Minimal Prenatal Care During Limited Access: A Guide for Rural Pregnant Women

Question
I live in the middle of nowhere Angola.  I am 99.9% I am pregnant, which is great except there is absolutely no medical care available to me here.  I am extrememly healthy and dont forsee any complications, what would be the absolute minimum exams I would need to have and when?  Since I will have to fly out of the country, I dont think I can do the 10 plus exams I have been reading about.  Thank you

Answer
Dear Dawn,

Wow - you have a dilemma. Obviously you have researched what the normal schedule is for prenatal visits, so I won't repeat all that information for you. I guess if I had to pick and choose and were limited in the amount of visits, I would suggest this:

1st Prenatal Visit between 8-12 weeks after LMP - This will be the most important visit, in my opinion. During this visit, your OB doctor can start you on a regimen of prenatal vitamins, do a thorough physical work-up, blood tests and screenings, get an initial ultrasound to confirm dating of the pregnancy and make sure there are no abnormalities with implantation, etc,.. With you living in another country, immunizations or other extra precautions may also be necessary. At this 1st visit, it will be very important to discuss your living situation in full detail and get the doctor's recommendations as to when he/she will want you to return for visits. The doctor you choose may have a different point of view than the suggestions I am making.

After the first visit, if you can make visits every six weeks, that would be about six total visits during the pregnancy - including a 40 week (delivery) visit. (Example - Weeks 10, 16, 22, 28, 34, 40) However, if you are wanting to deliver in the U.S., you may very well want to push all those back two weeks and remain here from the 38th week until you deliver - just in case you would happen to go into labor early. Since you would be here, you could get in for those last weekly visits as normal. The absolute MINIMUM I would suggest would be at least every 8 weeks.

Again, check with the OB doctor to ask what his/her specific recommendations are. This would just be a guideline. And the extensive travel will need to be taken into consideration once you are into your 3rd trimester as well. Some airlines have their own restrictions on that.

I hope this has helped you and answered your question. I wish you well.

Brenda