Fri. Nov 26th, 2021

Antenatal care during your pregnancy

Once your pregnancy is confirmed, it is important to see your GP or midwife as soon as possible so that you can determine your needs. The appointments during your pregnancy are called your antenatal visits or antenatal care.

Why go to antenatal appointments?

An antenatal appointment will allow your GP, midwife and others on your healthcare team to help both you and your baby stay healthy. Even you are feeling well and if your pregnancy is going well , it is important for you to attend your appointments so that any potential risks can be identified and prevented, or minimized. To be.

This is also a great opportunity to ask any questions you may have about your pregnancy such as what is happening during each trimester, physical pregnancy symptoms and the birth itself. You may want to ask questions about caring for your baby after birth.

You can also get help with your lifestyle, including mental health or dietary advice, or to quit smoking or avoid drinking alcohol. You can discuss any problem you may have at home.

Who will I see at my antenatal appointments?

You may want to see your own GP before choosing a midwife. this is up to you.

It may also depend on whether you plan to give birth in a public hospital or not. If so, it’s likely you’ll see a doctor or midwife in the hospital.

If you are planning to give birth at a birth centre, you will probably have visits with the midwife at the birth centre.

If you intend to have your baby in a private hospital, you will most likely have an appointment with your obstetrician in their room.

If you are planning to have a home birth, your prenatal care will probably be provided by a midwife in your home, hospital, or elsewhere in the community.

What will happen during the appointments?

The antenatal care you receive during pregnancy depends on:

  • your health and any risks to you or your baby
  • the stage of your pregnancy
  • any problems you are experiencing

There will be many investigations, scans, tests and discussions, such as:

  • When the baby is due, what trimester are you in and what this means for you and your baby
  • Finding out about your medical history, general health and previous pregnancies
  • discussing any medications you are taking
  • Make sure you are up to date with cervical screening
    making sure your mental health is okay, and supporting you if you have depression or anxiety
  • checking your weight and blood pressure and testing your urine
  • Organizing blood tests and investigations
  • Advice on healthy eating and lifestyle changes
  • Feeling and measuring your belly, and listening to the baby’s heartbeat
  • Asking you about your work , home environment and what support you have. If you are experiencing family violence, this is a good opportunity for you to discuss it.
  • checking for any physical symptoms that may be bothering you
  • you have your birth plan going with you
  • talking about whether something doesn’t go according to plan during birth
  • Finding out about antenatal classes

Advice about taking your baby home, feeding them, and other care

Antenatal care during your pregnancy
Antenatal care during your pregnancy

Checkup, tests and scans infographic

Check out our handy guide for antenatal visits.

How many antenatal appointments will I have?

If this is your first pregnancy and you’re not having any problems, you’ll likely have about 8 to 10 visits.

If this isn’t your first pregnancy, you’ll probably have 7-9 appointments if you haven’t had a complicated pregnancy before.

The number of visits may change depending on whether your pregnancy becomes complicated. If this happens, your midwife or doctor may need to increase the number of appointments and you may need more tests and scans.

Can my partner come along?

Yes. It’s a good idea to have your birth support partner, family member, or friend come to visit with you, especially when your birth plan is being discussed and you want them to support you during the birth.

further information

If you have any questions about antenatal concerns or care about your pregnancy, contact:

  • pregnancy, birth and baby 1800 882 436 to speak to the maternal and child health nurse
  • your gp
  • your babysitter
  • To give birth , the hospital where you plan

Prenatal care is essential to protect the health of women and their unborn children. Through this form of preventive health care, women can learn from skilled healthcare workers about healthy behaviors during pregnancy, better understand the warning signs during pregnancy and childbirth, and at this critical time in their lives. social, emotional and psychological support. Through antenatal care, pregnant women can receive micronutrient supplementation, treatment of high blood pressure to prevent eclampsia, as well as vaccination against tetanus. Antenatal care may also provide HIV testing and medications to prevent transmission of HIV from mother to child. In areas where malaria is endemic, health workers can provide pregnant women with medications and insecticide-treated mosquito nets to help prevent this debilitating and sometimes fatal disease.

Regular contact with a doctor, nurse or midwife during pregnancy allows women to receive services important to their health and that of their future children. The World Health Organization (WHO) has updated its recommendations from a minimum of four antenatal care contacts to a minimum of eight contacts, to reduce antenatal mortality and improve the care experience for women. However, reporting data at the global, regional and country levels is currently only available for a minimum of four visits, which is in line with the previous recommendation. These data indicate that the proportion of women receiving at least 4 antenatal care visits varies greatly between 13 percent in countries in sub-Saharan Africa to more than 90 percent in regions including Latin America and the Caribbean and European regions. varies. .

