Prenatal/Antenatal Care 101: When to Start, What to Expect and Essential Tips

Q: What are the symptoms of a silent miscarriage?

A silent miscarriage may present subtle signs, including brownish discharge and a decrease in or disappearance of early pregnancy symptoms like nausea and breast soreness. If you suspect a miscarriage of any kind, it's crucial to consult your doctor immediately.

Q: How do I know my pregnancy is progressing well?

The most reliable way to ensure your pregnancy is progressing well is through regular checkups and prenatal care with a qualified healthcare professional. Track fetal movements during the third trimester, aiming for 10 movements within a two-hour period. Every pregnancy is unique, so open communication with your gynaecologist is key to addressing any concerns.

8 min read

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By Wing Joo Loong Team

Key Takeaways

Start Prenatal Care Early: Begin antenatal care between 4-8 weeks of pregnancy to assess risks and monitor the health of both mother and baby. Regular check-ups are key to preventing complications.
Antenatal Classes and Nutrition: These classes prepare parents for childbirth and baby care, while a nutrient-rich diet and prenatal vitamins support healthy pregnancy and development.
Exercise Safely: Prenatal yoga can improve strength and reduce stress, but always consult your doctor before starting exercise, especially if you have a high-risk pregnancy.

Antenatal care is a series of pre-birth health checks involving regular appointments, screenings, and guidance to monitor the well-being of both the mother and the unborn baby throughout pregnancy. It is crucial for preventing complications, managing pregnancy symptoms and promoting overall health. Alongside antenatal care, practices such as consuming confinement food postpartum can play a role in recovery. In this guide, we’ll cover everything you need to know about antenatal care: when to start, what to expect, essential antenatal classes and tips on prenatal vitamins and exercises.

In this article, we'll explore:

When to Start Prenatal / Antenatal Care and What to Expect?
Antenatal Classes: What You’ll Learn and How It Benefits You
Nutritional Prenatal Vitamins, Supplements and Herbs
Exercise during Pregnancy: Benefits of Prenatal Yoga

When to Start Prenatal / Antenatal Care and What to Expect?

Experts recommend that antenatal care should ideally begin as soon as you find out you're pregnant, with the optimal time being between 4 and 8 weeks of pregnancy. It’s even recommended to consult an obstetrician a month before pregnancy for family planning and a comprehensive health check. This early start allows you to identify potential risks, establish your baseline health and confirm your pregnancy.

Your First Antenatal Visit

The first antenatal visit is particularly important. During this visit, the healthcare provider will collect your medical history to assess potential risks and personalise your care plan. Therefore, it’s important to bring along your medical records for reference. Essential tests such as blood tests, urine tests and an ultrasound may be performed to confirm the pregnancy’s progress and check for any abnormalities.

Medical History Review: Be prepared to discuss your medical history, including any previous pregnancies, menstrual history, medical conditions and current medications.
Initial Tests: The first antenatal visit usually includes antenatal blood tests to check your iron levels, blood type and potential infections.
Ultrasound Scans During Pregnancy: The first-trimester scan will confirm your pregnancy, assess the gestational sac, check your baby's heartbeat and examine the foetal anatomy for abnormalities.

A pregnant woman undergoing an antenatal checkup, with a doctor performing an ultrasound scan. The monitor shows the baby's image, highlighting the importance of antenatal screening and scans during pregnancy as part of regular antenatal checkups.

Regular Pregnancy Checkups

Following the first antenatal test, regular antenatal check-ups are essential to monitor your well-being and your baby’s development. These regular check-ups allow you to discuss any concerns with your healthcare provider and receive guidance on various aspects of your pregnancy. The typical schedule for antenatal visits is as follows:

Before the 28th week of pregnancy: Appointments are scheduled every 4 weeks.
Between the 28th and 36th week of pregnancy: Appointments are scheduled every 2 to 3 weeks.
Between the 36th and 40th week of pregnancy: Appointments are scheduled weekly until delivery.

