Preventive Services for Pregnant Women

Preconception counseling and prenatal care largely focus on strategies to prevent or detect potential complications for the pregnant woman, fetus, and newborn. Routine preconception counseling may include risk assessment based on family history, counseling about use of folic acid for the prevention of neural tube defects, and counseling about the harms of smoking, alcohol use, and certain foods (e.g., fish with high levels of mercury) and drugs (prescription and illicit) on pregnancy outcomes.

Prenatal care includes screening tests, counseling, preventive medications, and immunizations. Screening laboratory tests include a complete blood cell count, blood type, Rh sensitivity, urinalysis for bacteriuria, screening for several STIs (e.g., syphilis, HIV, hepatitis B, gonorrhea [high risk], Chlamydia [high risk]), screening for neural tube defects, gestational diabetes mellitus, and group B streptococci (Kirkham et al., 2005).

Counseling is often anticipatory guidance for the upcoming stages of pregnancy, delivery, and the postpartum period. Counseling for breastfeeding is a key preventive component to prenatal care, as is the use of prenatal vitamins and influenza vaccine administration. Chapter 21 discusses care of the pregnant patient, including prenatal preventive services.

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