The Pregnant Woman

Pregnancy is not an illness. By and large it is a normal healthy life-affirming process. Pregnant women are therefore not necessarily ‘patients’. Understandably, many dislike being treated as if they were. Many also hold strong views about pregnancy and birth, and about how they want to experience it.

All the same, pregnancy can bring problems for both mother and baby. In the UK, the maternal death rate is 6.7 per 100,000 live births, and every year there are thousands of stillbirths and perinatal deaths (deaths around birth and the first week of life).

Substandard care is a major factor in many of these deaths. Antenatal care needs to deliver woman-centred care that doesn’t neglect the medical risks.

Antenatal Care

Most antenatal care is shared between the hospital antenatal clinic and the practice. Midwives, whether hospital-based or in the community, are the lead professionals involved in normal pregnancy. But GPs too care for pregnant women, and are often the first health professional the woman consults at a pivotal moment in her life. As the lynchpin of continuity of care, a GP is well-placed to reassure the woman at a time of physical and emotional change.

Equally importantly, the GP has a key role in recognising and managing any complications, and may also see the pregnant woman for unrelated illness, such as flu. You therefore need to know about pregnancy in general, and the antenatal routine, screening tests and medical problems that can affect pregnancy or arise from it.

History

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