The Primary Health Care Corporation (PHCC) offers a comprehensive care package for expectant mothers, characterized by easy access and adherence to the highest standards of healthcare. Our specialized women’s and babies’ clinics at health centers are dedicated to monitoring the health of pregnant women through regular prenatal appointments, ensuring timely medical interventions. This approach aims to support a smooth and positive childbirth experience.

Prenatal care appointments can be scheduled as soon as pregnancy is confirmed at the health center. Early booking is recommended, ideally before 10 weeks of gestation. These appointments include a thorough review of the patient’s medical, surgical, and obstetric history, routine laboratory tests and ultrasounds, and the prescription of necessary supplements.

Dr. Rand Silwan Aboud, a Consultant Family Medicine at PHCC’s Omar Bin Al Khattab Health Center, underscores the importance of continuous monitoring by a family physician during pregnancy. This ensures the birth of a healthy child and reduces any potential risks to the mother. Regular evaluations help assess the mother’s health in terms of risk factors, address any medical concerns, prevent illness, and provide essential physical and psychological support.

Planning for Pregnancy

Women considering pregnancy should begin taking folic acid three months prior to conception and continue through the first trimester. A daily dose of 1 mg, typically prescribed by the family physician, is recommended to prevent brain and spinal cord abnormalities in the developing fetus. In certain cases, a higher dosage may be required.

Women with chronic health conditions, such as hypertension, diabetes, thyroid disorders, epilepsy, or hyperlipidemia, should consult with their family physician several months before conceiving. This consultation ensures the safe continuation of existing treatments during pregnancy, or may involve adjusting or changing medications as necessary.

Prenatal Vitamins

Dr. Rand advises that during the first trimester, the only recommended supplement is folic acid (1 mg daily). After the third month, the introduction of iron, folic acid, calcium, and a daily dose of vitamin D is advised. Alternatively, prenatal multivitamins may be used. Calcium supplementation is typically discontinued between weeks 30-34 to prevent placental calcification, which can restrict blood flow to the fetus.

It is crucial for pregnant women to avoid taking any medications without prior consultation with their physician.

Nutritional Guidelines During Pregnancy

Dr. Rand advises pregnant women with obesity to follow a balanced diet to manage weight gain appropriately. Certain types of fish should be avoided due to their mercury content, and liver consumption is discouraged during the first trimester due to its high vitamin A content, which can cause fetal abnormalities. She also advises against the consumption of papaya, as some studies suggest it may cause uterine contractions, and raw foods should be avoided to reduce the risk of foodborne illness. Caffeine intake should be limited, and it is preferable to prepare fresh meals at home. Pregnant women should drink 2-3 liters of water daily, avoid all forms of smoking, and minimize exposure to secondhand smoke.

Sleep, Exercise, and Clothing

According to Dr. Rand, moderate exercise and regular movement are beneficial for pregnant women. At a minimum, she recommends walking 200 meters daily and avoiding prolonged bed rest, except during normal sleep hours, to prevent blood clots. Adequate sleep is essential, with a preference for sleeping on the left side to improve uterine blood flow, or on the right side, as sleeping on the back can pose risks. She also advises wearing loose, comfortable clothing and avoiding high heels, as the additional weight during pregnancy can affect balance and increase the risk of falls.

Traveling While Pregnant

Regarding air travel, Dr. Rand notes that while research is ongoing, general advice includes wearing a mask in crowded places, maintaining hand hygiene, preparing meals at home, or choosing fresh food to avoid gastrointestinal infections. During flights, it is advisable to walk in the airplane aisle and avoid prolonged sitting to reduce the risk of blood clots in the legs and lungs. Heavy luggage should be avoided.

Regarding mental health, Dr. Rand highlights that hormonal fluctuations during pregnancy can significantly affect mood, leading to conditions such as depression and anxiety. She recommends consulting a family physician if such symptoms arise.

Warning Signs During Pregnancy

Pregnant women should be vigilant for warning signs such as bleeding, decreased or abnormal fetal movement, abdominal pain, or any trauma to the abdomen. Vaginal douching is not recommended due to the risk of urinary and uterine infections, with swimming in the sea being a safer alternative.

Fasting and Breastfeeding During Pregnancy

Dr. Rand assures that fasting is generally safe for pregnant women who are in good health. Fluid and nutrient intake can be managed during non-fasting hours, and a physician should be consulted if any risk factors are present.

If a woman is both pregnant and breastfeeding, milk production may decrease due to hormonal changes. However, continuing to breastfeed is generally safe. It is important to take vitamins, maintain a healthy diet, and stay hydrated.

As a family physician, Dr. Rand also advises against the use of chemicals on the hair, including dye, particularly during the first trimester.

Ultrasound Scans During Pregnancy

Pregnant women typically require four ultrasound scans, although this may vary from one individual to another. The first scan at 8 weeks confirms the fetal heartbeat; the second, between 11-14 weeks, assesses the neck and nose for Down syndrome; the third, between 18-22 weeks, checks for congenital anomalies; and the fourth, after 28 weeks, monitors fetal growth and size.

Gestational Diabetes

Screening for gestational diabetes begins at the first prenatal visit with a fasting blood glucose test, followed by an oral glucose tolerance test between 24-28 weeks. In most cases, gestational diabetes can be managed with dietary modifications under the guidance of the family physician, a health educator, and a nutritionist at the health center, along with regular exercise. In some instances, a referral to a diabetes specialist at Hamad Hospital may be necessary for treatment with medication or insulin.

Six to eight weeks after delivery, blood glucose levels are rechecked to ensure they have returned to normal. A history of gestational diabetes may increase the risk of developing type 2 diabetes later in life.

Dr. Rand advises new mothers to breastfeed as much as possible after childbirth, as it provides significant health benefits for both mother and child and strengthens their bond. A postpartum follow-up appointment at the health center is essential, where the family physician will assess the mother’s health, provide advice on exercise, breastfeeding, contraception, and conduct necessary health evaluations and a clinical examination.