Specific Prenatal Tests and Scans

In addition to routine check-ups, there are specific tests that may be recommended based on factors such as your age, medical history and the results of previous screenings, which include:

Chorionic Villus Sampling (CVS): CVS is a diagnostic test usually performed between 11 and 14 weeks of pregnancy. It involves taking a small sample of placental tissue to analyse the baby’s chromosomes. CVS can detect chromosomal abnormalities such as Down syndrome and genetic disorders.
Amniocentesis: Typically performed around the 15th to 20th weeks of pregnancy, this test involves extracting a small amount of amniotic fluid surrounding the baby. Similar to CVS, it analyses the baby’s chromosomes and can identify chromosomal abnormalities and genetic conditions. This test might be recommended if serum screening tests show a high risk of chromosomal abnormality.
Noninvasive Prenatal Testing (NIPT): Also known as cell-free foetal DNA screening, it’s a genetic screening blood test to analyse foetal DNA found in the mother’s blood to screen for common chromosomal abnormalities like Down syndrome and trisomies.

These tests, while optional, play a crucial role in providing information about your baby’s health and potential risks. They allow for early detection of conditions and offer you and your healthcare provider the opportunity to discuss available options and plan accordingly.

Antenatal Classes: What You’ll Learn and How It Benefits You

Antenatal classes, also known as prenatal classes, are designed to prepare expectant parents for labour, childbirth and early parenthood. These classes provide valuable information and practical skills to help you confidently navigate this significant life change.

It’s advisable to begin inquiring and registering for antenatal classes early in your pregnancy as they tend to fill up quickly. Consider attending prenatal classes from the second trimester (around the 30th to 32nd week of pregnancy) as it provides ample time for you to learn and practice techniques. For those expecting twins, starting antenatal classes earlier around the 24th week is recommended as multiple pregnancies are more likely to result in earlier deliveries.

What You’ll Learn from Antenatal Classes?

If you’re asking what antenatal classes cover, here’s a wide range of topics that are usually included:

Health in Pregnancy: Information on maintaining a healthy lifestyle during pregnancy, including guidance on diet and exercise.
Labour and Birth Preparation: Detailed explanations of the labour process, stages of labour, pain management options and potential interventions such as forceps or vacuum delivery.
Postnatal Care and Newborn Basics: Learn about baby care, breastfeeding and the postnatal recovery period.

Benefits of Joining Antenatal Classes

The importance of joining antenatal classes lies in the hands-on experiences that allow expectant parents to practise skills like diapering, swaddling or breastfeeding techniques. This helps build confidence as you prepare for parenthood. The safe and supportive classroom environment also allows you to address concerns and receive personalised guidance from healthcare professionals. By joining a prenatal class, you can connect with other expectant parents and form a supportive network.

Nutritional Prenatal Vitamins, Supplements and Herbs

Maintaining a balanced diet is vital during pregnancy. Key nutrients such as protein, calcium and vitamins support your baby’s growth and your health as a mother. Knowing the foods to eat and avoid during pregnancy is essential for optimal health. Consuming nutrient-rich foods like chicken essence, bird’s nest (commonly discussed in the context of bird nest pregnancy), fruits, vegetables and herbs like American ginseng and cordyceps can provide additional benefits during pregnancy.*

Note: Cordyceps and ginseng tonics are generally suitable from the 2nd trimester onwards. For ginseng tonics, switch to American ginseng in the 3rd trimester as they have cooling properties that align with the body's needs during this stage. However, it's advisable to avoid cordyceps and ginseng tonics 1 month before your estimated delivery date. Please consult your physician about any medical conditions or concerns you may have.

Prenatal Vitamins: Supporting a Healthy Pregnancy

Prenatal Vitamins are essential in providing the nutrients that might be missing from your diet. Here’s a look at some of the top prenatal vitamins and supplements to support your body throughout pregnancy.

