Why you should not miss antenatal visits
A health worker sits with a mother and her new born babies. Pregnant mothers are encouraged to attend antenatal services. File Photo.
Good care during pregnancy is important for the health of the mother and the development of the unborn baby. This is a key period to promote healthy behaviours and parenting skills.
Antenatal care is considered the link between an expectant mother, her unborn child, and the health system.
It is, therefore, important that every expectant mother attends antenatal classes.
However despite the importance associated with attending antenatal services, some women still miss out on this crucial engagement with the midwife or doctor.
This was the case with Phyllis Nsiime, a first-time mother.
“I knew about my pregnancy at four months old, after undergoing a test. The doctor advised me on a number of things to follow to have a safe pregnancy. He asked me to start attending antenatal as soon as possible but I did not see the importance,” says Nsiime.
She adds: “I bought iron supplements, took calcium drugs and I knew the baby and I were safe. However I used to experience morning sickness, lack of appetite and at some point, I lost weight but I knew these were normal stages in pregnanc.”
Nsiime, however never went for an ultra sound scan to check on the progress and sex of the baby.
She says she did not have the money.
However when she reached the third trimester (a pregnancy period between seven to nine months), her legs started to swell, and the skin became pale and she started feeling lazy. Nsiime says when contractions started, she had no idea she was due.
“My water broke when I was not prepared with anything. I called a friend and told her what had happened, and she told me it was time to deliver,” Nsiime narrates.
At the hospital, the doctor asked for Nsiime’s medical history form before taking her to the labour suite, but she had none.
“That was the moment I regretted not attending antenatal. When they examined the baby, they said I had put myself and the baby at great risk and that the baby was too big for me to have a normal delivery. I did not opt for a caesarian because I was determined to push and I gave birth to a four kilogramme baby girl,”says Nsiime.
Despite having a normal delivery, Nsiime developed a big tear, which she is treating to date.
Antenatal is not only an opportunity to promote the use of skilled attendance at birth and healthy behaviours such as breastfeeding, but also early postnatal care, and planning for optimal pregnancy spacing. Many of these opportunities continue to be missed, even though several pregnant women receive at least one antenatal visit.
According to Dr Hawa Nakanwagi of Mukwaya General Hospital, a good delivery process starts right from the time a mother learns about her pregnancy and starts to attend antenatal classes.
“These classes are essential as they help a mother to prepare for labour, a positive birth experience and parenthood without fear and complications,”says Dr Nakanwagi.
“We have a package called focused antenatal care that helps to achieve a full life-saving potential for women and their babies. This package is a four- visit appointment, where essential evidence based interventions, including identification and management of obstetric complications such as pre-eclampsia, tetanus toxoid immunisation, intermittent preventive treatment for malaria during pregnancy and identification and management of infections including HIV/Aids are provided, says Dr Nakanwagi.
Women who have been subject to female genital mutilation are more likely to have complications during childbirth, thus they are encouraged to attend all the antenatal visits. Also women who face domestic violence and exposure to workplace hazards should never miss these classes.
“There are a number of topics that are covered during antenatal. Some topics concentrate purely on physical and emotional preparation for labour and birth, while others provide a more rounded course for pregnant women and their birth partners,”says Kabahemba.
The classes also educate mothers on their developing baby, the changes the mothers go through during and after delivery, how to care for the baby and providing information on the right diet for mothers and their babies.
According to Lillian Kabahemba, a midwife at Mukwaya General Hospital, there are certain circumstances when expectant mothers should not wait to go for antenatal appointments.
“When a mother experiences a severe headache, vaginal bleeding and when they do not feel the baby’s movement especially from four months onwards,”says Kabahemba.
Expectant mothers who get involved in accidents should also visit a doctor as soon as possible. The time frame for antenatal check-ups normally differs from one mother to another depending on the mother’s physical health.
High risk mothers including those living with HIV/Aids, those who are diabetic, or those who have high blood pressure are usually given weekly appointments with their doctors.
