Emmanuel Durham and Maryam HusamudeenQ: What is prenatal care?

A: Emmanuel: Prenatal care involves things like helping mothers maintain healthy nutrition, monitor blood pressure and blood sugar levels during pregnancy. These are important areas to oversee and control during pregnancy because poor nutrition, poor blood pressure and out of control blood sugar can lead to gestational diabetes in the mother and the possibility for low blood sugar level, jaundice, or other problems.

Q: Why is prenatal care so important? What might happen to a mother or her baby without good prenatal care?

A: Emmanuel: A recent study conducted by Columbia University showed that approximately 46% of Black and Latino women surveyed received late care or no care at all during pregnancy in New York City.  Statistics show that a lack of prenatal care can cause a baby to have a low birth weight. Prenatal care is very important to prevent various abnormalities in the baby and allows the doctor to monitor the baby's well-being directly by listening to the fetal heartbeat and checking the size and position of both the uterus and the fetus. Early detection of problems can allow both the baby and the mother a better outcome during delivery.  

Maryam: Prenatal care is also important because of the high rates of diabetes in Harlem, which has an impact on pregnant women here. Many women, especially those who are in very difficult circumstances, may have a hard time eating right or taking care of their basic health needs. But even if women do eat well, are fairly healthy, and have no history of diabetes in their family, they may get gestational diabetes during pregnancy. If a mother has diabetes, it can cause problems for the child such as high birth weight and an increased risk for the child to develop type 2 diabetes later in life.

Q: What are the common misconceptions people have about prenatal care?

A: Emmanuel: The main problem is that pregnant women - especially those who are high-risk - are unaware of the importance of prenatal care.  It is not uncommon for patients to be referred to us in their eighth month of pregnancy. Without early prenatal care many health problems arise that could very well be avoided.

Maryam: I had an 18-year-old client who had never had prenatal care because she refused to accept that she was pregnant, even late in her term. It was two weeks before her due date before we were finally able to convince her to get care! Her aunt had convinced her to take prenatal vitamins and that was the only special treatment she received during her pregnancy. So while a poor economic situation contributes to people not getting care or even being able to eat well or take good care of themselves, people also come from many different cultural backgrounds where prenatal care is not seen as a big deal. Some cultures figure that women get pregnant naturally and the baby comes naturally so there is no reason to see a doctor.

Q: What specifically should women do to take care of themselves during pregnancy?

A: Maryam: Nutrition is one thing that is very important to a healthy pregnancy. Speaking personally, as a 46 year old woman with a 17-month old baby, there were many lifestyle and dietary changes I had to make when I was pregnant. I’ve never had any health issues; I had regular checkups and ate very healthy including not eating meat or dairy for many years. I chose to be more conscious of my health and what I ate when I learned I was lactose intolerant and after learning in school that I could get many of the same vitamins present in meat in vegetables and fruit. However, despite my healthy lifestyle, I developed gestational diabetes. This forced me to learn more about how my particular diet, which lacked dairy and some meat, affected my system. I had to learn how to decrease the sugars in food I regularly eat to manage my gestational diabetes.  For instance, I am a Muslim woman of Cherokee and Hispanic background, I had to slow down on eating bread and juicing vegetables like carrots, celery and beets, which I love, as well as eating mangoes while I cook, which are common in my culture’s cuisine, as these foods all carry natural sugars that elevate blood sugar levels. Based on my nutritionist’s recommendations, I started eating chicken, fish, and dairy. This was hard as I had not eaten any dairy products for over 20 years. This is just an example of how one thing, like nutrition, can be an important factor in a healthy pregnancy.

Read more from Emmanuel Durham and Maryam Husamudeen by clicking the links below:

• Programs working to keep pregnant women healthy
• Prenatal Care Assistance Program (PCAP)
• Helen B. Atkinson center and health in Harlem

To listen to our interview with Emmanuel Durham and Maryam Husamudeen, click here for our podcast page.

Harlem Word is a series of interviews with Harlem health experts, written by HHPC and reviewed by our Health Advisory Board.