Omega-3: Supports heart health and overall foetal development. Docosahexaenoic acid (DHA) as one of the omega-3 fatty acids helps support brain and eye development.
Iron: Crucial during pregnancy as it aids blood formation in the baby and helps pregnant mothers prevent anaemia. If you are concerned about your iron levels, consult your doctor to recommend iron supplements for pregnancy.
B Vitamins: Help support foetal development in general. Among the B vitamins group, folic acid (vitamin B9) is known to prevent neural tube birth defects.
Choline: Choline for pregnancy is essential for a growing foetus's hippocampus development (the seat of memory in the brain) while also helping to prevent neural tube defects.
Calcium: Sufficient calcium intake is vital to help build bone density in both the developing baby and the mother.
Vitamin C & D: Crucial for increasing iron and calcium absorption.

Chinese Herbs To Boost Your Pregnancy Health

Let’s also explore some herbs to support you throughout the pregnancy journey based on the traditional chinese medicine knowledge:

WJL Herbs & Tonics	Benefits
Bird's Nest (燕窝)	Bird's nest can help stimulate appetite and improve digestion during pregnancy. It provides pre-digested protein and essential nutrients that support quicker recovery for pregnant women from chronic illnesses. Additionally, bird's nest promotes normal bodily functions such as cell regeneration and immunity, both of which are crucial for maintaining health during pregnancy
Chicken Essence (鸡精)	Rich in protein and essential amino acids to boost energy. Protein and amino acids are vital during pregnancy for supporting maternal tissue growth, foetal development and placenta formation. They also play a key role in tissue repair, immune function and the production of crucial hormones and enzymes, helping ensure both mother and baby stay healthy.
Fish Essence	Deep ocean fish is rich in protein, essential amino acids and omega-3 fatty acids such as DHA and EPA, making it an excellent tonic for postpartum recovery. These nutrients support tissue repair, boost immune function and promote overall health, aiding new mothers in their recovery journey while providing key benefits for both mother and baby.
Chinese Yam	Alleviates constipation, nausea, poor appetite and frequent urination. It also helps replenish qi and blood, both of which are essential for maintaining a healthy womb.
Cordyceps	Nourishes the kidneys, supports Yin-Yang balance and improves vitality. Cordyceps is generally suitable as a pregnancy tonic from the second trimester onwards. However, it is advisable to avoid cordyceps one month before your estimated delivery date.
American Ginseng	Relieves fatigue, nourishes Yin energy and enhances immunity. American ginseng, Chinese ginseng and Korean red ginseng are generally suitable as tonics from the second trimester onwards. For ginseng tonics, switch to American ginseng in the third trimester, as it has cooling properties that align with the body’s needs during this stage. It is advisable to avoid ginseng tonics one month before your estimated delivery date.

Please make sure to always consult your healthcare provider for any advice on your pregnancy diet.

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Exercise during Pregnancy: Benefits of Prenatal Yoga

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While prioritising rest, it is important to stay active during pregnancy. Exercise, particularly prenatal yoga, allows you to build strength and improve flexibility. Promoting physical relaxation and body fitness, prenatal yoga also helps reduce stress and symptoms of depression and anxiety, improve mood and sleep, relieve pregnancy discomfort such as lower back pain and prepare the body for labour.

At this point, you may ask if it’s safe for you to exercise during pregnancy. According to The American College of Obstetricians and Gynaecologists, it is safe to continue or start regular physical activities for healthy women with normal pregnancies. However, it is important to note that women with certain health conditions or pregnancy complications such as pregnancy-induced high blood pressure, severe anaemia, certain types of heart and lung diseases or being pregnant with twins or triplets (or more) with risk factors for preterm labour, might not be suitable to exercise during pregnancy.

With that being said, it’s important to always consult a healthcare provider before getting yourself and your unborn baby moving. Pregnant mothers who prefer guidance on poses and physical movement can opt for prenatal yoga classes where professional advice will be provided. Not only do pregnant mothers get to move their bodies in a safe and professional environment, but they also get to connect with the community, share pregnancy experiences and support each other during the prenatal period.

