Obstetrics and Gynecology Overview
In the new millennium, when it comes to obstetrics and gynecology, we all have seen increased emphasis from programme implementers, ministries of health and donors on ensuring skilled care during pregnancy, childbirth and the postnatal period for both the women as well as new-born.
In a pregnancy, there is an important role of both antenatal care as well as Postnatal care.
The availability of routine antenatal care including screening and diagnosis, has reduced the number of miscarriages, birth defects, infant mortality, maternal deaths, reversible contraception, neonatal infections and other related women’s health issues over the years.
Antenatal care also involves treatment and training to ensure a healthy pre-pregnancy, pregnancy, labor and delivery for mother and baby.
Women must gain the requisite knowledge from their medicare professionals so that they can make informed decisions regarding their health and pregnancy.
Women also need to be involved in the decision-making process related to their care and treatment of pregnancy.
Pregnancy care consists of both antenatal or prenatal (before birth) and postnatal or postpartum (after birth) healthcare for expectant mothers.
There are many College of Obstetricians and Gynecologists and professionals passing out from these colleges are dedicatedly involved the health of women everywhere, by setting standards for clinical practices. An obstetrician-gynecologist is also referred to as OB-GYN.
Antenatal Care in Obstetrics and Gynecology
The care which you receive to make sure you as well as your baby are well – while you are pregnant is termed as antenatal care.
You’ll be having appointments with a midwife, gynaecologist and an obstetrician.
You should start with antenatal care as soon as you know you’re pregnant. The doctor and the midwife providing you antenatal care will do the following:
- Closely check the health of your baby and you.
- Impart you with information that will help you to have a healthy pregnancy.
- Share advice on exercise and healthy eating during pregnancy.
- Answer all your queries about pregnancy.
- Inform and discuss your choices and options regarding your care during pregnancy, labour as well as birth
- Normally, it will include two or more pregnancy ultrasound scans, one during 8-14 weeks and another during 18-21 weeks.
- Routine blood test for HIV, syphilis and Hepatitis-B
- Antenatal screening tests to evaluate the chances of your baby having some special conditions such as Down’s Syndrome.
- Special screenings for thalassaemia and sickle cell.
What Does Antenatal Care Include?
Antenatal care is also referred to as prenatal care. It is provided in the form of medical check-ups, recommendations on managing a healthy lifestyle for the mother and the baby.
It also includes the sharing of medical information such as maternal physiological changes in pregnancy, biological changes, and prenatal nutrition, including prenatal vitamins.
These recommendations prevent potential health problems during the complete course of the pregnancy and promote both mother and child’s health.
Importance of Antenatal Appointments
Antenatal appointments will allow your doctor team to help both you and your baby stay healthy.
Even if your pregnancy is going well, you’re feeling well and do not have any complications – it’s important for you to attend your appointments.
It is required so that any kind of potential risks can be identified and prevented at the initial stage.
It is also a great opportunity for you to ask any questions you have such as physical pregnancy symptoms, what’s happening during each month and the birth itself.
You can also ask many questions about how to care for your new born baby.
Your doctor can also give you tips on your lifestyle, including dietary advice or mental health or avoiding drinking alcohol.
You can discuss any kind of problems you might be having during this period.
Antenatal Care During Your Pregnancy
Once your pregnancy is confirmed, it becomes essential to schedule periodic healthcare appointments throughout each stage of your pregnancy.
Appointments during your pregnancy period are called your antenatal appointments.
Traditionally antenatal care comprise of monthly, weekly and fortnightly visits as per the plan below:
- During the first two trimesters ranging from 1st week to the 28th week , there will be monthly visits
- There will be fortnightly visits from the 28th week to the 36th week of pregnancy
- From the 36th week onwards till the 42nd week, you will be having weekly visits.
Diagnostic Tests for Obstetrics and Gynecology
During these visits, there will be various routine screenings as well as diagnostics and tests.
- There will be assessments of parental needs and dynamics of the family.
- Regular blood tests to measure the haemoglobin count and check for anaemia, HIV, and other parameters.
- Your weight gain will be measured and blood pressure will be monitored during each visit.
- The growth of the foetus and heart rate will be monitored during the ultrasound sessions.
- During these visits, your doctor may ask for ultrasound sessions more frequently depending on the health condition of the baby.
- Your doctor will be talking about exercises and special diet and will recommend some specific medicine and supplements to boost your haemoglobin count.
- Later visits will include checking and verifying the baby’s position in the womb and noting changes in your body as you prepare for birth.
