250 Where There Is No Doctor 2011
CHECK-UPS DURING PREGNANCY (PRENATAL CARE)
Many health centers and midwives encourage pregnant women to come for regular
prenatal (before birth) check ups and to talk about their health needs. If you are
pregnant and have the chance to go for these check–ups, you will learn many things to
help you prevent problems and have a healthier baby.
If you are a midwife, you can provide an important service to mothers-to-be
(and babies-to-be) by inviting them to come for prenatal check-ups—or by going
to see them. It is a good idea to see them once a month for the first 6 months of
pregnancy, twice a month during months 7 and 8, and once a week during the last
month.
Here are some important things prenatal care should cover:
1. Sharing information
Ask the mother about her problems and needs. Find out how many pregnancies
she has had, when she had her last baby, and any problems she may have had during
pregnancy or childbirth. Talk with her about ways she can help herself and her baby be
healthy, including:
♦ Eating right. Encourage her to eat enough energy foods, and also foods rich in
protein, vitamins, iron, and calcium (see Chapter 11).
♦ Good hygiene (Chapter 12 and p. 242).
♦ The importance of taking few or no medicines (p. 54)
♦ The importance of not smoking (p. 149), not drinking alcoholic drinks (p. 148),
and not using drugs (p. 416 and 417).
♦ Getting enough exercise and rest.
♦ Tetanus vaccination to prevent tetanus in the newborn. (Give at the 6th, 7th, and
8th month if first time. If she has been vaccinated against tetanus before, give
one booster during the 7th month.)
2. Nutrition
Does the mother look well nourished? Is she anemic? If so, discuss ways of eating
better. If possible, see that she gets iron pills preferably with folic acid and vitamin C.
Advise her about how to handle morning sickness (p. 248) and heartburn (p. 128).
Is she gaining weight normally? If possible, weigh her each visit. Normally she
should gain 8 to 10 kilograms during the nine months of pregnancy. If she stops
gaining weight, this is a bad sign. Sudden weight gain in the last months is a sign of
pre-eclampsia. If you do not
have scales, try to judge
if she is gaining weight by
how she looks.
Or make a simple scale:
bricks or other
objects of known
weight