Pre-natal attention and checkups
Once the meeting starts, welcome everyone and ask the participants: • Who can help us remember what we talked about in our last meeting? • Who was able to do the activity at home that we asked you to do at the end of the meeting? How did it go? • Does anyone have questions or concerns after doing the activity?
What are we going to learn?
The importance of pre-natal care to make sure baby and mother stay healthy. Let’s talk about it! We are going to look at some pictures, so we can talk about what we all know about this topic.
What sorts of things should be gone over in a pre-natal checkup?
What have you learned during a pre-natal checkup? Why do you think pre-natal checkups are important?
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“A letter for the future” We are going to write a letter to our baby who is going to be born soon.
What we’ll need: • Pens or pencils
WHAT WE’LL DO: • Paper • First ask the mothers to say how many months • Envelopes pregnant they are and when their due date is. Remind them that every month they should go to the clinic so that their pregnancy can be monitored and their baby can be well cared for. • Tell them that pregnancy is a time of waiting. During this waiting period the parents spend a lot of time thinking about the baby that is on the way. • Tell them that today they are going to write a letter to their baby expressing some of those thoughts, so that when our baby is bigger he or she will be able to read it and know that they were thinking about him or her during this waiting period, and wanted to give their baby the best care even before he or she was born. • Give each mother a paper and pencil (for those who cannot write, ask the other participants to help her or else the mother can make a few drawings of her ideas). Next, ask the mothers to write a letter to their child and tell her how they feel as they wait for her arrival and how they think their family is going to change once she arrives. The mothers can tell the baby that they love him and what they want for his life, etc. Once they are finished writing, tell them that whoever wants to can read her letter out loud. • Now give an envelope to each mother to put her letter in and tell the group that they can put their pre-natal checkup card in the same envelope so that every time they go in for a checkup they can add something to the letter until the day the baby is born. A few suggestions: • Ask the women who have already had children and have had pre-natal checkups to tell the other expecting mother what happens during the pre-natal checkup and during physical and laboratory exams. • They can also tell the other mothers about signs of complications during pregnancy (swollen feet, bleeding, high blood pressure and unusual contractions)
What did we learn today? Now, we’ll review what we discussed today. • How do you feel after this meeting? Why? • What are the two most important things you’ve learned today? • What will you do differently based on what you learned during the meeting?
7 • W hat did you like the most? Are there things you didn’t like? • Do you have any remaining concerns or questions about what we talked about? To finish, what would you recommend to improve today’s meeting when we do it again with another group. (Explain that answering this question will help the meeting be even better in the future for parents with small children.)
To do at home:
• Every week the couple can check for any signs of complication, such as swollen feet or if the baby is moving irregularly • Make sure that the mother is eating well so that the baby is able to grow.
Basic information for the facilitator: Learning more about pre-natal attention and checkups: Every pregnancy is a risk. Prenatal visits should be used to detect and treat problems on the spot like anemia and hypertension. In areas where HIV cases are predominant, prenatal visits should include voluntary counselling and testing. • In the past, prenatal care was used to screen pregnant women who might develop complications and might die. Now prenatal care is used to detect and treat problems like hypertension that could complicate pregnancy, labor and delivery. • Most pregnancy and delivery-related deaths are due to massive bleeding, infection, severe hypertension and obstructed labor–complications which can only be managed at a health facility. Family members should be trained to recognize danger signs of complications and know where and how to seek and receive appropriate care. • Communities should support and have emergency preparedness and complication readiness plans. These would include emergency funds, emergency transport, and an established link with the nearest health facility. During prenatal visits, pregnant women learn about proper nutrition, family planning, and receive iron/folate supplements, deworming tablets and the tetanus toxoid vaccine. If the pregnant woman lives in a malaria area, she should be given anti-malarial drugs and advised to sleep under insecticidetreated nets. Pregnant women can suffer complications from pregnancy without any warning signs. This is why it is so important to have a transportation plan and a health clinic where she can go in case any of the following present:
1- Warning signs during pregnancy.
• Failure to gain weight (at least 6 kilograms should be gained during pregnancy)
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8 • Anemia, paleness inside the eyelids (healthy eyelids are red or pink), very tired or easily out-ofbreath • Unusual swelling of legs, arms or face • The baby moves very little or not at all.
2- If the pregnant woman shows these signs it means she needs help urgently-it is an
emergency! • Spotting or bleeding from the vagina during pregnancy or profuse or persistent bleeding after delivery • Severe headaches or stomach-aches • Severe or persistent vomiting • High fever • Water breaks before due time for delivery • Convulsions • Severe pain • Prolonged labor
3- Reasons why people delay in getting help
• They don’t recognize that it is an emergency – they don’t recognize the danger signs • They delay in seeking care – it takes time to decide what to do, where to go, who should accompany the pregnant woman and who to call for help • Lack of emergency funds • Negative previous experience with the health system: • Uncaring aptitude of service providers • Lack of supplies and equipmentIn • Poor skills in the health care staff • Unavailability of health care staff • Lack of emergency transportation
4- Household and community emergency response plans • Know where to go if there is an emergency like the ones described above (family/community) • Have a transportation plan in place (family/community) • Have emergency funds to pay for transport and delivery cost (family/community) • Work with health authorities and local government to improve health services available in the community (community) • If the delivery will be at home, plan to have a midwife present or at least a trained birth attendant • If death or severe illness happens as a result EVERY PREGNANCY IS A RISK OR of pregnancy, try to find out the causes and POTENTIALLY DANGEROUS! avoid them in other pregnancies.