Here are some maternity yoga poses for different trimesters of pregnancy as recommended by Healthline:

The first trimester of pregnancy:

Head-to-knee forward bend: Strengthens your back muscles, stimulates digestion and promotes relaxation.
Cat-cow pose: Helps relieve back pain and improve spinal mobility.

The second trimester of pregnancy:

Child’s pose: Provides gentle relaxation and stretches your shoulders, chest and lower back.
Standing forward bend: Relieves tension and promotes inner calm.

The third trimester of pregnancy:

Warrior II: Helps strengthen the whole body and improves circulation.
Easy pose: Lengthens your spine, opens your hips and promotes mental clarity.

Conclusion

Antenatal care is a cornerstone of a healthy pregnancy, offering a structured approach to monitoring your health and your baby’s development. From timely check-ups to nutritional supplements and exercise, being proactive with your antenatal care can significantly impact your pregnancy journey. Stay informed, attend your appointments and embrace the changes of this remarkable phase with confidence!

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Frequently Asked Questions

What are the risks of not attending antenatal care?

Not attending antenatal care can lead to undiagnosed complications, increased risks during delivery and unmanaged pregnancy symptoms. Without regular checkups, potentially serious conditions like anemia, gestational diabetes and pre-eclampsia might go undetected, leading to more adverse outcomes.

Is it OK to go without prenatal care?

Skipping prenatal care is highly discouraged as it can pose serious risks to both the mother and baby. Prenatal care is essential for monitoring the health of both the mother and the baby throughout pregnancy. These appointments provide crucial screenings, vaccinations and education on healthy practices during pregnancy. Attending all recommended prenatal appointments is the best way to ensure a safe and healthy pregnancy.

What are some common signs of early labour?

Some common signs of early labour, also known as pre-term labour, include regular and painful contractions or tightening of the abdomen, "bloody show" (blood-stained mucus) and "breaking of your waters" (rupture of your membranes). These signs typically occur before 37 weeks of pregnancy, which is considered pre-term.

What should I include in my hospital bag checklist for labour?

Include essentials such as comfortable clothes, toiletries, baby clothes, and important documents such as identification cards, marriage certificates and admission forms. For your baby, you can also prepare a baby outfit for discharge, a swaddle and a pair of socks or booties.

What is the riskiest week of pregnancy?

The early weeks of the first trimester of pregnancy are generally considered the riskiest in terms of miscarriage. While pinpointing a single "riskiest week" is difficult, the sources highlight weeks 0-6 as having the highest likelihood of pregnancy loss. This is because the developing foetus is most vulnerable during these early stages. Notably, many miscarriages during this time occur before a woman might even realise she is pregnant, potentially appearing as a late period. After week 6, the risk decreases, particularly once a fetal heartbeat is detectable, usually around that time. However, the sources emphasise that potential complications can arise throughout the entire pregnancy, and consistent prenatal care remains essential.

What are the potential signs of problems during pregnancy?

Potential warning signs during pregnancy that require immediate medical attention include vaginal bleeding, convulsions, severe headaches accompanied by blurred vision, fever accompanied by weakness, severe abdominal pain and rapid or laboured breathing. Additionally, while not requiring immediate medical attention, pregnant women should go to a health centre as soon as possible if they experience fever, abdominal pain, general feelings of illness or swelling of the fingers, face and legs.

What are the symptoms of a silent miscarriage?

While typical miscarriages involve vaginal bleeding, abdominal pain and the discharge of fluid or tissue, a silent miscarriage may only present subtle signs. These signs can include brownish discharge and a decrease in or disappearance of early pregnancy symptoms such as nausea and breast soreness. If you suspect a miscarriage of any kind, it's crucial to consult your doctor immediately.

How do I know my pregnancy is progressing well?

The early weeks of the first trimester of pregnancy are generally considered the riskiest in terms of miscarriage. While pinpointing a single "riskiest week" is difficult, the sources highlight weeks 0-6 as having the highest likelihood of pregnancy loss. This is because the developing foetus is most vulnerable during these early stages. Notably, many miscarriages during this time occur before a woman might even realise she is pregnant, potentially appearing as a late period. After week 6, the risk decreases, particularly once a fetal heartbeat is detectable, usually around that time. However, the sources emphasise that potential complications can arise throughout the entire pregnancy, and consistent prenatal care remains essential.