Globally, while 87 percent of pregnant women access prenatal care with skilled healthcare workers at least once, less than three in five (59 percent) receive at least four antenatal care. In looking at these figures, it is important to remember that the percentage does not take into account the health care provider’s skill level or the quality of care, both of which can affect whether such care will actually bring about better motherhood. and newborn health.

Historical data shows that the proportion of women receiving at least four antenatal care visits has increased globally over the past decade. However, the scale and pace of this progress varies greatly by region. For example, in West and Central Africa, only half of pregnant women received four or more antenatal care visits between 2014 and 2020 (53 percent). Strong and rapid progress in all high-burden areas is needed to drastically improve maternal and neonatal outcomes.

Disparity in antenatal care coverage

Despite progress, large regional and global disparities are seen by residence and wealth among women receiving at least four antenatal care visits. Women living in urban areas were more likely to receive at least four antenatal care than women living in rural areas, with an urban-rural gap of 24 percentage points (73 percent and 49 percent, respectively). In addition, antenatal care coverage increases with wealth, with the richest quintile being more likely to receive at least four antenatal care than the poorest quintile, with a wealth gap of 40 percentage points (78 percent and 38 percent). it happens. st, respectively)

Measurement of reproductive, maternal, newborn and child health and nutrition

In line with the Sustainable Development Goals, the Global Strategy for Women, Children and Adolescent Health (2016–2030) is a priority for actions designed to help families live healthy, secure lives and meet their economic potential. represents the necessary change. The Reproductive, Maternal, Neonatal, Child and Adolescent Health and Nutrition (RMNCAH-N) agenda is now both broader and more complex than the case for the Millennium Development Goal era, creating a need for new data. To contribute to this need, the Countdown to 2030 for the Health of Women, Children and Adolescents, a multi-institutional network of academics from institutions around the world and representatives of United Nations agencies and civil society, aims to monitor and To increase the measurement. The health of women, children and adolescents globally and across countries.

The manuscripts in this collection represent the first development of countdown work to increase measurement. They identify some of the continuous measurement and monitoring gaps in the RMNCAH-N, for example, by reviewing the evidence on ways to create effective coverage estimates and by introducing actionable analytical methods to identify disparities within and between countries. . The collection also considers measurement advances for early childhood development and nutrition. In addition, it expands to analyze new priority issues, including using national surveys to analyze the impact of armed conflicts on the RMNCAH-N; and to illustrate the new data needed to better understand the social, political and contextual complexity of health system governance.

C13. Advice and counseling on nutrition and self-care and substance abuse

Use the information and counseling sheets to support your interactions with the woman, her partner, and family.

  • advice on nutrition
  • Advise the woman to eat more and a variety of healthy foods, such as meat, fish, oils, nuts, seeds, grains, beans, vegetables, cheese, milk, to help her feel good and strong (Give examples of
  • types of food and how much to eat).
  • Spend more time on nutrition counseling with very thin, adolescent and HIV-infected women.
  • Determine if there are significant taboos about foods that are nutritionally important for good health. Advise the woman against these taboos.
  • Talk to family members, such as a partner and mother-in-law, to help them ensure that the woman eats enough and avoids strenuous physical exertion.
  • Advice on self-care during pregnancy

Advice to the woman:

  • Take iron pills F3.
  • Rest and avoid lifting heavy objects.
  • Sleep under an insecticide impregnated sheet.
  • Counseling on safe sex, including the use of condoms, when at risk for an STI or HIV G2.
  • Avoid alcohol and smoking during pregnancy.
  • Do not take the medicine unless prescribed in the health centre/hospital.

Counselor on Substance Abuse:

Avoid tobacco consumption during pregnancy.
Avoid exposure to secondhand smoke.
Do not take any medication or nicotine replacement therapy to stop tobacco.

Advice on alcohol consumption:
  • Avoid alcohol during pregnancy.
Counseling on drug use:
  • Avoid the use of drugs during pregnancy.

 

C14-C15. DEVELOP A BIRTH AND EMERGENCY PLAN

Use the information and counselling sheet to support your interaction with the woman, her partner and family.

