e. Early Care. Early, competent care is essential for the patient to avoid
unnecessary risks to herself and her fetus.
INITIAL PRENATAL VISIT
a. The initial prenatal visit should be scheduled at the first signs of pregnancy.
This is usually shortly after the second menstrual cycle is missed. Depending on where
the care is to be given, the first prenatal visit may not be scheduled until after a positive
urine pregnancy test is documented.
b. The initial prenatal visit may be particularly stressful to the patient. Some
patients may be anxious about the nature of exams and tests to be done during the
visit. The pregnancy may have been unplanned, there may be already existing financial
or family problems, or some patients may have had unpleasant experiences with
previous pregnancies. The presence of one or more of these problems may serve to
heighten the emotional content of the visit.
c. Setting a comfortable climate is very important to the patient. The patient's
first impression and initial reception will influence how she may comply with the
instructions given during pregnancy. If treated with a true concern as an individual, she
will be more inclined to follow instructions. If the patient is rushed with little concern for
her as an individual, she may decide not to return. A cordial, respectful environment in
which the patient feels like a person is a necessity for every visit.
d. A thorough medical/obstetrical history is obtained. The history is essentially a
screening tool that identifies the factors that may detrimentally affect the course of
pregnancy. This process involves interviewing the patient and possibly having the
patient to complete a questionnaire to obtain the following information:
NOTE: See figures 6-1 and 6-2 for a typical prenatal questionnaire and a prenatal and
pregnancy medical record.
(1) Past medical history of the patient's mother and father (for example,
hypertension, diabetes, and tuberculosis).
Family illnesses (that is, diabetes, mental illness, and bleeding