Definition of ANC
Ø This is a preventive care plan for pregnant women and their unborn babies.
Ø It looks at healthy behaviours during pregnancy and the warning signs during labor and childbirth.
Ø It also focuses on creating an environment for social, emotional and psychological support for the woman at this critical time.
HOW DOES PREGNANCY OCCUR?
Ø An egg is released from a woman’s ovaries once every month and if the conditions are right, the egg combines with a sperm from the male counterpart, combine into a process called fertilization, which takes place in the fallopian tube inside a woman’s reproductive health system.
Ø After fertilisation, the formed zygote implants in the uterine walls of the woman, becomes and embryo and the process of cell division and growth starts. This takes about 4-6 weeks after fertilization
Trimesters in Pregnancy
1-12 weeks– 1-3 months
13-28 weeks – 4- 6 months
28- 40 weeks - 7-9 months
Expected changes per trimester
Ø1st trimester; On the mother.
Cravings and mood swings, weight gain
Tender, swollen breasts
Nausea with/out vomiting
Fatigue and heartburn
Reduced focus and forgetfulness
Nausea and weight gain
Increased weight and stretch marks
Darkened areola, skin and neck.
Tired and uncomfortable
Back pain and discomfort
Emotional highs and lows
Shortness of breadth
Increased swelling of limbs
Fluid leakage from the breast and firmer nipples
ANC Services in KE context
Ø Hiv counselling and testing
ØART initiation and PMTCT care
ØRPR screening and testing
Ø Prevention of T.T through immunization schedule ( 1st as soon as possible and 2nd 4 weeks after 1st and 2 weeks before due date.)
Ø Micronutrient supplementation- IFAs
Ø Blood pressure monitoring – r/o pre eclampsia
Ø Blood sugar monitoring – r/o pregnancy induced DM
Ø ITN provision
Ø Malaria prophylaxis
Ø Health education( breast care, UTIs and STIs, hygiene, b/feeding and cravings)
ANC Recommended visits.
Minimum of up to 8 visits with your HCP for a positive experience. This helps in reducing stillbirths and maternal mortality compared to short visits to the HCP clinic. Improves detection of anomalies early.
1st contact; 0-12 weeks 5th contact; 34 weeks
2nd contact; 20 weeks 6th contact; 36 weeks
3rd contact; 26 weeks 7th contact; 38 weeks
4th contact; 30 weeks 8th contact; 40weeks
U/sound; 1 before 24 weeks gestation. An additional one can be done towards end of pregnancy.