By sumanOn

Preventive Services for Mothers in the Prenatal Period 

The first visit irrespective of when it occurs should include: 

• Health history 

• Physical examination 

• Laboratory examination: 

Complete urine analysis 

  • Stool examination 
  • Complete blood count including Hb estimation 
  • Serological examination
  • Blood grouping and rhesus (Rh) determination
  • Chest X-ray, if needed

  • Gonorrhoea test, if needed. 

On subsequent visits: 

  • Physical examination including weight and blood pressure
  • Laboratory tests including urine examination and haemoglobin estimation 
  • Iron and folic acid supplementation and medications as needed 
  • Immunization against tetanus 
  • Group or individual teaching on nutrition, self-care, family planning, delivery and parenthood 
  • Home visiting by a female health worker or trained dai (trained traditional birth attendant) 
  • Referral services, when necessary.

Domiciliary Care:

Mothers with a normal obstetric history may be encouraged to have their babies in their own houses if the living conditions are adequate. In such instances, the Female Health Worker, Assistant Nurse Midwife, or qualified dai (trained traditional birth attendants) may perform the delivery. This is referred to as domiciliary midwifery service.  Domiciliary midwifery services are still important in India since a major portion of the population (74%) lives in rural areas where there may be no more than one physician per 20,000-30,000 people. Domiciliary outreach is an important feature of intrapartum care.

The Benefits of a Domiciliary Midwifery Service:

  • The mother gives birth in her familiar surroundings, which helps to reduce her anxiety of giving birth in a hospital.  
  • There are fewer chances of cross-infection than in a hospital/nursery. 
  • The mother can keep an eye on her children and household concerns. 
  • Her phobia of hospitals is gone, which may help to relieve her mental tension.  The financial load on the family, which would otherwise be a hardship, is minimised. 
  • The burden on hospital/health centre facilities is decreased, allowing other clients in greater need of urgent medical care to be handled effectively.

Reference:

  1. JaypeeDigital | Preventive Obstetrics and Domiciliary Care in Maternity Nursing [Internet]. [cited 2023 Oct 1]. Available from: https://www.jaypeedigital.com/book/9789351526384/chapter/ch49
  2. Preventive obstetrics [Internet]. [cited 2023 Oct 1]. Available from: https://www.slideshare.net/amandeepjhinjar1/preventive-obstetrics
  3. Scribd [Internet]. [cited 2023 Oct 1]. Preventive Obstetrics (By Mohan.s) | PDF | Pregnancy | Obstetrics. Available from: https://www.scribd.com/doc/23645527/Preventive-Obstetrics-by-mohan-s
  4. Boertien S, Franx A, Jansen DEMC, Akkermans H, de Kroon MLA. Connecting Obstetric, Maternity, Pediatric and Preventive Child Health Care: A Comparative Prospective Study Protocol. Int J Environ Res Public Health. 2022 Jun 1;19(11):6774.
  5. Spira N, Audras F, Chapel A, Debuisson E, Jacquelin J, Kirchhoffer C, et al. [Domiciliary care of pathological pregnancies by midwives. Comparative controlled study on 996 women (author’s transl)]. J Gynecol Obstet Biol Reprod (Paris). 1981;10(6):543–8.