Regular antenatal care eases delivery

Background. Amudat District borders Moroto District in the North and Kenya to the East. It was carved out of Nakapiripirit District in 2010. File photo

What you need to know:

The traditional pattern for antenatal care was laid out in the early 20th Century with monthly visits until 28 weeks’ gestation, visits every two weeks until 36 weeks and weekly visits until delivery.

Antenatal care refers to care given to a mother during pregnancy. It comes after preconception counselling or check up.

In Uganda, a pregnant woman is scheduled to visit the doctor at least four times. This is termed as focused or oriented antenatal care.

The main aim of antenatal care is to have a healthy mother and baby at the end of the pregnancy. Antenatal care is a risk assessment exercise identifying from the patient’s history and from physical examination whether there are any factors which may have an adverse effect on the patient or her foetus during the pregnancy and the correction of these problems.

The traditional pattern for antenatal care was laid out in the early 20th Century with monthly visits until 28 weeks’ gestation, visits every two weeks until 36 weeks and weekly visits until delivery.

This entails 12 to 14 visits per pregnancy and is probably more than necessary to enable detection of the major complications of pregnancy such as hypertension and foetal growth restriction. The usual aim is to have the booking visit early in the pregnancy – if possible in the first trimester - to enable advice to be given on diet, smoking, alcohol, and medication, much of which might be more appropriately dealt with under pre-conceptual counselling.

The main objectives of antenatal care are:
Prevention and treatment of any complications that may arise during pregnancy
Emergency preparedness for the couple
Birth planning: when and where to give birth from, signs and symptoms to watch out for to know that labour has started, what to carry to the delivery room.

Satisfying any unmet nutritional, social, emotional, and physical needs of the pregnant woman
Provision of patient education, including successful care and nutrition of the newborn

Identification of high-risk pregnancy and planning for an appropriate care, for example an unborn child with physical abnormalities detected on ultrasound during pregnancy may need surgery at birth and that may require extensive arrangement and preparation during pregnancy
Encouragement of (male) partner involvement in antenatal care. Where women are dependent on their husbands, it is easier for him to support her if he understands why she needs this support. Where men are more educated, they can explain the health education given at the health centre.

Women are encouraged to bring their partners or a family member to at least one visit. If she does not deliver by 41 weeks of gestation she should return to hospital immediately for induction of labour or operative delivery, depending on her doctor’s assessment at the time.

The writer is an obstetrician and gynaecologist with St Paul Medical Centre, Ntinda, Kampala.