Chapter 7: Learning a pregnant woman’s health history
Has she been vaccinated against tetanus? If yes, when?
Tetanus (lockjaw) is caused when a germ that usually lives in dirt or stool enters
the body through a wound. A woman can get tetanus if something that is not
sterile is put into her womb or vagina during or after childbirth or from an unsafe
abortion. A baby can get tetanus if the cord is cut with something that is not
sterilized, or when anything (like dirt or dung) is put on the cord stump.
Tetanus vaccinations
Everyone should get a series of vaccinations to prevent tetanus. It is best if these
vaccinations happen early in life to prevent ever getting sick.
Give tetanus vaccinations (tetanus toxoid) according to this schedule:
• Injection 1: best to give to children, but can be given at any time in life
• Injection 2: 4 weeks after injection 1
• Injection 3: at least 6 months after injection 2
• Injection 4: 1 to 3 years after injection 3
• Injection 5: 1 to 5 years after injection 4
After these injections, everyone needs another injection at least once every 10 years.
People who have received all of these vaccinations will not get sick if they are
exposed to tetanus.
Pregnant women who have not
received all the vaccinations listed
above should receive 2 injections,
These shots will
protect you and
the baby
against tetanus
Good!
4 weeks apart. These 2 vaccinations — for a while.
will protect a woman for only
3 years. If you cannot give her the full series of
vaccinations, you must give the 2 pregnancy
vaccinations again the next time she becomes pregnant.
To protect pregnant women from tetanus, give these vaccinations:
• Injection 1: the first time you see the pregnant woman
• Injection 2: best if given earlier than 4 weeks after the first injection and at least
4 weeks before the end of the pregnancy. But it is not dangerous to give the
second injection early if you need to.
Vaccinations during pregnancy will also protect the baby from tetanus during
the first few weeks after birth. But the baby must be vaccinated after birth so that
the protection will continue.
It is hard to know how much protection a woman already has against tetanus.
Most people do not remember if they had the vaccinations or not. If you do not
know that someone has had the vaccinations, assume that she has not. Vaccinate
her in this pregnancy — an extra vaccination will not harm her.
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A Book for Midwives (2010)