The importance of Early Booking in pregnancy
By Dr. Marion Ntsako Nkanyane
Obstetrician/Gynaecologist and currently practices at Melomed Richards Bay
To have a positive pregnancy experience with less complications for you and your baby it is important to see your health care provider as soon as you find out that you are pregnant or as early as the first missed menstrual period. Your health care provider can be the local clinic or hospital where you stay, the general practitioner with experience in ante-natal care or your obstetrician. This first visit is called the “booking visit” and the benefits of this early first visit will be discussed below. Ideally it is important to consult your health care provider even before you fall pregnant so that you become physically and emotionally prepared for the pregnancy journey.
According To the Guidelines For Maternity Care In South Africa, The Booking Visit Comprises Mainly Of The Following:
- Screening of pregnancy problems.
- Assessment of pregnancy risk, whether it is a high-risk or a low-risk pregnancy.
- Treatment of problems that may arise during the ante-natal period, such as optimizing the blood level (haemoglobin) to prevent anaemia from developing.
- Giving medications that may improve pregnancy outcome, such as Folic acid and Calcium.
- Provision of information to the pregnant woman, as they say that “knowledge is power”.
- Physical and psychological preparation for childbirth and parenthood, which can ease most anxieties associated with the transition to motherhood.
Screening of pregnancy problems such as developing high blood pressure during pregnancy, gestational diabetes, recurrent miscarriages, pre-term delivery, having a baby with genetic conditions such as Downs syndrome can be done from the first visit. Based on the presence of certain risk factors women can then receive the appropriate interventions early in the pregnancy to prevent adverse outcomes. For example, high blood pressure in pregnancy and its complications is one of the leading causes of maternal deaths and poor outcomes for the baby. Early delivery is often warranted either to improve the mother’s condition or because the baby is not growing well. Women at high risk for this condition who are identified earlier in the pregnancy can be offered medication that can help to reduce the complications of this disease. A second example is of women at high risk of having a baby with a genetic condition such as Down’s syndrome. These women can be offered screening tests todetect their level of risk and subsequently further tests to diagnose if their baby is affected or not; this will enable the couple to make informed decisions about further management of the pregnancy.
After this first visit a provisional ante-natal care and a delivery plan can bediscussed with the patient bearing in mind that the course of the pregnancy can change with the possible emergence of other health challenges. Earlier referral to a higher level of care or another specialized health care provider can also be done, depending on the patient’s condition and level of risk, which contributes to better management of the pregnancy and better outcomes for both mother and baby.
Some of the barriers to booking early are traditional beliefs of keeping the pregnancy a secret for about five months, women relying on their previous pregnancy experiences and neglecting early booking, the cost of these visits(financial or time-taken off work) and accessibility.
Women with such barriers are encouraged to seek the opinion of their healthcare providers on how to overcome some of these factors as the benefits of early booking are far more important.
CHECK-UPS, SCANS AND TESTS DURING PREGNANCY.
Your first visit may be one of the longest you’ll have during your pregnancy – and the most comprehensive.
- Confirming pregnancy and your due date
- Medical and family history
- Blood pressure, height and weight
- Full blood test
- Urine test
- Generic screening tests
- Cervical screening
- Vitamin D deficiency