Why Prenatal Care?

Years ago before I went to medical school I had a close friend who became pregnant.  She was young and healthy.  She was also unemployed and did not have any health insurance.  She did not think to apply for medicaid because she had just graduated from law school and hoped that she would be able to find a job with benefits.  She decided not to seek consistent prenatal care because she reasoned that having a baby was the most natural thing in the world.  What would an obstetrician tell her to do except take prenatal vitamins?  She could get that kind of advice from a book.

 

She went for only one prenatal visit and was told that she was having twins.  She never returned.  At about 22 weeks (5 months) gestation she felt she was leaking fluid and went to the ER.  She was admitted to the hospital and lost the twins shortly thereafter.  It turned out that my friend had cervical insufficiency, a condition where the cervix is not strong enough to hold in a pregnancy. 

 

Could my friend’s pregnancy have been saved if she had gotten consistent prenatal care?  Only God knows.  But I do know that obstetricians are trained to intervene for patients like my friend.  With prenatal care, the twins may have at least had a chance.  Without it, they had none.

 

I agree that pregnancy and childbirth are natural processes.  But so are cervical insufficiency, gestational diabetes, preeclampsia and death.  Once upon a time, before the advent of modern medicine, having a baby was dangerous business.  Pregnancy and childbirth were once leading causes of death for women.  But today we have the tools to avert many disastrous outcomes.  Plus with advances in neonatology, we are keeping premature infants alive and healthier.  Fifty years ago some of those babies would not have survived.

 

It is also worth mentioning that even today, infant mortality rates in the African American community rival those in some developing countries.  If you are pregnant, don’t be a statistic.  Seek out prenatal care.  While nothing can guarantee a perfect baby, prenatal care puts you in touch with a provider who is trained to identify certain problems should they arise.  You and your baby deserve nothing less.