Prenatal care

The so-called prenatal care - better antenatal care to not use contraception to be confused - including health care, counseling and testing before and during pregnancy by gynecologists or midwives . In the GDR it was called pregnancy care .

Before pregnancy

This includes the recording of medical risks in the own and family medical history of the pregnant woman, her general condition and the use of medication. Once the rubella titre has been determined, it may be possible to carry out a vaccination before pregnancy, since an infection during pregnancy ( rubella embryo fetopathy ) can lead to malformations.

During pregnancy

This article or paragraph presents the situation in Germany . Help us to describe the situation in other countries.

In Germany every mother-to-be has the right to care by a midwife or a doctor during pregnancy, at birth and a few weeks after the birth. In the case of an uncomplicated pregnancy, visits are initially recommended at an interval of four weeks after the pregnancy becomes known, from the 32nd week of pregnancy at an interval of two weeks and, if the due date is exceeded, every two days.

All findings are entered in the mother passport (or mother-child passport in Austria).

In Germany, according to Section 7 (1) of the Mutterschutzgesetz (MuSchG) , the expectant mother is entitled to paid ( Section 23 (1) MuSchG) leave from work for examinations during pregnancy and maternity.

At the beginning of pregnancy, the blood group is usually determined and serological examinations for syphilis and, in the case of unvaccinated or unknown vaccination status, a determination of the rubella titer. If there is justified suspicion, existing protection against toxoplasmosis (e.g. when dealing with cats) and an HIV test can be carried out. The examination for hepatitis B is carried out at the earliest after the 32nd week of pregnancy, as close as possible to the due date . In addition to determining the laboratory values, the child’s body weight, blood pressure and heart rate are checked at each examination. In the case of a regular pregnancy, three ultrasound examinations are recommended in Germany (in weeks 9–12, 19–22 and 29–32) and are covered by health insurance companies as a standard service. Pregnant women have to pay for additional ultrasound examinations themselves. The IGeL monitor of the MDS (Medical Service of the Central Association of Health Insurance Funds) rates supplementary ultrasound examinations during pregnancy as "unclear" after a systematic literature search. There is no evidence of a medical benefit, but also no evidence of harm. If there is cause for concern, the statutory health insurance companies will pay for additional examinations. In order to detect possible gestational diabetes at an early stage, a glucose test should be carried out towards the end of the 2nd / beginning of the 3rd trimester . As pregnancy can affect the gums, a visit to the dentist between the 17th and 20th week of pregnancy is recommended. At the end of the pregnancy, the labor activity can be followed with CTG examinations. Furthermore, the heart rate of the unborn child during pregnancy (from the 28th week of pregnancy) and during birth are monitored with the CTG. Since a CTG records the child's heartbeat precisely, an exact evaluation of the measured values ​​can then take place, which is not the case with an ultrasound. The evaluation gives the midwife or doctor an image of the condition of the fetus. B-streptococci are usually tested in the 36th week of pregnancy. It is one of numerous pathogens that can spread to the child at birth. A vaginal smear is taken for the examination; if the result is positive, an antibiotic is administered.

Further examinations are blood pressure measurements , urine and blood tests , control of the position of the uterus , position of the child, determination of the blood group and the Rhesus factor .

See also

• Maternal health
• Screening
• Early detection of diseases
• STORK

Web links

• Guidelines for the prenatal diagnosis of diseases and disease dispositions. German Medical Association
• Erich Saling : Self-provision during pregnancy. Institute for Perinatal Medicine V.
• BabyCare - the preventive care program for a healthy pregnancy with questionnaire and individual analysis

Individual evidence

1. ↑ Rubella . ( Memento of the original from September 29, 2007 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Robert Koch Institute , RKI Infectious Diseases Guide - Leaflets for Doctors . 
2. ↑ Guideline of the Federal Committee of Doctors and Health Insurance Companies on Care During Pregnancy and After Childbirth ("Maternity Guideline") full text. (PDF; 184 kB)
3. ↑ Ultrasound during pregnancy . IGeL-Monitor (supplementary investigations) accessed on November 15, 2018. More on the justification for the assessment in Evidence compact . (PDF)
4. ↑ Article by a freelance midwife on prenatal care - u. a. also CTG.
5. ↑ Visits to the doctor during pregnancy. In: papa.de. Retrieved October 19, 2016 . 

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !