Essential Care for Mothers and Newborns:
Pregnancy and Postpartum
Leader Mother Flipchart
Essential Care for Mothers and Newborns: Pregnancy and Postpartum
Table of Contents
Lesson 1: Antenatal Care and Dangers Signs during Pregnancy 3
Lesson 2: Preparing for Delivery and Birth 7
Lesson 3: Importance of Maternal Postpartum Care 11
Lesson 4: Newborn Care Practices 15
Lessons, stories, and activities in the Essential Care for Mothers and Newborns: Pregnancy and Postpartum Lesson Plan complements the information provided in Essential Care for Mothers and Newborns: Pregnancy and Postpartum Leader Mother Flipchart.
Acknowledgements
Many thanks to the illustrators including maitre Wabangu, Ir Léonidas Nisabwe (Burundi), and Octávio Consalves (Mozambique). Games used in the lessons are available through the HIV/AIDS Alliance. See below for full details and resources used in the development of this module.
Suggested Citation: Hanold, Mitzi J. (2011) Essential Care for Mothers and Newborns: Pregnancy and Postpartum. Washington DC. Food for the Hungry (FH), made possible through support provided by the Office of Food for Peace, Bureau of Democracy, Conflict, and Humanitarian Assistances, and the U.S. Agency for International Development under the terms AID-FFP-A-11-00007. The opinions expressed herein are those of the authors and do not necessarily reflect the view of the U.S. Agency for International Development.
Resources used in the development of this module include the following:
· Beck, Diana, et al. Care of the Newborn: Reference Manual. DC: Save the Children, 2004.
· Burns, A. August, et al. Where Women Have No Doctor. Berkley: Hesperian Foundation, 1997. Available: http://www.hesperian.org/index.php
· 100 ways to energize groups: games to use in workshops, meetings and the community. Available at www.aidsalliance.org. International HIV/AIDS Alliance, 2002.
Lesson 1: Antenatal Care and Dangers Signs during Pregnancy
Materials:
1. Attendance Registers
/ 1. Game: People to People/ 2. Attendance & Troubleshooting
3. Story: Visiting the Health Center (Picture 1.1)
Mama Mubaya sees Mama Muzuri walking along the path. “Where are you going?” Mama Mubaya asks. “I am going to the health center. The health worker will examine me to make sure the child is growing well.” Mama Muzuri says. Mama Mubaya says, “Growing well? I thought that only sick people went to the health center.”
/ 4. Ask about Current Practices
? Where is Mama Muzuri going? Why?
? Why would she go to the health center if she is not sick?
? How often did you visit the health center during your last pregnancy?
Let’s compare your ideas with the messages on the following pages.
Antenatal Care during Pregnancy (Picture 1.2)
/ 5. Share the Meaning of Each Picture? What do you think these pictures mean?
· Visit the health center at least four times during pregnancy.
o Go as soon as you know you are pregnant.
· The health worker measures the growth of the mother and child.
o If the infant is too small, she will give advice to help the infant grow.
o If the mother is too thin, she will give advice to help her gain weight.
· The health worker examines the mother for weak blood and other illnesses.
o She looks for symptoms of malaria.
o She looks for swelling in the hands and face.
· The health worker looks for problems that might cause a difficult birth.
o Poor position of the infant can put the mother at risk of death during delivery.
? Do you think spending your time visiting the health center is a wise use of your time? Why or why not?
o Visiting the health center a few times may save your life or the life of your child.
Advantages of Delivery at the Health Center (Picture 1.3)
/ 6. Share the Meaning of Each Picture? What do you think these pictures mean?
· The health center is a clean place for delivery.
o Clean beds and equipment prevent infection.
· Health workers have medicine and equipment to overcome problems during delivery.
o This woman has been in labor too long.
o The health worker gives medicine to hurry delivery.
· Health workers are able to give special care to weak or sick infants.
o This newborn is not breathing.
o They use special equipment to help the child breathe.
o If this child were born at home, he would not survive.
· Before leaving, newborns receive vaccinations to prevent illness.
o This mother is sure that she and her infant are healthy.
o She is receiving a vaccination to prevent tetanus.
? What are some other reasons why delivering at the health center is better than delivering at home?
Danger Signs during Pregnancy (Picture 1.4)
/ 7. Share the Meaning of Each Picture? What do you think these pictures mean?
· If you see any of the following danger signs, go to the health center.
· Vaginal bleeding
· Severe headaches
· Severe stomach aches
· Vomiting that won’t stop
o Even women who eat well and rest during pregnancy have difficulties.
o Don’t wait.
o Go immediately to the health center for treatment.
/ / 10. Practice and Coaching /8. Activity:
Delivery at Health Center / 9. Discuss Barriers / 11. Request Commitments
Lesson 2: Preparing for Delivery and Birth
Materials:
1. Attendance Registers
/ 1. Game: Musical Mats/ 2. Attendance and Troubleshooting
3. Story: Breaking Waters (Picture 2.1)
Mama Mubaya has decided to have her birth at the health center. She has prepared her supplies, put together food and water for after delivery, and talked with the neighbors about her plans. She is on her way to the market when a gush of water comes out of her. What is this? Is this a sign of labor?
/ 4. Ask about Current Practices
? What happened to Mama Mubaya? What does it mean?
? Should she go to the health center or wait for another sign?
? What are the signs that you should leave for the health center?
Let’s compare your ideas with the messages on the following pages.
Signs that Birth is Near (Picture 2.2)
/ 6. Share the Meaning of Each Picture? What do you think these pictures mean?
· Clear water comes out of the vagina.
o The infant is inside a bag of liquid in the mother’s belly.
o When the bag breaks, liquid comes out of the body.
· Clear or pink-colored mucus comes out of the vagina.
o The bag which holds the infant is sealed with this mucus.
o When the bag opens, the mucus comes out.
o There may also be some blood.
· Pains in the belly that are frequent, strong, and regular.
o Pains will start slowly.
o Pains will increase in number, strength, and length as time passes.
o These pains begin to open the bag that holds the infant.
· These are signs that birth is near. Go immediately to the Centre de santé.
o Do not give medicine or put anything in the woman’s vagina to hurry the birth.
Delivery at the Health Center (Picture 2.3)
/ 6. Share the Meaning of Each Picture? What do you think these pictures mean?
· To help the child come, take long deep breaths.
o The health worker will tell you when it is time to start pushing.
o It may take from sun up to sun down for your body to be ready.
o Pushing helps the infant’s head to birth.
o Never push on the outside of the woman’s body to make the infant come out.
· When the top of the head appears, take quick, slow breaths.
o This helps the head come slowly.
o If the mother pushes hard and fast, she may tear.
· After birth, quickly dry the infant’s head and body.
o Wipe the mucus from the nose and mouth.
o Dry the head and hair.
Final Stages of Delivery (Picture 2.4)
/ 7. Share the Meaning of Each Picture? What do you think these pictures mean?
· When the cord stops beating, tie it in two places.
o The cord will turn white.
o Tie it two, finger-widths away from the infant.
o Add another tie two finger-widths away.
· Cut the cord with a clean razor in between the two ties.
o Always us a new razor.
· Place the naked infant onto the mother’s naked chest. Cover them with a warm blanket.
o The mother’s body heat will warm and calm the infant.
· Breastfeed immediately to help the placenta come out.
o Never pull on the cord. It may break inside.
o The nurse will tell you when to push.
/ / 10. Practice and Coaching /8. Activity: Making A Birth Plan / 9. Discuss Barriers / 11. Request Commitments
Lesson 3: Importance of Maternal Postpartum Care
Materials:
1. Attendance Registers
2. A woman’s health card
3. Container of iron pills
/ 1. Game: I’ve Never/ 2. Attendance and Troubleshooting
3. Inkuru: Mama Mubaya Goes Back to Work (Picture 3.1)
Two days after delivery, Mama Mubaya begins her work again. In the morning, she sweeps her compound and goes to the market. In the afternoon, she begins preparing food, but she is not able to finish. She lies down and quickly falls asleep. Her son sees that her bleeding is heavy and runs for help.
/ 4. Ask about Current Practices
? Why is Mama Mubaya bleeding?
? How long should a woman rest after delivery?
? How many days did you rest after delivery?
Let’s compare your ideas with the messages on the following pages.
Maternal Care after Delivery (Picture 3.2)
/ 5. Share the Meaning of Each Picture? What do you think these pictures mean?
· Ask someone to stay with you after delivery for one week or more.
o This woman lets Mama Muzuri rest.
o She cooks for the family.
o She cares for the children.
· For six weeks after delivery rest often. Work less than normal.
o Women lose a lot of blood during delivery.
o Women who do not rest bleed more.
o Work less until your body has healed.
· Eat two additional snacks each day to gain strength after delivery.
o This mother eats beans, lentils, green leafy vegetables and organ meats, to make her blood strong.
o These foods are high in iron.
o Additional snacks help her to gain strength.
o She drinks more water than normal to bring breast milk.
? Is it difficult to rest after delivery?
? Who can help the mother complete her work after delivery?
? What advice would you give to a new mother about resting after delivery?
Services after Delivery at the Health Center (Picture 3.3)
/ 6. Share the Meaning of Each Picture? What do you think these pictures mean?
· Take iron pills each day for three months after giving birth.
o Take iron pills with food.
o Iron helps to make the mother’s blood strong.
o Iron gives energy and strength to the mother.
· Receive Vitamin A in the first six weeks after giving birth.
o The mother receives a drop of Vitamin A during her visit.
o Vitamin A helps to restore the mother’s health.
o Vitamin A in the mother’s breast milk helps the infant to resist sickness.
· Receive a tetanus vaccination if your card is not complete.
o Tetanus causes lockjaw and painful convulsions.
o Vaccinated mothers are protected from germs that may have entered the body during delivery.
o Breastfeeding infants are protected by drinking their mother’s milk.
? How many of you are taking iron pills?
? How many of you have already received vitamin A?
? Why are these services important?
Danger Signs after Delivery (Picture 3.4)
/ 7. Share the Meaning of Each Picture? What do you think these pictures mean?
· If you see any of these signs, go immediately to the health center.
· Fever
· Sharp pains in the belly
o These are signs of infection inside the belly.
o Many women die from untreated infections after delivery.
· Heavy bleeding or bleeding that doesn’t stop after two weeks.
· Urine or feces leaking from the body.
o If you see one of these signs, do not wait. Go to the health center.
? How does a woman know if her bleeding is heavy? What is the normal amount of bleeding after delivery?
? Why is it important to go immediately to the clinic?
/ / 10. Practice and Coaching /8. Activity:
Care after Delivery / 9. Discuss Barriers / 11. Request Commitments
Lesson 4: Newborn Care Practices
Materials:
1. Attendance Registers
/ 1. Game: Rainstorm/ 2. Attendance and Troubleshooting
3. Story: Washing Furaha (Picture 4.1)
Mama Muzuri gave birth to a girl a few days ago. She was named Furaha. After she returned from the clinic she rested at her mother’s house. She kept her child close to her body to keep her warm. Mama Muzuri’s mother says, “Let me bathe her in this basin.” “Not yet,” says Mama Muzuri. We must wait until her umbilical cord heals. If she sits in dirty water, it will bring sickness and infection.”
/ 4. Ask about Current Practices
? How did Mama Muzuri care for her infant after birth?
? Why did Mama Muzuri ask her mother to wait? Is this good advice?
? How and when did you bathe your infant after birth?
Let’s compare your ideas with the messages on the following pages.
Washing the Newborn (Picture 4.2)