There is a need to control, change the
medication, complications' assessment in many diseases prior to pregnancy. Lack
of attention to disease increases the mortality rate of maternal / fetal /
neonatal
Diseases and conditions affecting pregnancy and
need paying attention at the time before pregnancy are as following: heart disease, diabetes, lupus, rheumatoid
arthritis, mental disorders, anemia, thalassemia, epilepsy, hypertension,
tuberculosis, thyroid disease, Consumers
of alcohol, tobacco and drugs, symptomatic vaginal infections, body mass index
greater than 25 and less than 18/5, eating disorders, poly cystic ovary syndrome
Self-care actions before
pregnancy
Refer to health centers for medical
examination and Midwifery
Preliminary tests in order to identify some
of the problems before pregnancy
Doing Papsmear
Consuming folic acid supplements for at least
3 months before pregnancy
Consultation with doctor about any possible
disease before pregnancy
If the pre-pregnancy result is abnormal,
follow-up should be done by a doctor to treat or control the disease.
The importance of prenatal care
Prenatal care includes a series of steps in
which a periodic examination, testing and preclinical studies are offered to
mothers also maternal education and her family education will be performed.Recognizing the danger
signs, Timely referral for treatment and preparing mother for delivery is the
purpose of these practices which prevent obstetric complications in the mother,
fetus and newborn and finally leads to a lower mortality rate
Self-care actions during
pregnancy
Timely referral for pregnancy diagnosis, one
to two weeks after cessation of menstruation
Referring to physician, midwife or health
care centers at the specified time for routine pregnancy care
Usually a normal pregnancy lasts 40 weeks. Necessary
care should be offered to mother 8 times in this period (two times in the first
20 weeks and 6 times in the second 20 weeks of pregnancy).
Meeting times are as follow:
First time: visiting in one of the 6 to 10 weeks of the pregnancy
Second time: visiting in one of the 16 to 20
weeks of the pregnancy
Third time: visiting in one of the 26 to 30
weeks of the pregnancy
Fourth time: visiting in one of the 31 to 34
weeks of the pregnancy Fifth time: visiting in one of the 35 to 37
weeks of the pregnancy
Sixth time: visiting in 38th week of the
pregnancy
Seventh time: visiting in 39th week of the
pregnancy
Eighth time: visiting in 40th week of the
pregnancy
Note: According to the mother situation and
doctor or midwife orders the number of the visits may change.
Screening tests for fetal abnormalities in
pregnancy
Routine pregnancy and ultrasound tests in
pregnancy
Daily consumption of 400 micrograms of folic
acid until the end of pregnancy (The pills are recommended 3 months before
pregnancy.)
Iron supplementation one tablet daily from 16
weeks of pregnancy to three months postpartum, one tablet daily
Taking one multivitamin tablet or capsule
daily from sixteenth week until the end of pregnancy (no more folic acid is
needed if the multivitamin tablet contains 400 micrograms of it)
Note:
Before taking multivitamin pills, check the available amount of vitamin A with
your doctor or midwife, since the excessive amounts will be harmful in
pregnancy
Participating in childbirth Preparation
classes from 20 weeks of pregnancy
Paying attention to the danger signs in
pregnancy, once encountering any of the following symptoms, you should
immediately go to hospital or medical centers:
Bleeding or spotting- Reduction or absence of
fetal movement- Sudden runny or getting wet- Unilateral swelling and joint pain
of the legs and thighs- Abdominal and flank pain or heart pain- Burning or pain
when urinating- Persistent and severe vomiting or bloody- Fever and chill- Shortness
of breath and palpitations- Swelling of hands, face or the whole body- Headache
and blurred vision- Sudden weight gain- Infections, abscesses and tooth pain
Common complaints during pregnancy and postpartum
First half of the pregnancy
1- Breasts become Painful and sensitive
**Cold compresses relieves this problem
** These conditions are not harmful for mother and merely because the
body adapts itself to changes occurring during pregnancy and gradually improved.