Use the information and counseling sheets to support your interactions with the woman, her partner, and family.

facility delivery

Explain why birth in a facility is recommended

  • Any number of complications can develop during childbirth – they are not always predictable.
  • A facility has staff, equipment, supplies and medications available, and a referral system to provide the best care if needed.
  • If HIV is infected she will need appropriate ARV treatment for herself and her baby during delivery.
  • Complications are more common in HIV-infected women and their newborns. HIV-infected women must deliver in a facility.

advise how to prepare

Review delivery arrangements:

  • How will she get there? Will he have to pay for transportation?
  • How much will it cost to get to the facility? How will she pay?
  • Can she start saving immediately?
  • Who will accompany her to assist during labor and delivery?
  • Who will help her when she is away to take care of her home and other children?

advise when to go

  • If the woman lives near the facility, she should visit at the first signs of labor.
  • If she lives away from the facility, she should leave 2-3 weeks before the baby’s due date and either stay in the maternity waiting home or near the facility with family or friends.
  • Recommend asking the community for help when needed. I2.

advise what to bring

  • Home-based maternal records.
  • Clean clothes to wash, dry and wrap the baby.
  • Extra clean clothes to use as sanitary pads after birth.
  • Clothes for mom and baby.
  • Food and water for the lady and the helper.
  • Home delivery with skilled attendant

advise how to prepare

Review the following with him:

  • Who will be the partner during labor and delivery?
  • Who will be near for at least 24 hours after delivery?
  • Who will help take care of her home and other children?
  • Advise to call a skilled attendant at the first signs of labor.
  • Advise to prepare her home based maternal record.
  • Recommend asking the community for help when needed. I2.

Specify the supplies needed for home delivery

  • Warm place for birth with a clean surface or clean cloth.
  • Cleaning cloths of various sizes: for bedding, for drying and wrapping baby, for cleaning baby’s eyes, for washing and drying hands for birth attendants, for use as sanitary pads.
  • Blanket.
  • Bucket of clean water and some way to heat this water.
  • Soap.
  • Bowls: 2 for washing and 1 for cord.
  • Plastic to wrap the cord.
  • advice on labor signs

Advice to visit the facility or contact a skilled birth attendant if any of the following symptoms occur:

  • A bloody sticky discharge.
  • Painful contractions every 20 minutes or less.
  • The water has broken.
  • danger signs advice

Advise to go to the hospital/health center immediately, day or night, without waiting, if any of the following symptoms occur:

  • Vaginal bleeding.
  • Objection.
  • Severe headache with blurred vision.
  • Fever and too weak to get out of bed.
  • severe abdominal pain.
  • rapid or difficult breathing.
  • If he has any of the following symptoms, he should go to the health center as soon as possible:
  • Fever.
  • stomach ache.
  • feels sick.
  • Swelling of fingers, face, feet.

Discuss how to prepare for an emergency in pregnancy

  • Discuss emergency issues with the woman and her partner/family:

    where will she go?

    how will they get there?

    how much it will cost for services and transport?

    can she start saving straight away?

    who will go with her for support during labour and delivery?

    who will care for her home and other children?

  • Advise the woman to ask for help from the community, if needed I1I3.
  • Advise her to bring her home-based maternal record to the health centre, even for an emergency visit.

C16. ADVISE AND COUNSEL ON FAMILY PLANNING

Counseling on the importance of family planning
If appropriate, ask the woman if she would like another family member or her partner to be included in the counseling session.
Let us tell you that if she has sex after birth and is not exclusively breastfeeding, then she can get pregnant only after four weeks of delivery. That’s why it’s important to start thinking early about what family planning method they’ll use.

Ask about plans to have more children. If she (and her partner) wants more children, advise that waiting at least 2 years before trying to get pregnant again is good for the health of the mother and baby.

Knowing when to start a method after delivery depends on whether the woman is breastfeeding or not.

Arrange for the woman to see a family planning counselor, or consult her directly (see Decision Making Tools for Family Planning Providers and Clients for information on the method and counseling process).

Counseling on safe sex, including the use of condoms for dual protection against sexually transmitted infections (STIs) or HIV and pregnancy. Promote especially if you are at risk of STIs or HIV G4.
See G4 for family planning considerations , For HIV-infected women,
Her partner can decide to have a vasectomy (vasectomy) at any time.

Method options for the non-breastfeeding woman

Can be used immediately postpartum Condoms
Progestogen-only oral contraceptives
Progestogen-only injectables
Implant
Spermicide
Female sterilization (within 7 days or delay 6 weeks)
Copper IUD (immediately following expulsion of placenta or within 48 hours)
Delay 3 weeks Combined oral contraceptives
Combined injectables
Diaphragm
Fertility awareness methods

Special considerations for family planning counselling during pregnancy

Counselling should be given during the third trimester of pregnancy.

