Philosophy
- Pregnancy, labor and delivery and puerperium are part of the continuum of the total life cycle
- Personal, cultural and religious attitudes and beliefs influence the meaning of pregnancy for individuals and make each experience unique
- MCN is FAMILY CENTERED- the father is as important as the mother
Goals
- To ensure that expectant mother and nursing mother maintain good health, learn the art of child care, has a normal delivery and bear healthy children
- That every child lives and grows up in a family unit with love and security, in healthy surroundings, receives adequate nourishment, health supervision and efficient medical attention and is taught the elements of healthy living
Classification of pregnant women
- Normal – healthy pregnancy
- With mild complications- frequent home visits
- With serious or potentially serious complication – referred to most skilled source of medical and hospital care
Home Based Mother’s Record (HBMR)
- Tool used when rendering prenatal care containing risk factors and danger signs
Risk Factors
- 145 cm tall (4 ft & 9 inches)
- Below 18 yrs old, above 35 yrs old
- Have had 4 pregnancies
- With TB, goiter, heart disease, DM, bronchial asthma, severe anemia
- Last baby born was less than 2 years ago
- Previous cesarian section delivery
- History of 2 or more abortions, difficult delivery, given birth to twins, 2 or more babies born before EDD, stillbirth
- Weighs less than 45 kgs. or more than 80 kgs.
Danger Signs
- any type of vaginal bleeding
- headache, dizziness, blurred vision
- puffiness of face and hands
- pallor
Prenatal Care
Schedule of Visits
- 1st – as early as pregnancy, 1st trimester
- 2nd – 2nd trimester
- 3rd & subsequent visits – 3rd trimester
- More frequent visits for those at risk with complications
Tetanus Toxiod Immunization Schedule for Women
| Vaccine | Minimum Age Interval | Percent Protected | Duration of Protection |
| TT1 | As early as possible during pregnancy | 0% | None |
| TT2 | At least 4 weeks later | 80% | Infants born to the mother will be protected from neonatal tetanus. Gives 3 years protection for the mother from the tetanus. |
| TT3 | At least 6 months later | 90% | Infants born to the mother will be protected from neonatal tetanus.
Gives 5 years protection for the mother. |
| TT4 | At least 1 year later | 99% | Gives 10 years protection for the mother |
| TT5 | At least 1 year later | 99% | Gives lifetime protection for the mothers. All Infants born to that mother will be protected. |
Dose: 0.5ml
Route: Intramuscular
Site: Right or Left Deltoid/Buttocks
Components of Prenatal Visits
- History – taking
- Determination of obstetrical score- G, P, TPAL, AOG, EDD
- U/A for Proteinuria, glycosuria and infxtn
- Dental exam
- Wt. Ht. BP taking
- Exam of conjunctiva and palms for pallor
- Abdominal exam – fundic ht, Leopold’s maneuver and FHT
- Exam of breasts, face, hands and feet for edema and neck for thyroid enlargement
- Health teachings- nutrition, personal hygiene, common complaints
- Tetanus toxoid immunization
- Iron supplementation – from 5th mo. Of pregnancy – 2 mos. Postpartum
- In goiter endemic areas – iodized capsule once a year
- In malaria infested areas- prophylactic Chloroquine (150 mg/tab ) 2 tabs/ wk for the whole duration of pregnancy