Unassisted Pregnancy: Designing a Prenatal Self-Care Routine

There are a few things that a pregnant woman can't do for herself, but usually they aren't necessary. Most of the tests professionals perform can be done at home, affordably, and certainly women are capable of measuring their vitals. Most of a prenatal visit is spent answering and asking questions about the pregnancy, but most answers can easily be found by picking up a book or doing an internet search. More and more women are choosing not to see pregnancy as a medical condition needing treatment, and they are foregoing formal prenatal care unless high risk. Some women have none at all, and many more monitor and test themselves. It's not hard to develope a prenatal self-care routine.

In an earlier piece I discussed routine prenatal testing that may be harmful or unnecessary. First you must decide which tests, if any, you will have. STD testing includes Hepatitis B & C, Syphilis, and HIV, all blood tests. The Pap Smear checks for chlamydia, gonorrhea, and cervical cancer (which is usually caused by HPV.) It can also locate cervical abnormalities such as an incompetent cervix, as well as vaginal infections. Your blood work usually includes a blood type check, a Cystic Fibrosis and Tay-Sachs screening test, the Triple/Quad Screen, Anemia check, and a check for German measles and chickenpox. CVS and Amniocentesis may be done to check for deformities and defects. GBS tests for group B streptococcus, which can (rarely) cause infection in the newborn.

Most of these tests are unnecessary. If you may have been exposed to an STD, if you may have a child with a defect or would discontinue the pregnancy if so, if you don't know your blood type or are at risk for measles and chickenpox, you may wish to have those tests performed. I recommend testing for these conditions if you can, because the more complete your home records are, the better you'll be treated when interviewing pediatricians or if you end up in the ER. Many can be performed at home, and some must be done by a doctor. The ones only available from a doctor, such as CVS and Amniocentesis, are actually the least necessary. Many women do chose to at least go in for one ultrasound, but they do as much home self-prenatal care as possible.

Tests for vaginosis, anemia, HIV, Hepatitis C, chlamydia, GBS, and gestational diabetes can be done at home. The others must be done by a health professional, and if it's unlikely that you would have abnormal results, there is no harm in refusing them. Craigmedical.com sells a lot of home tests at very affordable prices, and froogle is another good place to search. The Gestational Diabetes test is performed around 24 weeks. Fast for 8-10 hours, drink the special beverage, and then test your blood sugar an hour later; the supplies can be bought online. You can also buy urinalysis strips to use every few weeks. A combination chlamydia and GBS screen are available at drthom.com and should be taken near the end of the pregnancy. Whether you make that part of your self-prenatal care routine is up to you.

You need to create a schedule for monitoring your pregnancy. You may wish to check every week, every other week, or once a month. I recommend picking the same day and time for every check. At the most, you should do your routine once a week, and at the least it should be done very month--which is how often traditional prenatal routines are performed. Many useful materials are available at allheart.com at affordable prices, such as blood pressure cuffs and fetoscopes. You should start prenatal care no earlier than 8 weeks and no later than 12 weeks, which is when appointments traditionally begin. Design your self-prenatal care routine the way you want.

Routinely monitoring yourself can give you a picture of how your pregnancy is going. It will make it easy to spot warning signs of complications. Keeping a record will be useful when dealing with doctors. If they have no clue what your pregnancy has been like, they'll be cautious and treat you as an emergency for having had no prenatal care. A diary assures them you have done your homework and are taking care of yourself. It can help them make a diagnosis and recommendations about treatment. It can also assure you and those close to you that everything is fine. A self-prenatal care routine has a lot of benefits.

You should routinely monitor your weight, blood pressure (many pharmacies have blood pressure machines!), pulse, and symptoms. Write down how you are treating your symptoms. Begin recording the fetal heartbeat when you can hear it (10 weeks Doppler, 20 weeks fetoscope). When you can feel your uterus (16 weeks), measure your fundal height, distance from navel and pelvis in centimeters. This can help establish a due date and let you know you're growing as you should. You should record the first day of your last menstrual period, your pre-pregnancy weight, the date that you got your positive pregnancy test, and your estimated due date. In the third trimester, learn to palpitate your stomach to determine the position of the baby and placenta. Write down what you discover. I don't recommend cervical checks.

How much prenatal care you perform or receive is up to you. It doesn't have to be all or nothing. You can do as much or as little as you want. You decide what tests are necessary and how often you need to monitor yourself. You are likely to pay far more attention to what is going on than a doctor, as this is your body, your pregnancy, and your baby. You have much more vested in your well-being. The standard of care you can give yourself, unless you are high risk, is quite high, despite the popular belief that prenatal self-care is useless. A woman recording her weight is just as good as a doctor doing it! Take good care of yourself by exercising and following a healthy diet, as well as performing prenatal care. Good luck to you in this incredibly journey to motherhood! I'm sure you will create the self-prenatal care routine that is right for you.