Medical Check-ups: Safety for Mother and Child

Medical Check-ups: Safety for Mother and Child

Medical Check-ups: Safety for Mother and Child
Medical Check-ups: Safety for Mother and Child

The regular check-ups serve to keep an eye on the development of the child and the health of the mother. They provide an opportunity to act in a timely manner if problems arise.

Legal entitlement to examinations and advice
Scope of the investigations
Prevention or prenatal diagnostics?

Pregnancy is a time of constant development and change for both mother and child. The purpose of the preventive pregnancy examinations is to carefully observe this development and document it in the maternity record. If the examination appointments are kept regularly, there is a good chance of recognizing risks early on and taking action if necessary. The maternity guidelines also provide that the pregnant woman and, if requested, her partner are informed about the test results and advised if medically necessary or sensible measures are pending.

What many pregnant women do not know: Almost all preventive medical checkups can be carried out by both midwives and doctors. An exception is the ultrasound examination, which can only be carried out by a doctor. A high-risk pregnancy must always be looked after by a gynecological specialist, unless the pregnant woman decides against it on her own responsibility.

Legal entitlement to examinations and advice
Every pregnant woman has a legal right to an adequate medical examination. The doctor should also offer advice on, for example, nutrition, oral health, vaccination against viral flu (influenza) and the risks of HIV infection. The costs for this are covered by the statutory and private health insurance companies. If a pregnant woman receives benefits under the Federal Social Welfare Act, the Social Welfare Office pays the costs.

Working pregnant women must be released from work for all preventive examinations without loss of earnings.

Scope of the investigations
The check-ups are initially scheduled once a month and from the 32nd week of pregnancy every two weeks. During the initial examination, the general state of health and possible previous illnesses of the pregnant woman are recorded in a detailed examination interview (anamnesis). The doctor or midwife also ask about possible physical and psychological stress on the expectant mother. If she already has one or more children, the findings from the maternity passports issued previously are included in the anamnesis.

The pregnant woman's blood pressure and weight are noted at every preventive medical check-up. The urine is analyzed and the position of the uterus is felt. The child's position and heart rate are also checked. The blood is also examined at regular intervals.

As part of prenatal care, three ultrasound examinations are planned: in the third, sixth and eighth month of pregnancy. If certain risks exist or complications arise, more frequent ultrasound examinations can be useful (and are then also covered by the health insurance company).

Many examinations are part of normal preventive care based on maternity guidelines. Others are so-called Individual Health Services (IGeL), which can be carried out either when there is a particular risk or at the request of the pregnant woman, such as the toxoplasmosis test. If there is justified suspicion of an individual risk, the costs of the additional services will be covered by the health insurance company.

Prevention or prenatal diagnostics?
Examinations as part of prenatal diagnostics are not part of the normal preventive examinations. The doctor must point out the possibilities of prenatal diagnostics if there are certain health or family risks.

In addition to the usual three ultrasound examinations, women in the 12th week of pregnancy are often offered the "first trimester test". The results of an ultrasound and a blood test are used to calculate whether there is a statistically increased risk of a chromosome abnormality. These non-invasive methods of prenatal diagnosis are often offered with the preventive examinations. However, they may only be undertaken with the express consent of the mother-to-be.

Doctors who recommend a genetic test are obliged to inform the pregnant woman about the purpose, type, scope, significance and consequences of the test. This also includes possible psychological stress from the findings as well as possible risks from sample collection with invasive examination methods. It is also mandatory to obtain a written declaration of consent from the pregnant woman for the examination and to document this. The pregnant woman can revoke her consent at any time.