Prenatal Care Guidelines For Developing Countries - Midwives For Haiti

Prenatal Care Guidelines For Developing Countries

VOLUNTEER RESOURCES

PRENATAL CARE GUIDELINES FOR DEVELOPING COUNTRIES

Focused Prenatal Care

  • Focused four antenatal visits by skilled provider—a midwife, nurse, doctor to detect any problems
  • Birth preparedness and complications readiness planning with family
  • Detection and management of co-existing conditions and complications
  • HIV-voluntary counseling and testing
  • Counseling for breast feeding, family planning, danger signs, HIV/STIs and nutrition
  • Treatment of diagnosed infections, i.e., syphilis, gonorrhea or tuberculosis
  • Tetanus toxoid (2 doses)
  • Iron and folate-for 6 months of pregnancy, 60mg iron and 400 mg of folate, for areas with >40% anemia continue same dosage for 3 months postpartum
  • Helminth Presumptive treatment – studies shown that eradication of hookworms can reduce moderate and severe anemia by 42-56%
  • Routine testing and treatment of malaria- reduces anemia and low birth weight

 

Services Provided For Each Antenatal Care Visit

Visit Service to be provided Purpose of service Equipment/supplies needed
1st visit or registration A personal medical history is taken To diagnose pregnancy and identify any complications during previous pregnancies
Thorough physical and abdominal exam To detect and manage any co-existing condition or complication: TB, Malaria, STDS Stethoscope, speculum
Check blood pressure To identify and manage hypertension Blood pressure apparatus and stethoscope
Lab testing Test for anemia, HIV, STDs Rapid test kits, hemoglobinometer
Malaria test and treatment of positives with 1 gm chlorquine and then 500 mg the following week Treat malaria and prevent the anemia it causes. Rapid test kit and chloroquine
Urine test Test for proteinuria/albumin for pre-eclampsia and sugar for diabetes Dipsticks
Weight measured Establish baseline weight Scale
Registration of pregnant woman To effectively track the completeness of care and pregnancy outcomes Registration form/pregnancy register
First dose of Tetanus Toxoid Prevention of tetanus in newborn and mother Vaccine
Provide 3 month supply of Iron and Folate Prevention of anemia Adult Iron and folate tablets
Counsel on need for 3 ANC visits, healthy diet, need for rest and signs of an emergency To prevent and prepare for possible complications Flipcharts, teaching aids
2nd visit
(4th-6th month)
Check blood pressure Detect and manage hypertension Blood pressure apparatus and stethoscope
Do an abdominal and physical exam To detect and manage any co-existing condition or complication. Refer to expert medical care if a sign of an emergency is detected (vaginal bleeding, blurring vision with severe headache, convulsions)
Urine test Protein/albumin Dipsticks
Second dose of Tetanus Toxoid
Provide 3 additional months supply of Iron and Folate Prevent anemia Adult tablets
Review Nutrition, need for rest, signs of emergency Prevent and prepare for complications
Test and Treat for malaria if not done in 1st trimester Prevent severe anemia Rapid tests and Chloroquine
Treat for (worms) Albendazole 400 mg X 1 or mebendazole 500 mg X 1 Prevent severe anemia Albendazole
3rd visit
(8th month)
Check blood pressure Detect and manage hypertension Blood pressure apparatus
Do an abdominal and physical exam To detect and manage any co-existing condition or complication. Refer if indicated. Stethoscope and fetoscope
Provide additional Iron and folate Prevent anemia Adult tablets
Assist woman and family in developing a birth preparedness/complication readiness plan-selection of birth place, attendants To be prepared for a safe and clean delivery and in the event of an emergency Birth Kit if available

Clean sheets

Test for malaria at 32 weeks and treat positives with Cloroquine 1 gm now then 500 mg in 1 wk Prevent severe anemia Rapid tests and chloroquine
Treat for (worms) Albendazole 400 mg X 1 or mebendazole 500 mg X 1 Prevent severe anemia Stool test
4th visit
(9th month)
Check blood pressure To detect and manage hypertension Blood pressure apparatus
Do abdominal and physical exam To detect and manage any co-existing complication, Refer if indicated Stethoscope or fetoscope
Counsel on breast feeding, birth spacing, Postpartum care, newborn care To prevent unwanted pregnancies and too closely spaced pregnancies

To Prevent complications

Flipcharts, teaching aids
Review birth preparedness and complication readiness plan, meet the matrone who will attend a planned home birth To prevent any delays in case of an emergency

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