3.1. ANTENATAL CARE
3.1.1. Psychological features and behavior changes of pregnant women
Pregnancy is not a disease; rather, it is a special time in the woman's life when her organs and systems function in intensive mode, sometimes approaching the critical mode. The need to provide for fetal development and to protect the fetus from various negative influences of the internal and external environment is accompanied by invariable strain on all vital functions.
In early pregnancy even a healthy woman may show vegetative or neurotic disorders (weakness, undue fatigability, nausea, vomiting, salivation, hyperosmia, abrupt mood swings, tearfulness). As pregnancy progresses, these signs are followed by those induced by vagal effects, uterine growth and the effect of placental hormones on all organs and systems (heartburn, constipation, frequent urination, heart palpitations, muscular pain in legs). Nearer to the due date the woman may show dyspnea, edema, pain in the lower back and pubic symphysis, emotional instability (see Chapter 2 "Physiological Changes During Pregnancy"). All these features should be taken into account when consulting pregnant women and giving them recommendations about their health, lifestyle, the course of pregnancy and fetal condition, as well as specific features of postpartum period (including breastfeeding).
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Safety of the embryo during the first eight weeks of gestation and during critical periods (see section 1.7 "Critical Periods of Fetal Development") is of prime importance as this is the time of active organogenesis.
3.1.2. Standards of antepartum care
Antepartum care is the main function of a prenatal clinic. The quality of outpatient observation aimed at preventing obstetric complications determines, to a great extent, the outcome of pregnancy and delivery. It was established that in women who present for antepartum care at early gestational age and see their doctor no less than 7 times, the perinatal mortality rate is twice lower than in those who were not registered with prenatal care clinic. A pregnant woman with uneventful course of pregnancy should make no less than 7 visits to a prenatal care clinic.