** In the absence of gradual improvement for
any of the common complaints, it is necessary to visit your doctor or refer to
a health unit
2- Frequent urination
**This is due to the increased volume of the
uterus and consequently pressure on the bladder, this happened and we should
make mother sure that this problem will be solved in the second Trimester
3- Fatigue
** Fatigue
is caused by hormonal and physiological changes and intermittent rest during
the day will be helpful
4- Morning sickness
** Morning sickness is caused by hormonal changes which can be
improved using dry biscuits or bread and changes in dietary patterns
5- Increased saliva
** Increased saliva is improved by limiting some starchy diets
6- Increased vaginal discharge
**Increased vaginal discharge is caused by
hormonal and physiological changes and fungal infections can be prevented by
constantly changes in underwear
7- Changes in mood and behavior
**Changing in mood is the result of hormonal
changes and family support is very useful in Acceptance of the current
situation
8- Hyperemesis gravidarum** it is the result of hormonal and physiological
changes in gastrointestinal as well as psychological effects of pregnancy which
can be improved by using suitable nutritional patterns and usually it will
resolve spontaneously in the second trimester of pregnancy.
Second half of pregnancy
1-Skin toning of the certain parts of the body
like some areas around the breasts and navel
**These variations are caused by hormonal
changes and will improve after pregnancy
2- Constipation and bloating
** Constipation and bloating are caused by hormonal changes and slow
gastrointestinal motility which can be improved by modifying nutrition pattern,
using fiber and laxative foods as well as doing mild exercise movements
3- Increased vaginal discharge
**Increased vaginal discharge is caused by
hormonal and physiological changes and fungal infections can be prevented by
constantly changes in underwear
4- Back pain
**Back pain is caused by enlargement of the
abdomen, uterine pressure on the spine and stretching of muscles and ligaments
around the spine and pelvis
5- Heartburn
** Heartburn caused by hormonal changes, delay in digestion as well
as uterine pressure on the stomach. by modifying Food consumption pattern, Sleeping in a semi-sitting
position, Increased meal
frequency and reducing the size of the
meals as well as Limiting stimuli foods such as coffee, spices and tea
6- Frequent urination
** Frequent urination caused by enlargement of the uterus and fetus
descent into the pelvis resulting
in increased pressure on the bladder and reducing its volume. It will improve after delivery.
The importance of postnatal care
Many mothers are at the risk of infection,
bleeding and high blood pressure after delivery Therefore it is essential for mother to visit doctor after
delivery at the designated time in order to ensure her health and her baby
health
Postpartum self-care actions
Refer at the following times to health
centers, doctors or midwife for postpartum cares
Referral time:
The first visit: The first three days
The second visit: Ten to fifteen days after
delivery
The third visit: forty two to sixty days
after delivery
Note: According to the mother situation and
doctor or midwife orders the number of the visits may change.Paying attention to the danger signs after
delivery, once encountering any of the following symptoms you should
immediately go to hospital or medical centers:
Excessive menstrual bleeding during the first
week- Pain and burning and discharge at the site of sutures- pain in abdomen
and flanks- Severe depression- Postpartum insanity- Burning or pain during
urination- purulent and malodorous discharge from vagina- Breast pain, swelling
and stiffness- ague- Unilateral swelling and joint pain of the legs and thighs- dyspnea- palpitations- vertigo- headache that does not improve with sedatives
Paying attention to individual health and having
sanitary sutures:
Frequent replacement of sanitary pads and
underwear, if your delivery
was in vaginal form: Daily
washing of the genital area, sitting in warm water, Using a hair dryer or heat
lamp covered with cloth (For faster healing of sutures) and if your delivery
was in cesarean form: Daily dressing of sutures, If there is redness and pain
in the operated area, you should go to health centers.
Daily taking of a multivitamin and Iron
tablet within 3 months after delivery
Safe delivery
Delivery in a safe place
by a skilled person (hospitals- medical centers- delivery facilities) is essential
It is necessary for a pregnant woman to refer
to the nearest health center as soon as encountered delivery signs like; plasma
discharge, rupture of membrane and regular
muscle pain in abdomen and back.