References

https://www.nhsinform.scot/ready-steady-baby/pregnancy/looking-after-yourself-and-your-baby/vitamins-and-minerals-in-pregnancy/
https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/complications
https://www.healthhub.sg/live-healthy/pregnancy-what-to-pack-and-what-to-expect-in-the-delivery-suite
https://www.healthhub.sg/live-healthy/pregnancy-nutrition-during-pregnancy-eating-right-for-two
https://monashivf.com.sg/genetic-testing/nipt/
https://www.healthline.com/health/pregnancy/missed-abortion
https://www.gleneagles.com.sg/health-plus/article/facts-about-miscarriages
https://www.medicalnewstoday.com/articles/322634
https://www.healthline.com/health/pregnancy/miscarriage-rates-by-week
https://www.medparkhospital.com/en-US/disease-and-treatment/antenatal-care
https://gleneagles.com.my/health-digest/prenatal-care-guide-antenatal-classes
https://www.fourtrimesters.com/antenatalclasses
https://www.empowa.sg/services-mums-to-be
https://www.thomsonmedical.com/courses-and-workshops/childbirth-education-course
https://www.rafflesmedicalgroup.com/services/specialist-centres/women/services/maternity-services/antenatal-care/
https://www.ncbi.nlm.nih.gov/books/NBK304178/
https://www.healthhub.sg/live-healthy/essential-info-on-antenatal-classes
https://www.healthhub.sg/live-healthy/pregnancy-is-my-baby-developing-normally
https://www.healthxchange.sg/women/pregnancy/traditional-chinese-medicine-pregnancy-supplements
https://www.ncbi.nlm.nih.gov/books/NBK235221/
https://americanpregnancy.org/healthy-pregnancy/is-it-safe/herbal-tea/
https://cnalifestyle.channelnewsasia.com/women/tcm-treatments-pregnancy-303126

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Any self-care tips to help manage menstrual pains?

1.Avoid cold drinks, reduce water sports, and keep warm before your expected menstrual period.

2.Drink Brown Sugar Ginger Tea 2 days before menstruation starts or when menstrual cramps occur. Boil 15g of brown sugar and 15g of young ginger in a pot of water.

3.Acupressure massage for pain relief:

He Gu Acupoint

Location: Tender point found on the back of the hand between the thumb and the index finger

Function: He Gu Acupoint is a common point used to relieve pain and can help to relieve painful period cramps

How to massage: Press the acupoint with your other thumb and massage for 1 minute each time

Tai Chong Acupoint

Location: Tender point between the big toe and second toe

Function: Tai Chong Acupoint belongs to the Liver meridian and can help to improve Qi circulation to help improve mood and reduce irritability

How to massage: Press on the acupoint with your thumb and massage for 1 minute each time

Qi Hai Acupoint

Location: 1.5 inches below the belly button

Function: Qi Hai literally translates to “Sea of Energy” and is believed to be the point on the body where Qi gathers. Pressing this acupoint can help to increase Qi and energy and reduce bloating

How to massage: Press with your index and middle finger and massage for 1 minute each time

4.Add TCM herbs to your cooking or as dietary supplements

Angelica root (当归): Nourishes blood, regulates menstrual cycle and improves blood flow
Rehmannia (熟地): Nourishes Kidney, regulates menstrual cycle and improves blood circulation
Red peony root (赤芍): Improves blood circulation and relieves pain
Sichuan loveage root (川芎): Improves both Qi and Blood circulation

5.Exercise moderately to improve blood circulation, strengthen immunity, and increase Qi to overcome fatigue during menstruation.

Any self-care tips to help manage menstrual pains?

Note: All contents including medical information published in this blog is for information and educational purposes only and does not amount to advice. Please seek the advice of your physician or other qualified health provider regarding any medical condition that you may have.