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Department of Reproductive Health and Research (RHR), World Health Organization Managing Complications in Pregnancy and Childbirth A guide for midwives and doctors |
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Section 1 - Clinical Principles Talking with women and their families Pregnancy is typically a time of joy and anticipation. It can also be a time of anxiety and concern. Talking effectively with a woman and her family can help build the woman’s trust and confidence in her health care providers. Women who develop complications may have difficulty talking to the provider and explaining their problem. It is the responsibility of the entire health care team to speak with the woman respectfully and put her at ease. Focusing on the woman means that the health care provider and staff:
It is understandable to disagree with a woman’s risky behaviour or a decision which has resulted in a delay in seeking care. It is not acceptable, however, to show disrespect for a woman or disregard for a medical condition that is a result of her behaviour. Provide corrective counselling after the complication has been dealt with, not before or during management of the problem.
Providers should be aware of the rights of women when receiving maternity care services:
When a provider talks to a woman about her pregnancy or a complication, s/he should use basic communication techniques. These techniques help the provider establish an honest, caring and trusting relationship with the woman. If a woman trusts the provider and feels that s/he has the best interests of the woman at heart, she will be more likely to return to the facility for delivery or come early if there is a complication.
Speak in a calm, quiet manner and assure the woman that the conversation is confidential. Be sensitive to any cultural or religious considerations and respect her views. In addition, providers should:
If a woman must undergo a surgical procedure, explain to her the nature of the procedure and its risks and help to reduce her anxiety. Women who are extremely anxious have a more difficult time during surgery and recovery. For more information on providing emotional support during an emergency
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Clinical principles Rapid initial assessment Talking with women and their families Emotional and psychological support Clinical use of blood, blood products and replacement fluids Provider and community linkages Symptoms Vaginal bleeding in early pregnancy Vaginal bleeding in later pregnancy and labour Vaginal bleeding after childbirth Headache, blurred vision, convulsions or loss of consciousness, elevated blood pressure Unsatisfactory progress of Labour Malpositions and malpresentations Labour with an overdistended uterus Fever during pregnancy and labour Abdominal pain in early pregnancy Abdominal pain in later pregnancy and after childbirth Prelabour rupture of membranes Immediate newborn conditions or problems Procedures Local anaesthesia for caesaran section Spinal (subarachnoid) anaesthesia Induction and augmentation of labour Repair of vaginal and perinetal tears Uterine and utero-ovarian artery ligation Salpingectomy for ectopic pregnancuy Appendix
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The Mother and Child Health and Education Trust
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