Counseling for pregnant women

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)