SAFE MOTHERHOOD.pptx

Safe Motherhood

1. SAFE MOTHERHOOD Lecture notes by MCO ACHEN CATHERINE DCM 2:1 2021

2. Definition Safe motherhood means that no woman and child should die or be harmed by pregnancy or birth. Safe motherhood begins with the assurance of basic safety living as a girl and a woman in society. Safe motherhood is defined as a series of initiative, practices and protocols and service delivery guideline designed to ensure that women receive high quality gynecological, family planning, prenatal, delivery and post-partum care in order to achieve optimal health for the mother, fetus and infants during pregnancy, childbirth and post-partum.

3. Note: Safe motherhood is the concept that no woman or fetus or baby should die or be harmed by pregnancy or childbirth. This is made possible by providing timely appropriate and comprehensive quality obstetric care during: Preconception Pregnancy Childbirth Puerperium

4. Components of safe motherhood Pre conception care Antenatal care Ante partum care Post-partum care Post-abortion care Emergency obstetric care/Life saving skills Care of the new born.

5. Major causes of maternal mortality In Uganda 380 per 100,000 women die of pregnancy and birth related complications which compromise mainly of; Hemorrhage Sepsis Unsafe abortion Eclampsia Obstructed labour Infection Other direct causes Indirect causes

6. Predisposing factors to maternal mortality and morbidity Early pregnancy (less than 20 years old ) Uncontrolled fertility Low social economic status of women Poverty and lack of empowerment of women Lack of access to quality services Inadequate referral systems Lack of support from spouses

7. Pillars of Safe Motherhood Family planning; to ensure that individuals and couples have the information and services to plan the timing, number and spacing of pregnancies and thus the number of unsafe abortion is controlled Antenatal care; to prevent complications where possible and ensure that complications of pregnancy are treated appropriately and very serious conditions referred within the shortest possible time. Clean/safe delivery and post natal care; to ensure that all birth attendants have the knowledge, skills and equipment to perform a clean and safe delivery and provide postpartum care to the mother and baby, all women should have access to basic maternity care during delivery. Emergency obstetric care; to ensure that essential care for high risk pregnancies and complications is made available to all women and girls who need it. It is estimated that about 15 % of all normal pregnancies end up with complications therefore the need to always be prepared for emergency obstetric care.

8. Cont’

9. The roles of community in safe motherhood The community can give support in several ways to make motherhood safer: Share the work load so that mother can avoid heavy physical work Encourage pregnant mother to eat a balanced diet and rest than usual especially during the last three months Encourage mother to take their non-pills or other medication as provided Help with looking after children so that mother can go for antenatal care an delivery in the hospital Establish transport readiness for emergency referral and obstetrical complications Encourage risk mothers to use maternity waiting areas, if advised to do so during antenatal care Creates inform and motivated community based safe motherhood groups

10. High Risk Pregnancy This is the pregnancy that is likely to end up with complication, death of the mother or baby or both and the mother must be cared for or delivered from a well-equipped health unit under doctor‘s supervision

11. Some High Risk Mothers Young primigravida age 16 below Elderly PG age 35 and above Multigravida of 5 and above Mothers who have had 3 or more miscarriages Mothers in small statures- (153cm and below) Limping mothers

12. 7. Mothers with history of pelvic fractures 8. Cephalopelvic disproportion which is compound 9. Multiple pregnancy 10. Mothers with intra uterine fetal death (IUFD) 11. PPH on previous deliveries 12. Mothers with history of retained placenta on previous delivery 13. Pre-eclampsia, eclampsia and nay mother with a history of post eclampsia toxemia 14. Mothers with cardiac or renal diseases, essential hypertension, diabetes, anemic, asthmatic, APH, Rhesus negative (medical conditions) 15. Mothers with history of instrumental deliveries 16. Mothers with history of mental illness 17. Mothers with history of premature deliveries 18. Mothers with history of 2 or more still birth

13. The Roles of a Husband in Safe Motherhood They are subdivided into: 1 During pregnancy 2 During child birth/ labour 3 After delivery 4 In family planning 5 During child rearing

14. During pregnancy To understand & appreciate the discomfort, anxiety & tiredness that pregnancy may cause in a mother Take over physically tiring tasks like working in the field, lifting heavy loads, washing and scrubbing floors to avoid any work load on a woman Take care of other children Provide encouragement and emotional supports by trying not to make demands on her and not criticizing Learn about pregnant related conditions along with the mother to enable him to help her more effectively and understand what she is going through especially danger signs in pregnancy Accompany the wife when going to the health center for antenatal care and health education Understand that good nutrition and medical care during pregnancy are important and should provide it Provide whatever money necessary to pay for transport fees, or medication Arrange to have transport ready in case of any emergency during pregnancy and post natal care.

15. During Labour /Child Birth 1. Give money, clothing, transport, etc. 2. Stay with his wife during labour and delivery to provide comfort and support

16. After Delivery Adopt to a new person (baby) in his new life and meets the baby‘s demands and needs especially breastfeeding Give the mother and the baby understanding, support, attention and help her with day to day tasks Contribute to having a healthy and happy family by ensuring that the mother is well fed and that both the mother and the baby receive medical care Should be aware of danger signs that might necessitate seeking for medical health