What are the types of prenatal care?

At present, prenatal care routinely covered in China is mainly divided into three directions: free follow-up by the public health system, clinical monitoring in hospitals, and personalized payment guidance, basically covering all levels of needs from basic basics to high-end customization.

When I was rotating in community maternal and child health care two years ago, I met Sister Zhang who lives in an old community. Just two days after she found out she was pregnant, the community's maternal and child specialist came to register, measured her basic blood pressure and weight, asked her about her last menstrual period and early pregnancy reactions, and gave her a free handbook of folic acid and early pregnancy precautions. This is the most basic public health prenatal care. This kind of service is provided free of charge to all pregnant women under the national public health project. Covering everything from early pregnancy registration to 42-day postpartum follow-up, the content is general science that has been verified by disease control. However, there are now different opinions. Many young pregnant mothers feel that the content is too "universal" and is not useful for reference if they have basic problems such as hypothyroidism and polycystic disease. However, public data from the Centers for Disease Control and Prevention also shows that this kind of cover-up service has reduced the incidence of premature births in remote areas of the country by nearly 12 percentage points, and it is still not universal.

When the card is completed and transferred to the obstetrics department at 12 weeks of pregnancy, what pregnant mothers come into contact with during daily prenatal check-ups will fall into the clinical prenatal care category of medical institutions. Different from the general content of public health, this type of care follows diagnosis and treatment, such as fetal heart rate monitoring during each prenatal checkup, risk information after non-invasive Tang screening, and fetal movement counting teaching in the third trimester. If you are diagnosed with gestational diabetes, the obstetrics nurse will teach you one-on-one how to measure your fingertip blood at home and how to adjust the carbohydrate ratio of three meals. I have managed a pregnant woman with hyperthyroidism before. Mom, the nursing plan for the entire pregnancy was jointly formulated by nurses from the obstetrics and endocrinology departments. After each reexamination, the schedule and dietary recommendations will be adjusted according to her thyroid function value. This is the most professional, but the shortcomings are also obvious. The number of patients in the tertiary obstetrics department is tight. Many pregnant mothers complain about queuing for two hours. The time to communicate with the nurses and doctors is only three to five minutes, and there is no time to ask many trivial questions.

If you feel that the public health content is too basic and the hospital’s services are not detailed enough, there are now many market-based personalized prenatal care options available, such as one-on-one delivery rehearsals at midwives’ clinics, customized pregnancy nutrition at private institutions, and pregnancy yoga classes led by certified coaches. My best friend was pregnant with twins last year, so she booked full-course prenatal care from a private institution. A dedicated nurse came to her home every week to measure her uterine height, abdominal circumference, and fetal heart rate. A nutritionist would prepare weekly recipes based on her dietary restrictions and blood sugar conditions. Even what to bring with her delivery bag and how to choose the route to the hospital were all planned by the nurse in advance. It really saved her a lot of worry during the entire pregnancy. However, the price difference of this type of service is very large, ranging from a single consultation of several thousand yuan to a full customization of more than 100,000 yuan. Now there are many voices in the industry saying that some institutions will package ordinary fetal heart rate monitoring as a "high-end fetal security project" at a premium of several times. When choosing, it is best to check the professional qualifications of the institution and practitioners first, and don't be fooled by marketing rhetoric.

In fact, for most ordinary pregnant mothers with no underlying medical conditions, it is enough to follow the regular procedures in the community and hospital. If there are special needs or complications during pregnancy, personalized services can be added as needed. There is no need to blindly pursue "high-end care."