Why pregnant women should attend Antenatal clinics.

  

A pregnancy period is an essential event in a woman's life and her immediate family. During this period, a pregnant woman needs special and adequate attention immediately pregnancy is confirmed until after delivery. This is the time women learn how to be mothers and men learn how to be fathers, though some parental ideas have already been learned from their own parents, now it is time to practice what they have learned.

   This means the kind of relationship between a child and his or her parents will certainly have an influence on their children when they start bearing their own children. In order not to be caught unaware, expectant mothers and fathers need to prepare for the transition into parenthood the reality of their roles and responsibilities.
Many psychological and physiological development tasks occur when a woman is pregnant which is caused by the development of the growing fetus in the uterus (womb).

What is antenatal care?
Antenatal care (ANC) is the care given to a woman once pregnancy is confirmed to the beginning of labor. It is the advice, supervision, planned examination, observation, and guiding an expectant mother throughout the period of pregnancy to deliver a healthy baby at the end of labor.

Goals of Antenatal care
  • To give birth in the best situation possible.
  • Pregnancy with the nearest minimum of mental and physical discomfort.
  • Delivering a normal, life, and healthy baby.
  • Ensuring that the expectant mother is healthy.

Aims of antenatal clinic.
The broad aim of antenatal care is to monItor the progress of pregnancy in order to support maternal health and normal fetal development.
 Other aims include:
  • To  evaluate, promote and maintain the physical, psychological and sociological effects of pregnancy on the woman.
  • To monitor the progress of the pregnancy so as to ensure maternal health and normal foetal development during pregnancy.
  • To prevent maternal as well as neonatal tetanus.
  • Exchanging information with the woman and her family and enabling them to make informed choices about pregnancy and birth.  
  • Early detection of high-risk pregnancy such as teenage pregnancy, a pregnant woman over age 35 years, women with underlying health conditions (asthma, diabetes, kidney diseases, severe anaemia, mental illness among others), multiple pregnancy,a woman with more than four children etc.
  • To ensure safe delivery of a well developed live and healthy baby.
  • Treatment of minor disorders in pregnancy such as hyperemesis gravidarum. 
  • Recognizing complications in pregnancy e.g pre-eclampsia. 
  • Helping the woman and her spouse to make birth plans and select a birth assistant.
  • Antenatal care helps the woman to be prepared for breastfeeding and parenthood.
  • To support and encourage the family as they adjust to the psychological and physiological development of parenthood.
  • To educate the expectant woman the need for family planning 


Types of Antenatal care
1. Focussed antenatal care which is a goal-oriented approach, which was recommended by researchers in 2001 and adopted by the World Health Organization (WHO) in 2002.
2. Traditional antenatal care is the care given to pregnant women in groups. It is an ancient and common type. 

Steps in Antenatal clinic
  • Booking: it is the first contact of the woman to maternal services. It involves :
*Screening
Good antenatal care includes regular screening which can detect and prevent early complications such as hypertension and pregnancy diabetes; both of which can dramatically affect the fetus. Early detection means regular monitoring and treatment. Blood tests such as complete blood count, HIV/AIDS, blood group, genotype, rhesus factor and urinalysis among others are also done.

*Adequate nutrition
There are certain foods that should be avoided during pregnancy. Foods such as raw fish, undercooked eggs, and unpasteurized/soft cheese (undone wara)  which contain enzymes and proteins that are dangerous to a developing fetus. Your immune system is also working for two, making it more susceptible to bacterial attacks. 

*Important vitamins
Prenatal vitamins play a big part in the health of your child. Even with a healthy diet, you will need supplements due to the additional hard work your body is doing. Additional key nutrients are typically found in folic acid and pregnancy multivitamins, both of which help support neural tube defects, baby’s development, and the prevention of anemia.

*Pre-natal classes
Being pregnant is wonderful and it’s even better when you meet other expectant parents. Not only do antenatal classes provide the opportunity for friendly support, but you are also educated on the finer points of dealing with pregnancy, how your child is developing, what to expect when you give birth and how to go about giving your child the best just after the birth. Look for classes that cover all the lablabord birthing options as well as early baby care.

*Partners
Your other half may not quite understand the other side of pregnancy, the side where dad comes in. Antenatal care goes a long way to educating expectant fathers on what they can do to help. Some dads-to-be may feel helpless but they are not, and their roles are big and important; they just need to be shown the way. Many expectant parents are not sure where everyone fits into the initial scheme of things, but a good prenatal care provider can provide guidance.

