Today is our topic of discussion Components of maternal care
Components of maternal care
Antenatal care
Antenatal visits:
After conception or at 20 weeks, 32 weeks and 36 weeks. The services are –
- History taking & recording (ANC & PNC card): General health status &
- Physical examination: BP, weight gain, fundal height
- Investigation: CBC, Urine R/M/E, Blood sugar estimation, Blood grouping, HBsAg and others (if necessary).
- Iron & folic acid supplementation and other medication (if needed)
- TT injection: For previously immunized, one booster dose of TT after 20 weeks is sufficient. If previously unimmunized, two doses of TT at one month interval between 16 to 36 weeks.
- Education: About nutrition, self care, delivery & parenthood
- Planning of delivery: If choice is home delivery, advice about importance of service by TBAs. If institutional delivery is choice, advice about pre-planning of transport, counselling of family members (if necessary).
- Identify ‘At Risk’ Mother: Elderly primi (30 years and over), Stunted primi, Elderly grandmultipara, H/o previous C/S, Preeclampsia and eclampsia, Pregnancy with DM, CLD, CKD, TB & Hypertension, APH, Twin pregnancy, Hydramnios and Malpresentation.
II. Prenatal advice: adequate diet, maintenance of personal hygiene, careful to drug use & exposure to radiation, knowledge about warning signs (such as, edema of feet, blurred vision, convulsion, PV bleeding, headache) and child care.
III. Specific health protection: For anaemia and other nutritional deficiencies, toxaemias of pregnancy, tetanus, syphilis, Rh-status, screening for rubella and HIV (if necessary).
IV. Mental preparation
V. Family planning advice
Intranatal care:
Domiciliary care through TBA:
Recognize the ‘danger signs’ and take immediate measure to transfer the mother to nearest PHC or hospital. The ‘danger signs’ are –
- Sluggish or no pain after rupture of membrane
- No progress within one hour after rupture of membrane in spite of pain
- Prolapse of the cord or other body parts
- Meconium-stained liquor or slow irregular or excessively first foetal heart beat) (
- Excessive ‘show’ or bleeding during labour
- Collapse during labour g. Retained placenta
- PPH
- A temperature of 38°C or more during labour
II. Institutional care: Recommended for all high risk pregnancies and unsuitable home delivery.
III. Rooming-in: Keeping the child’s bed at the side of the mother.
Postnatal care:
Care of the mother:
- To prevent complications of post-partum period: Puerperal sepsis, thrombophlebitis, PPH, UTI, mastitis
- Restoration of mother to optimum health: Through physical and phychological mprovement and social adaptation.
- Breast feeding
- Family planning and
- Basic health education.
II. Care of the neonate: By Essential Newborn Care Interventions (described below)
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