About 4 weeks before the expected date of birth, many pediatric providers offer a prenatal interview to expectant parents whom they have not met.
Obstetricians, midwives, leaders of prenatal classes, or friends who have previously enjoyed this experience may refer the parents.
The prenatal interview is an effective way for prospective parents to meet the provider at a relatively unpressured time. It is best to schedule the interview at the end of office hours (i.e., at a time when the office is quieter and the pressure to keep seeing patients is no longer there). Because expectant mothers often work until their due dates, the end of the day is often convenient for both parents.
After the initial introductions and questions relating to how the couple was referred, the interview should take the form of a formal medical history of both prospective parents.
This should include the following topics:
- The length of time the couple has been married
- How easy or difficult it was to achieve conception
- Problems that the parents experienced during this or previous pregnancies
- Medications now being used
- Alcohol and smoking habits
- Problems that they or other family members may have had with their children
- Medical and genetic problems of other family members
- Ultrasound results
- Results of maternal screening tests; for example, chromosomal/genetic disorders
Expectation of Interviews
Although in many cases the answers to these questions yield relatively little information, focusing the discussion in this way helps the pediatrician learn about how the couple interacts, how they deal with apparent tensions, and whether any information elicited from one parent is a surprise to the other. The interview is a good gauge of how well prospective parents communicate. The interview is also a good way for the parents to learn how the physician communicates.
In the average middle class American family, the expectant mother asks most of the questions, with the support of the husband. It is unusual if the man does most of the talking. In such instances, the pediatrician may need to provide the woman with a great deal of support in the first few months of her infant’s life. She may be depressed, and this condition may become worse after delivery.
The next portion of the interview should focus on what the couple plan to do after the baby is born. Although much of this deals with breast-feeding versus bottle-feeding, safety and general care concerns warrant attention. Now is the time to provide information about car seat usage; the risks to the infant of passive exposure to cigarette smoke; fluoride, iron, and vitamin use; and crib safety, including the potential dangers of old cribs and how to determine proper mattress size.
Successful Prenatal Interview
Questions about if and when the mother or father plans to return to work, the couple’s plans for child care, and the availability of social support from family and friends are all appropriate at this time. In closing, the pediatrician should ask the parents whether there are any issues that have not been covered or are unclear. After that, the pediatrician should explain how he can be reached after the delivery and when and how often the infant will be seen in the hospital. He should also ask the couple to phone him if they have further questions after leaving the office. If the pediatrician uses e-mail and/or a Web site for communication, this, too, should be discussed. An interview of this depth takes between 30 and 45 minutes, but it is well worth the investment of time, especially if any problems arise during or after the birth of the infant. After a successful prenatal interview, the pediatrician has achieved credibility as someone who is concerned about the parents and the unborn child. Th is interview makes it easier to discuss issues that may arise at the time of delivery, which occur at an emotionally charged time.
Source: Pediatrics for Medical Students edited by Daniel Bernstein, Steven P. Shelov
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