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Counseling for pregnant women

This topic provides information regarding themes on which pregnant women are to receive counseling.

Care during pregnancy and preparation for child birth

  • Birth preparedness/micro birth plan - including place of delivery and the presence of an attendant at the time of the delivery.
  • Advantages of institutional deliveries and risks involved in home deliveries.
  • Signs of labor and danger signs of obstetric complications.
  • Complication readiness - recognizing danger signs during pregnancy, labor and after delivery/abortion
  • Importance of seeking Ante Natal Check-ups and Post Natal Check-ups
  • Care during Medical Termination of Pregnancy
  • Information on sex during pregnancy.
  • Promoting family planning.
  • Malaria prophylaxis and treatment
  • Advise on diet (nutrition) and rest.
    • Advice to eat more than her normal diet throughout the pregnancy - a pregnant woman needs about 300 kcal extra per day, over and above her usual diet, and 500 kcal extra in the post-partum period.
    • Importance of a high protein diet, including items such as black gram, groundnuts, ragi, whole grains, milk, eggs, meat and nuts or any other locally available food items for anemic women.
    • Intake of plenty of fruits and vegetables containing vitamin C (e.g. mango, guava, orange and sweet lime), as these enhance the absorption of iron.
    • Avoid taking tea or coffee within an hour after a meal
    • Rich fiber diet to avoid constipation.
    • Sleep for eight hours at night and rest for another two hours during the day and refrain from doing heavy work, especially lifting heavy weights
    • Refrain from taking alcohol, tobacco in any form or addictive drugs such as opium derivatives during pregnancy
    • Refrain any medication unless prescribed by a qualified health practitioner.
    • Special categories of women who require additional nutrition during pregnancy include the following:
      • Women who are underweight (less than 45 kg)
      • Women who have an increased level of physical activity, above the usual levels, during pregnancy
      • Adolescent girls who are pregnant
      • Those who become pregnant within two years of the previous delivery
      • Those with multiple pregnancy
      • Women who are HIV positive.

Breastfeeding

  • Initiate breast-feeding especially colostrum feeding within an hour of birth.
  • Do not give any pre-lacteal feeds
  • Ensure good attachment of the baby to the breast
  • Exclusively breast-feed the baby for six months.

Care of the newborn

  • Ensure that the baby is warm, breathing normally, and accepting and retaining breast milk, and that the cord is clean.
  • The baby should receive – BCG/ OPV-0/ Hepatitis B-0 vaccinations preferably before discharge from the health facility.
  • Ensure care of the umbilicus, skin and eyes
  • Ensure good suckling while breastfeeding
  • Screen the newborn for danger signs
  • Advise the mother and family members on immunization
  • Danger signs in newborns –seek immediate care:
    • If baby is breastfeeding poorly
    • If baby develops fever or feels cold to the touch
    • Breathes fast
    • Has difficulty in breathing
    • Has blood in the stool
    • If the palms and soles are yellow
    • Has convulsions

Source : Guidebook for Enhancing Performance of Multi-Purpose Worker (Female)

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