Prenatal care major

The prenatal care major is an applied medical care major that focuses on maternal and infant health intervention in the entire stage from pregnancy diagnosis to delivery, and has both clinical medical attributes and public health attributes. The core goal is to reduce maternal and perinatal mortality and improve the quality of the birth population through pre-emptive scientific intervention. The employment direction covers public maternal and child health care systems, private obstetrics and gynecology institutions, maternal and infant health consultation and other tracks. It is neither the same as the traditional midwifery major, nor is it the "confinement center nursing position" in public perception.

In the past two years, I helped an old colleague in maternal and child care as an intern in this profession. On the first day of the consultation, a girl who was just entering her third year was asked by the pregnant mother who came to set up a record, "Are you going to help me deliver babies in the future?" She was stunned on the spot. It was not until I followed the teacher for three months of special follow-up for gestational diabetes that I was finally able to clearly explain the boundaries of my work to the patient: "Delivering babies is the job of a midwife, and I help you eliminate all risks that can be avoided before giving birth. ”

Interestingly, even within the industry, there is still no completely unified view on the training positioning of this major. Universities with a more clinical system will require students to study pathological diagnosis and high-risk pregnancy identification. After graduation, they can take the assistant physician qualification certificate and go in the direction of clinical midwifery and high-risk pregnancy management. Teachers from these universities often say: "Prenatal care that cannot even recognize the signs of preeclampsia is just a castle in the air. If there is an emergency, you can't let pregnant women go to the emergency room by themselves, right?" ”Public health-oriented colleges and universities focus on mass science popularization, healthy behavior intervention, and postpartum follow-up. Their logic is also very practical: now more than 90% of ordinary pregnant women in the country lack high-end diagnosis and treatment at all, but scientific weight management, fetal movement monitoring, and emotional counseling. If these basic tasks are done thoroughly, unnecessary medical visits and pregnancy risks can be reduced by more than half.

When I was stationed at the district maternal and child prenatal clinic last week, I happened to come across a typical case. Ms. Lin was 28 weeks pregnant with her second child. She had gained 8 pounds in one month and her blood pressure was stuck at the critical value. She had gone to a private institution for a prenatal check-up. The prenatal nurse there only told her to strictly control her diet. She was hungry for three days and went to do a urine routine. She found three plus ketones, which almost caused problems. She was treated by a nurse who had graduated from the clinical field. She first checked for latent edema and calculated her basal metabolic rate. The final diet included not only two taels of lean beef and half a stick of corn, but also allowed her to eat a small piece of grapefruit as a snack every day. Ms. Lin became red-eyed on the spot and said that she had thought she could only eat cucumbers during the entire pregnancy.

Many people think that prenatal care is just about “teaching pregnant mothers to count fetal movements”, but that’s not true. I met a prenatal nurse at a community health center a few years ago. When she went to the community for free screening last year, she touched the belly of a pregnant woman who was 34 weeks pregnant and felt something was wrong. The uterine height was almost 3 centimeters smaller than that of the same gestational week. She forced her to go to the superior. The hospital did a color ultrasound and finally found out that it was a rare velamentous placenta vasa previa. If it had been discovered a week later, there was a high chance that the baby would not be able to be saved once the membranes were ruptured. Later, the pregnant woman gave birth to a cesarean section 37 weeks ahead of schedule. The mother and baby were safe. After leaving the hospital, the whole family went to the community with a banner to express their thanks.

I have been dealing with this profession for almost ten years, and the most intuitive feeling is that the gap is really big. If you go to a grassroots maternal and child health care hospital, a prenatal nurse often has to take care of more than 200 registered pregnant women, and she doesn't even have time to drink water. But on the other hand, many students who have graduated from this major cannot find suitable jobs - everyone is trying to get into a tertiary A hospital, and no one wants to go to the community or to sinking maternal and child service institutions. In fact, the demand for the latter is greater, and the income is not necessarily low. I know a girl who graduated in Grade 19. She did not go to the public sector after graduation. Instead, she went to a chain of high-end maternity and gynecological institutions to provide exclusive prenatal care, serving high-demand pregnant mothers. Her monthly salary can reach 20,000 yuan, which is almost twice as much as her classmates who entered the public sector in the same class.

There is also an interesting debate. Many people in the industry are now arguing about whether psychological intervention should be included in the core assessment content of prenatal care. Practitioners of the old school always think that "it is normal for pregnant women to be emotionally sensitive and it will be fine after giving birth." However, many of the younger generation of prenatal nurses have taken the psychological counselor certification themselves. I once met a pregnant mother who was 32 weeks pregnant. She always secretly cried in her belly and said, "Mom, I'm sorry." Our nurse talked to her three times before finding out that she had previously been pregnant with a child with cleft lip and palate. She had problems with her baby. Later, the nurse helped her contact the doctor in the genetics department. She broke down each abnormality report and told her. She also got her into a group of pregnant mothers of the same gestational age. Later, she gave birth to a 7-pound girl by chance, and gave us a big bag of wedding candies after the confinement period.

To be honest, this profession is difficult to say. You need to understand clinical, nutrition, and psychology, and you must have enough patience to deal with pregnant mothers with different needs.； To put it simply, the core is to block danger before delivery and to be the "health gatekeeper" of the pregnant mother throughout her pregnancy. There are actually not many young people who are willing to settle down and do this, but as long as they can survive the trivial matters in the first two years, the road ahead will be quite stable - after all, who doesn't want a professional person to accompany them when they are pregnant and eliminate all the pitfalls in advance?