When is the right time to start ante-natal clinics?

Dear Doctor, I am pregnant for the first time and I am so excited. I have received conflicting advice about when to start attending ante-natal clinics. Please advise. Jane

Supervised medical care in pregnancy, commonly referred to as ante-natal care, is a well-established practice. It is recommended for every pregnant woman regardless of their current health status or the number of previous pregnancies. Adherence to ante-natal care improves eventual outcomes for both the mother and her developing baby.

Once you confirm you are pregnant, you must take steps to ensure your pregnancy will be as smooth as possible. If not already on the recommended pregnancy supplements, you should start taking these immediately. Every pregnant woman is advised to take Folic Acid vitamin supplements, ideally prior to conceiving and up to the end of the first 12 weeks of pregnancy.

Folic Acid reduces the risk of some developmental abnormalities, and is readily available even without a prescription.

It is important to have a clue about the approximate duration of your pregnancy once you know you have conceived. Pregnancy is dated in weeks, counting from the first day of the last menstrual flow. Women with irregular periods may have unclear dates, but you will often have a clue as to when you might have conceived.

You should aim to commence ante-natal care around the eleven to the thirteenth week of pregnancy. At this point, the growing baby is well-developed to allow a detailed assessment of normality. Virtually every organ is formed by this point, allowing some developmental or genetic abnormalities to be detected. This is also the best time to accurately date your pregnancy, giving you the estimated date of delivery, usually abbreviated as EDD.

Early scans can be combined with additional testing to confirm or refute any suspected genetic abnormalities. Majority of babies will be normal. But if any baby is diagnosed with serious abnormalities, a discussion can be held about how to proceed. Some abnormalities may be incompatible with survival, necessitating termination of the pregnancy before it advances further.

You will also need a thorough evaluation and screening tests for your general health. The earlier this is done the better, again emphasising the need to start your ante-natal clinic visits early. If you are found to have certain risks, these can be remedied early enough. Planning for individualised care henceforth will also be done, in attempts to mitigate potential complications as the pregnancy advances.

Is there any point in being seen earlier than the eleventh to the thirteenth week? If you have had a healthy pre-conception period, and haven’t experienced any unusual symptoms, there isn’t much reason to be seen earlier.

Conversely, starting attending ante-natal clinics well beyond the 13th week is not advisable. You will miss out on many potential interventions that may have a positive impact on your pregnancy.

Dr Alfred Murage is a consultant gynaecologist and fertility specialist, [email protected]