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Every pregnancy deserves attention, as there is always a risk of something going wrong. Many dangers can be avoided if the woman goes to a health centre or to a skilled birth attendant when she first suspects she is pregnant. She should then have at least four check-ups throughout each pregnancy and also be checked during the 12 hours following each delivery and six weeks after each birth.
If there is bleeding or abdominal pain during pregnancy or any of the warning signs listed above, a health worker or a skilled birth attendant should be consulted immediately.
Having a skilled birth attendant assist at the delivery in a health facility and check on the mother in the 12 hours after delivery reduces the likelihood of either the mother or the baby becoming ill or dying.
A skilled birth attendant (such as a doctor, nurse or trained midwife) will help ensure a safer pregnancy and healthy baby by:
- checking the progress of the pregnancy so that if problems arise the woman can be moved to a hospital for the birth
- checking for high blood pressure, which can be dangerous to both mother and child
- checking for anaemia and providing iron/folate supplements regularly
- prescribing an adequate dosage of vitamin A to protect the mother and her newborn baby against infection (in vitamin A deficient areas)
- checking any infections during pregnancy, especially urinary tract infections and sexually transmitted infections, and treating them with antibiotics
- giving the pregnant woman two injections to protect her and her newborn baby against tetanus
- encouraging all pregnant women to use only iodized salt in food preparation, to help protect them from goitre and their children from future mental and physical disabilities
- checking that the foetus is growing properly
- giving antimalarial tablets, if necessary
- preparing the mother for the experience of childbirth and giving advice on breastfeeding and caring for herself and her newborn
- advising the pregnant woman and her family on where the birth should take place and how to get help if problems arise during childbirth or immediately after delivery
- advising on how to avoid sexually transmitted infections
- providing voluntary and confidential HIV testing and counselling. All women have the right to voluntary and confidential HIV testing and counselling. Pregnant women or new mothers who are infected, or suspect that they may be infected, should consult a trained health worker for counselling on how to reduce the risk of infecting their infants and how to care for themselves.
During delivery, the skilled attendant knows:
- when labour has gone on for too long (over 12 hours) and when a move to a hospital is necessary
- when medical help is required and how to obtain it
- how to reduce the risk of infection (clean hands, clean instruments and a clean delivery area)
- what to do if the baby is in the wrong position
- what to do if the mother is losing too much blood
- when to cut the umbilical cord and how to care for it
- what to do if the baby does not begin breathing right away
- how to dry the baby and keep her or him warm after delivery
- how to guide the baby to breastfeed immediately after delivery
- how to deliver the afterbirth safely and care for the mother after the baby is born
- how to put recommended drops in the baby's eyes to prevent blindness.
After delivery, the skilled attendant should:
- check on the woman's health in the 12 hours after birth and six weeks after delivery
- advise women on how to prevent or postpone another birth
- advise women on how to avoid sexually transmitted infections such as HIV or how to reduce the risk of infecting their infants.
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