  Pregnancy is fun and exciting and, at times, hard and exhausting, but there is a great amount of help out there. With antenatal care, you will discuss birthing options, newborn care, breastfeeding, vaccinations and family planning

 What to expect at your first antenatal care clinic
Well, it might be expected that majority of pregnant women will experience a normal delivery without stress but complications do occur frequently in pregnant women who are identified as "high risk pregnancy". That is why it is essential to give adequate health history, family history, reproductive health to your health care providers on your first visit to the hospital.

Questions about your general health history will be asked to know if you have undergo any surgical incisons, any underlying health conditions such as severe anaemia, diabetes, hypertension , taking any drugs or having heart, liver or kidney diseases.

The current status of the present pregnancy is also asked if there is any abnormalities such as persistent vomiting, vaginal bleeding, frequent tiredness, swollen of the face and leg and other minor disorders of pregnancy . The expectant mothers height, weight, temperature, blood pressure, pulses, respiration are checked and recorded for further references. Urine is also collected and tested to check for presence of albumin and sugar while blood is collected to check if there is adequate blood count or reduced level in the body.

You will also be asked of your family health history to know the health status of the expectant mother, her spouse,  already born children and parents of the expecting parents. Details of any recent death, serious illness such as mental, cancer and other hereditary diseases will be asked in order to know measures to mitigate further spread in the family.

Social health history which includes food patterns, food habits, kind of house living, environment, sedentary lifestyle such as smoking, alcohol and substance abuse.

Reproductive health history such as history of first menses, duration and cycle in every month, abortions, stillbirths, premature labor or deaths, antepartum hemorrhage, postpartum hemorrhage, completion or incompletion of previous pregnancies, health care  care used during previous pregnancies are asked. The estimated date of pregnancy is also calculated. 

Physical examination which is an assessment of the head to toe to detect any abnormalities. This help to give proper advice to the expectant woman or referral for further care.

Examination of the head and neck to indicate if the pregnant woman is healthy or ill, nourished or malnourished, happy or sad, swollen face or neck or goiter. The skin is assessed for turgor, adequate diet, or paleness. The pallor of the gums, lips and conjunctiva of the eyes may indicate anemia while the teeth and gums may show bleeding or nutritional deficiencies.

The chest and breasts are checked to examine the breast if they are suitable for breastfeeding and to rule out any abnormality. The breasts is assessed for asymmetry, dimpling and extraction of the nipple or skin surface, the size and shape are also checked to see if they are inverted or normal, enlargements, lumps or cancer. 

Auscultation of the heart and lungs are done to check for irregularities.

The upper and lower limbs (hands and legs) are examined for edema (swollen), varicose veins, colour or restricted movements and pallor (paleness). Paleness in the palm denotes anaemia( insufficient blood level), oedema of the ankle and feet (swelling) indicates toxemia. The tendency of having varicose veins increases during pregnancy.

Abdominal examination is done to detect any tenderness or mass, to observe signs of pregnancy, to assess foetal size and growth, to assess the foetal health, to diagnose the foetal location and to detect any abnormalities. Abdominal examination when done after 30th week of pregnancy help to estimate the stage of pregnancy, the position of the foetus, presence of excessive fluid and the possibility of twins.
Inspection will be done above the symphysis pubis to help estimate the stage of pregnancy. Progress of pregnancy is measured from the symphysis pubis to the top of the fundus. The size and shape of the uterus and the fundus are usually measured during each visit to the hospital to monitor and record the rate of foetal growth.

During antenatal visit, the vulva is inspected to detect if there is any complain about vaginal discharge, itching or sore on the vagina. Lesions, scars, redness or infections are also looked out for to detect infections that might lead to serious or potential complications. If excessive vaginal discharge and smell is found, a pap smear will be obtained to screen for cervical cancer cells or gonorrhea.

Palpation is also done on the pregnant woman, the height of the fundus is measured, the fundus is palpated. This help to estimate the period or stage of pregnancy, determine whether the foetus is in breech( buttocks) or cephalic (head). 

Health education on the following healthy  lifestyle will be stressed on:
  • Intake of adequate nutrition containing all the six classes of food (protein, carbohydrates, fats and oils, vitamins, mineral salt.
  • Adequate intake of water.
  • Consumption of fruits and vegetables.
  • Importance of personal hygiene. 
  • Adequate rest and sleep. 
  • Healthy care of the breast.
  • Wearing of comfortable cloths.
  • Brisk walking.
  • Avoidance of herbal concotions.
  • Refrain from alcohol and smoking.
 The above listed healthy lifestyle will help the pregnant woman to enjoy good physical and mental health and be proud of herself, improve her self esteem and appearance during the pregnancy period. 

  Pregnancy should be an eventful situation and productive experience to pregnant women and their family. In the next article, discussion on Do's and Dont's during pregnancy will be emphasized on.


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