1. Clinical/ Antenatal/Post Natal Health Care for mothers within Reproductive Health AgeBy
Mrs Susana Larbi Wumbee
Deputy Director Nursing Services
Institutional Care Division GHS Headquarters

2. No Woman Should Die Giving Life

3. Outline of Presentation
Introduction
Pre-Pregnant Care
Antenatal Care
Intra Delivery Care
Post Natal Care
Normal Delivery
Maternal Mortality
Way forward
Conclusion

4. Introduction
Preparing the woman for child birth starts from infancy through the pubertal years to pregnancy and post natal care.
Issues of Good diet , counseling on the choice of a partner to rule out genetic complications and education on pregnancy, delivery and post natal care all come into play.
The need to access the assistance of the health care provider becomes crucial in this developmental/reproductive stage of life.

5. Clinical or Pre-pregnant state
Child Hood
The girl child must be given proper diet and taught how to keep up her posture to avoid any deformities especially the spine and pelvis bones that may cause obstructed labour in future
Puberty
Educate on personal cleanliness and the consequences of sexual immorality

6. Pre Pregnant stage (Cont)
Preparation for Marriage:
Counseling on diseases in the family such as sickle cell anemia, diabetes, schizophrenia etc,
Preparation for pregnancy
Visit to the doctor or midwife for assessment
Treat every infection
Take a nutritious diet
Avoid smoking, alcohol and poor mental health

7. Antenatal care
Pregnancy is typically a time of joy and anticipation, it can also be a time of concern and anxiety.
Pregnant women should attend antenatal clinic at least four times or visits before delivery
It is important for the assessment and monitoring of the mother and baby in terms of their health, growth of the baby, safe delivery and prevention of complications

8. Antenatal Care
Assessment include: History taking General Examination –Physical, Obstetric Laboratory investigation Medications - TT, SP Schedule of visits Education on pregnancy and preparation for birth and motherhood

9. Intra Partum Care Signs of onset of labour Diet during labour
Pain control during labour
Examination and monitoring of labour
Emotional support

10. Post Natal Care Initial and subsequent care of mother and baby
Breast feeding
Care of the Cord
Immunizations
Nutrition and prevention of infection
Family Planning

11. Normal Delivery Important for the life of mother and baby
Mother, family and friends are happy
Involves the maintenance of the health of mother and baby
Counseling for Family planning for birth spacing
Assure uneventful subsequent deliveries
In the long term -- Increase the productive labour force of the country

12. Maternal and Mortality
“Women are not dying because of
diseases that we cannot treat.
they are dying because societies
have yet to make the decision
that their lives are worth saving.”
Prof. Mahmoud Fathalla, 1997

13. What needs to be done is well known
Prevention of pregnancy: Family Planning
Prevention of complications: Skilled Care at Delivery
Prevention of death by timely management of life-threatening complications: Emergency Obstetric Care
Management of abortion and post abortion care

14. Family Planning
A woman has the right to decide if and when she becomes pregnant
30% of maternal deaths could be prevented with family planning
Full citation: Non-Use and Use of Ineffective Methods of Contraception,” in Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors, ed. Majid Ezzati et al. (Geneva: World Health Organization, 2004):
Session 2
Source: Comparative Quantification of Health Risks: Global and Regional Burden of Disease Attributable to Selected Major Risk Factors, ed. Majid Ezzati et al. (Geneva:
World Health Organization, 2004)

15. Skilled Care
Ideally every woman should have a Skilled Birth Attendant (SBA) during the continuum of care
SBA: midwifery skills or more, i.e. they attend normal deliveries, recognize complications and treat or refer
For many years to come some countries will not have enough SBAs for all women

16. Emergency Obstetric Care
Approximately 15% of pregnant women develop complications
Most maternal deaths are caused by direct obstetric complications that can be treated
Many direct obstetric complications cannot be predicted or prevented which is why it is important for faciltites to offer EmOC services
Session 2

17. Other Maternal Mortality Reduction (MMR) Strategies
Safe abortion and post-abortion care (PAC)
PAC is treatment of all abortions and miscarriages + counseling and provision of contraception + referral for other reproductive health needs
Abortion as a cause of maternal mortality is highly preventable
Focused antenatal care
Session 2

18. Wrap up
Improving the health of women in the reproductive age for safe delivery and Reducing maternal mortality is possible
What needs to be done to save lives is well-known
Equity of coverage to quality maternity services is key
Reducing maternal mortality is a collective responsibility

19. Responsibility for action involves diverse groups
4/13/2017
Responsibility for action involves diverse groups
Media
Individuals, households, community, Advocates, civil society, NGOs, parliamentarians
Research institutions
Health Workers
Funders
Government

20. Nothing is Impossible

21. Thank you