- At this stage, your doctor may recommend various workshops at different stages of your pregnancy. These workshops will discuss what pregnant women should expect and prepare themselves for childbirth. Some workshops will teach you basic skills for baby care, holding the baby delicately yet firmly, breastfeeding methods, etc. You may be recommended for specific workshops if you are considered high risk due to your age and heal conditions. You might also be referred to a doctor specializing in high-risk pregnancies.
Postnatal Care in Obstetrics and Gynecology
The postnatal period, also called the postpartum period, begins immediately after childbirth. In this period, the size of the uterus and the levels of hormones returns to a non-pregnant state.
We define the period of the first six weeks following childbirth as the immediate postpartum period or the puerperium.
This period is the most critical in the lives of mothers and babies as most of the maternal and new-born deaths occur during this period. In gynecology, we further categorize this period as normal puerperium and abnormal puerperium.
Normal and Abnormal Puerperium in Obstetrics and Gynecology
Puerperium is the time period from the delivery of the placenta through the first few weeks after the delivery.
1) Normal Puerperium
Normal postpartum bleeding usually starts immediately after the new-born baby is born. Whether you have delivery via caesarean section or vaginally, normal bleeding is common. It is perfectly normal to have post-birth bleeding as during this time all the accumulated red blood and clots drain out.
2) Abnormal Puerperium
After you have a new-born, days and nights will start running together as you have to spend hours caring for your baby. You will get busy with constant feeding, changing, rocking in a cyclic manner. Soothing a new-born requires a lot of time, and you will not get time to look after yourself.
In such a scenario, it is perfectly normal to experience some pain and discomfort in the weeks after giving birth. Having said that, you need to be aware so that you should be able to differentiate between normal and abnormal. If you leave out some of the postnatal complications unaddressed, it can interfere with your healing process and cause long-lasting problems.
The list below mentions some of the most common postpartum complications, what to look out for, and when exactly to seek medical help.
a) Excessive Bleeding
Bleeding after giving birth is normal. It is common among women to bleed for 2 to 6 weeks. Some women even experience excessive bleeding after childbirth.
Following the days after birth, your bleeding should begin to slow down. You will notice a reduced flow of darker blood lasting for a few weeks.
While you might notice temporary increases in the flow with increased physical activity or specially after breastfeeding, however, each day should bring a lighter flow.
Giving birth is a complex process and might result in open wounds or stitches for several reasons. Vaginal tearing during childbirth is common for mothers and often requires stitches.
If you give birth to a child via caesarean delivery, you’ll surely have stitches at the incision site.
While it’s normal for these stitches to cause some discomfort as it heals, it is a matter of concern, if there is sudden increase in pain.
This is one of the indications that the area might has an infection. Some women also have other infections, like kidney, urinary, or vaginal infections, after birth.
c) Constipation or Incontinence
Sneezing and peeing your pants after childbirth is perfectly normal. Urinary incontinence immediately after birth is a very common problem among women.
And it’s not dangerous, but this complication can cause you inconvenience, discomfort, and embarrassment.
Sometimes simple home remedies at home can treat the issue. But if you have a more extreme case, you might need medical intervention to get relief.
d) Breast Pain
Breast pain and discomfort are common complications during the postpartum period, irrespective of whether you choose to breastfeed or not.
When you start producing milk, typically 3 to 5 days after childbirth, you might notice significant breast swelling.
Once you choose to breastfeed, you may also start to experience nipple pain and discomfort.
Taking warm showers and taking over-the-counter pain relief medications might help ease pains.
Breastfeeding should not continue to be painful; else consult your doctor.
e) Postpartum Depression
It is normal to feel lower than usual or feel a little up and down in the weeks after birth.
These can be termed as baby blues, but If these signs last more than a few weeks or start interfering with baby care, then you are experiencing postpartum depression.
But remember, postpartum depression is treatable, and it doesn’t need to cause you guilt or embarrassment.
Once you start with the treatment, you begin to feel better very quickly.
f) Other Issues Related to Obstetrics and Gynecology
Other serious complications following your childbirth could be uncommon but you’d need to address them immediately for your health and safety.
Some issues that may affect you during the postpartum stage include sepsis, cardiovascular events, stroke and embolism.
Therefore, when it comes to obstetrics and gynecology, you need to take extra care to stay as healthy during pregnancy and during the postpartum period.
IT will not only help you to take better care of your baby but will help you to heal faster.
Try to stay on top of all of your health care appointments and follow your doctor’s instructions strictly – for the health and safety of both mother and the baby.