Pregnancy care consists of Antenatal (before birth), delivery (child birth) and postpartum (after birth) healthcare. It includes consultation and treatment to ensure a healthy process for mother and child.
The primary objective of antenatal care is to establish contact with the women and manage potential risks and problems. This creates the opportunity for the woman and her health care provider to establish a delivery plan based on her unique needs, resources and circumstances. The delivery plan identifies her intentions about where and with whom she intends to give birth and contingency plans in the event of complications (transport, place of referral, etc.).At least four antenatal visits are recommended, ideally with the first visit early in the pregnancy. This number may vary based on national policies. Appropriate antenatal care should include:
- Low basic obstetric emergency and newborn care coverage
- Poor involvement of communities in maternal and newborn care
- Limited provincial commitment of resources for maternal and newborn health care
Even with the best possible antenatal screening, any delivery can become a complicated one requiring emergency intervention. Therefore, skilled assistance is essential in delivery care. In the absence of midwives or nurses, TBAs (who usually perform home deliveries, often as a source of income) should be trained to identify complications, provide immediate first aid, and know when and where to refer women for additional care. It should also be remembered that:
The first priority for a delivery is to be safe, atraumatic and clean; and
Most maternal deaths are due to a failure to get skilled help in time for delivery complications.
The health and wellbeing of newborn should also be assessed with its birth weight measured. Newborns should be referred to the static center for immunizations, growth monitoring and other well-child services.
Lady Health Visitors, Female Medical Technicians and Community Midwives (LHVs/FMTs/CMWs) Lady Health Workers (LHW) and TBAs should be trained for appropriate referral of postpartum complications, such as hemorrhage, sepsis, perineal trauma, breast feeding problems, and newborn complications, such as prematurity or failure to thrive, that may require additional surveillance and/ or treatment.