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.
- 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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