (may be done at a selfcare-selftesting center or supplies may be purchased online)

*CBC – Determines whether anemic (HGB and HCT are indicators)

Syphilis, Hep B (HBV), Hep C (HCV), HIV

Pap (recommended) (STD’s and abnormal cells)

Rubella anibody titre

Blood Type

UTI

Kidney infection

TB

Genetic screening

Alpha-fetoprotein screening and Triple screen

Amniocentesis

Chronic villus sampling

*Glucose Testing

*Group B Strep

Way to reduce chances of newborn infection

Take twice a day with breakfast and dinner

2 capsules lactobacillus acidophilus (2 billion per capsule – try Nature’s Plus)

1 capsule Echinacea – 350 mg

1 capsule garlic – 580 mg

1 gel or capsule vitamin E – 500 mg

10 day regimen

6 capsules EHB by NF Formulas (an antibacterial supplement)

Tea trea oil suppositories (soak a cotton ball or small tampon with 50/50 blend of tea tree and olive oil every 4 to 6 waking hours

400 mg vitamin C every four waking hours

Herbs

Nausea – Ginger, Pulsitilla, Sepia, Nux Vomica, Ipecacuanha, Antimonium Tartrate, Argentum Nitricum, Petroleum, Sulfur, Tabacum

Anemia – Dandelion, Nettles, Kelp, Parslet, Yellow Dock Root, Floradix Herbs plus Iron

Heartburn –Slippery Elm

Sleep Difficulties – eye cover with flaxseed and lavender, Skullcap tincture, Valerian tincture, Hops tincture, Aconite

.....

The Last Six Weeks

Lack of flexion – press the occiput (back of baby’s head) down into pelvis while pulling the sinciput (forehead) toward you

Dilation – opening diameter

Effacement – softening or shortening of the cervix depends on how far the baby has descended and how much pressure is exerting on uterine tissues

Uterus Layers – external – longitudinal layer, internal – circular layer, middle – connective layer

Descent – measured according to relationship between level of presenting part and the ischial spines

Vaginal Muscle Awareness and control -try the elevator exercise


PROBLEMS IN PREGNANCY

Anemia

Take pill with vitamin C and vitamin B-complex plus more fruits veg. and whole grains. No more than 100 mg total in one day

Strive to maintain HCT of 34 or HGB of 11.5 throughout most of pregnancy

Mean corpuscular volume and mean corpuscular hemoglobin microcytotic, macrocytic megaloblastic. Highly recomended to resolve this as hemmorage and problems in birth occur with low oxygen blood levels.

Problems with weight gain

Miscarriage

Threatened – whenever the mother has vaginal bleeding with cramping and backache. Usually bright red blood loss

Two cups blood is the maximum safe blood loss. If the miscarriage lasts for more than a day she is at risk for infection

Brownish bleeding for many weeks may indicate missed miscarriage

Disseminate intravascular coagulation ---leftovers after miscarriage occurred

Ectopic Pregnancy – Dangerous – Caused by BCP!! Contact Doctor immediately if this occurs as it can be life threatening!

Hydatidiform Mole – more common in pregnancies over 40 – can lead in invasive cancer Contact Doctor immediately if this occurs as it can be life threatening!

Bleeding late in pregnancy – ruptured cervical polyp,

Placental abruption- Marginal, concealed, complete

Placenta previa – placenta implanted low in uterus

Never do a vag exam if there is bleeding late in pregnancy. Care should be done in hospital as can be lifethreatening.

Gestational Diabetes.

Hypertension

Readings of 160/100 may require medical intervention

Preclampsia – swelling, hypertension, swelling and excessive weight gain

Polyhyramnios/Hydramnios – excessive fluid in uterus. Shows high fundal height for gestational age. Can be found in multiples.

Oligohydramnios - little fluid in uterus. Results when fundal hight is low and fetus is cramped. Can be resolved with drinking more fluid.

Multiple Pregnancy – Fundal height greater than gestational age is typical with twins. Homebirth is still posspible.

Breech Presentation/Transverse-May be massaged to be rotated. Transverse presentation need to be in hospital care as can be lifethreatening

Small for gestational Age-

Large for gestational Age-

Postdatism- Pregnancy past 42 weeks. Up to 19 percent reach this point. Problem when amniotic fluid is low.

That is about what I have for now. I will add more later as needed. I hope to develop a basic chart that shows when an emergency arises that alternative health professional care is absolutely needed.


Remember, just as all elderly people do not choose nursing home care, home health care is always an option and studies show that home health patients live healthier and longer lives as they continue to maintain control of their own circumstances rather than giving their health-need circumstance over to others. The same can be said of home birth care..... In both cases.....education is the key to success ;)


Sorry about the formating.....there was an error in the HTML on this post. I may edit and place the outline in a different format to give the HTML a break.
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