  • If the woman chooses female sterilization:

    can be performed immediately postpartum if no sign of infection (ideally within 7 days, or delay for 6 weeks).

    plan for delivery in hospital or health centre where they are trained to carry out the procedure.

    ensure counselling and informed consent prior to labour and delivery.

  • If the woman chooses an intrauterine device (IUD):

    can be inserted immediately postpartum if no sign of infection (up to 48 hours, or delay 4 weeks)

    plan for delivery in hospital or health centre where they are trained to insert the IUD.

Method options for the breastfeeding woman

Can be used immediately postpartum Lactational amenorrhoea method (LAM)
Condoms
Spermicide
Female sterilization (within 7 days or delay 6 weeks)
Copper IUD (within 48 hours or delay 4 weeks)
Delay 6 weeks Progestogen-only oral contraceptives
Progestogen-only injectables
Implants
Diaphragm
Delay 6 months Combined oral contraceptives
Combined injectables
Fertility awareness methods

C17. ADVISE ON ROUTINE AND FOLLOW-UP VISITS

Encourage the woman to bring her partner or family member to at least 1 visit.

Routine antenatal care visits

1st visit Before 4 months Before 16 weeks
2nd visit 6 months 24-28 weeks
3rd visit 8 months 30-32 weeks
4th visit 9 months 36-38 weeks
  • All pregnant women should have 4 routine antenatal visits.
  • First antenatal contact should be as early in pregnancy as possible.
  • During the last visit, inform the woman to return if she does not deliver within 2 weeks after the expected date of delivery.
  • More frequent visits or different schedules may be required according to national malaria or HIV policies.
  • If women is HIV-infected ensure a visit between 26-28 weeks.

Follow-up visits

If the problem was: Return in:
Hypertension 1 week if >8 months pregnant
Severe anaemia 2 weeks
HIV-infection 2 weeks after HIV testing

C18. HOME DELIVERY WITHOUT A SKILLED ATTENDANT

Reinforce the importance of delivery with a skilled birth attendant

Instruct mother and family on clean and safer delivery at home

If the woman has chosen to deliver at home without a skilled attendant, review these simple instructions with the woman and family members.

  • Give them a disposable delivery kit and explain how to use it.

Tell her/them:

  • To ensure a clean delivery surface for the birth.
  • To ensure that the attendant should wash her hands with clean water and soap before/after touching mother/baby. She should also keep her nails clean.
  • To, after birth, dry and place the baby on the mother’s chest with skin-to-skin contact and wipe the baby’s eyes using a clean cloth for each eye.
  • To cover the mother and the baby.
  • To use the ties and razor blade from the disposable delivery kit to tie and cut the cord.The cord is cut when it stops pulsating.
  • To wipe baby clean but not bathe the baby until after 6 hours.
  • To wait for the placenta to deliver on its own.
  • To start breastfeeding when the baby shows signs of readiness, within the first hour after birth.
  • To NOT leave the mother alone for the first 24 hours.
  • To keep the mother and baby warm.To dress or wrap the baby, including the baby’s head.
  • To dispose of the placenta in a correct, safe and culturally appropriate manner (burn or bury).
  • Advise her/them on danger signs for the mother and the baby and where to go.

Advise to avoid harmful practices

For example:

not to use local medications to hasten labour.

not to wait for waters to stop before going to health facility.

NOT to insert any substances into the vagina during labour or after delivery.

NOT to push on the abdomen during labour or delivery.

NOT to pull on the cord to deliver the placenta.

NOT to put ashes, cow dung or other substance on umbilical cord/stump.

Encourage helpful traditional practices:

Advise on danger signs

If the mother or baby has any of these signs, she/they must go to the health centre immediately, day or night, WITHOUT waiting

Mother

  • Waters break and not in labour after 6 hours.
  • Labour pains/contractions continue for more than 12 hours.
  • Heavy bleeding after delivery (pad/cloth soaked in less than 5 minutes).
  • Bleeding increases.
  • Placenta not expelled 1 hour after birth of the baby.

Baby

  • Very small.
  • Difficulty in breathing.
  • Fits.
  • Fever.
  • Feels cold.
  • Bleeding.
  • Not able to feed

By Pooja Yadav

My name is Pooja Yadav and I live in Varanasi UP. I have done Nursing from UP Nursing Council. I am a trained nurse as well as a mother of two children. The things I face every day in my profession, I solve problems that my patients face and share my experiences with you.

Leave a Reply

Your email address will not be published. Required fields are marked *