Antenatal care is the complete supervision of women during pregnancy to monitor foetal growth progress and to determine the well-being of the mother and the foetus. An appropriate antenatal check-up provides necessary care to the mother and helps in identifying any complications of pregnancy such as pre-eclampsia, anaemia, and hypertension etc. in the mother and incomplete or slow growth of the foetus. Antenatal care allows for the timely management of complications by referring to an appropriate facility for further treatment. It also gives a better chance to prepare a birth plan and recognise the facility for delivery and referral in case of any difficulties
Antenatal check-ups Schedule
Four antenatal check-ups are recommended for every pregnant woman. It should be taken care that this is only a minimum requirement and more visits may be necessary, depending on the woman's condition and needs. The schedule suggested for antenatal visits is as follows. The first visit/registration timing- As soon as the pregnancy is suspected, the first visit or registration of a pregnant woman for ANC should take place. The first visit should take place within 12 weeks ideally.
Second visit - Between 14 and 26 weeks
Third visit - Between 28 and 34 weeks
Fourth visit - Between 36 weeks and term
Antenatal check-up components
Taking the complete history of woman
A detailed history of the woman needed to be taken:
Any current medical/surgical or obstetric condition(s) that may complicate the present pregnancy need to be identified.)
The Expected Date of Delivery should be calculated using menstrual history.
Enquire about Nausea and vomiting / Constipation / Heartburn / Increased frequency of urination
Unusual vaginal discharge/itching
Obtain information about any Recurrent early abortion/ Post-abortion complications /Hypertension, pre-eclampsia or eclampsia / Ante-Partum Hemorrhage (APH) / Breech or transverse presentation / Obstructed labor, including dystocia / Perineal injuries/tears / Excessive bleeding after delivery / Puerperal sepsis during previous pregnancies.
History of blood transfusions should be noted.
For pregnancy confirmation (first visit only)
Fundal height to be measured
Listening of the Fetal Heart Sounds
Inspecting any other relevant abdominal findings.
Hemoglobin estimation and blood grouping including Rh factor using Blood investigations
To assess the presence of sugar and proteins using urine test
Rapid test for malaria and syphilis
Supplementation of Iron Folic Acid (IFA) along with counseling about the necessity of taking IFA and the dangers associated with anemia
Administration of two doses of TT injection for prevention of maternal and neonatal tetanus (tetanus of the newborn).
Micro-Birth Planning and Counseling
For the purpose of keeping a record, registration of pregnant woman and filling up of the Maternal and Child Protection Card and JSY card/below poverty line (BPL) certificates/necessary proofs or certificates should be done.
The woman need to be informed about the dates of antenatal visits, schedule for TT injections and the Expected Date of Delivery.
The place of delivery and the person who would conduct the delivery need to be identified.
A referral facility and the mode of referral need to be identified.