Maternal Health Lesson Plan

***Ask participants their knowledge concerning Pre-natal Care. Place information received on
any surface that can be seen by entire audience. During Health Lesson, review information on
the board, verify and/or correct preconceived notions. Use posters when appropriate.***

Pregnancy:

How should women stay healthy during pregnancy?

1. All pregnant women should eat enough to gain weight regularly.
2. Pregnant women should eat well, eating foods rich in proteins, vitamins, and minerals
3. Use iodized salt to increase the chances that the child will be born alive and will not be
retarded.
4. Keep clean. Bath and clean your teeth daily
5. It is best to avoid sexual contact to keep from breaking the bag of water and causing an
infection
6. Avoid taking medicine if at all possible, unless directly prescribed by a health worker.
7. Do not smoke or drink during pregnancy
8. Stay far away from children with measles
9. Try to continue to work and get exercise, but do not get too tired

Danger signs during pregnancy include the following:

1. Bleeding. This could be a sign of a miscarriage. Look for medical help immediately
2. Severe anemia.
a. If the woman is weak, tired and has pale or transparent skin, she might die from
blood loss at childbirth. Seek medical help.
3. Swelling of the feet, hands, and face, with a headache, dizziness and sometimes blurred
vision are signs of poisoning of pregnancy. Seek medical help.

Pre-natal Care:
It is a good idea to have regular pre-natal checkups. The following is the ideal timeline:
1. Once a month for the first 6 months of pregnancy
2. Twice a month during months 7 and 8
3. Once a week during the last month of pregnancy

At the prenatal visits, both the matron and the pregnant woman should discuss:
1. Sharing Information
a. How many pregnancies has the woman had?
b. When did she last give birth?
c. Has she had any problems with previous childbirths? If so, what?
d. Discuss ways of helping the pregnant woman and her baby
i. Eat right
ii. Stay clean
iii. Do not smoke or drink alcohol
 iv. Exercise and rest
v. Get Tetanus Vaccination
2. Nutrition
a. Does the mother look well nourished? Is she anemic?
b. Is she getting enough minerals in her diet? If not, will iron pills help?
c. Is she gaining weight normally
3. Signs of Danger and Special Risk
a. Take the mothers pulse each visit
b. Weigh her
c. Be aware of the following danger signs, and if they occur, seek medical help
immediately:
i. Sudden weight gain
ii. Swelling of hands and face
iii. Marked increase in blood pressure
iv. Severe bleeding
v. Any bleeding
vi. If regular labor pains begin more than 3 weeks before the baby is expected
vii. If the woman is suffering from chronic or acute illness
viii. If she is under 15, over 40, or over 35 at her first pregnancy
ix. If she has had more than 5 or 6 babies
x. If she is especially short or has narrow hips
xi. If she has diabetes or heart trouble
xii. Is she has a hernia
xiii. If it appears to be that she will have twins
xiv. If the baby is not in a normal position
xv. It water breaks but labor does not begin within a few hours
xvi. If the baby is not born 2 weeks after 9 months of pregnancy

4. Check the position of the baby

a. Each visit, write down how many finger widths the womb is above or below the
navel. If the womb seems to big or grows to fast, it may mean the woman is
having twins.
b. If the baby appears to be lying sideways, the mother should go to a doctor before
labor begins, because an operation might be needed.
5. Check for the Baby’s heartbeat after 5 months
a. A baby’s heart beats about twice as fast as an adults.
i. If one has a watch, count the baby’s heartbeat. From 120 to 160 beats per
minute is normal. If it less than 120, something is wrong.
6. Prepare the mother for birth
a. Ask her how long labor lasted with her previous children, if applicable.
b. Did she have any problems?
c. Tell her to rest more as the birth approaches
d. Possible practice deep slow breathing
7. If there is any suspicion that the labor might result in problems, seek medical advice from
a hospital or a major health center
8. Keep Records when possible of each visit
Things a Mother Should Have Before Giving Birth:
1. A lot of very clean cloths or rags
2. Any soap
3. A clean scrub brush for cleaning the hands and fingernails
4. Alcohol for rubbing hands after washing them
5. Clean cotton
6. A new razor blade
7. Sterile gauze or patches thoroughly cleaned cloth for covering the navel
8. Two ribbons or strips of clean cloth for tying the cord
a. Both patches and ribbons should be wrapped and sealed in paper packets and then
baked in an oven or ironed

Care of the Baby at Birth:

Immediately after the baby comes out
1. Put the babies head down so that the mucus comes out of his mouth and throat. Keep it
this way until he begins to breathe.
2. Keep the baby below the level of the mother until the cord is tied. (This way the baby
gets more blood and will be stronger).
3. If the baby does not begin to breathe right away, rub his back and neck with a towel or
cloth
4. If he still does not breathe, clean the mucus out of his nose and mouth with a suction bulb
or a clean cloth wrapped around your finger
5. If the baby has not begun to breathe after 1 minute after birth, start MOUTH-TO-
MOUTH immediately
6. Wrap the baby in a clean cloth. It is very important not to let him get cold, especially if
he is premature.

How to Cut the Cord:

1. When the child is born, the cord pulses and is fat and blue. WAIT.
2. After a while, the cord becomes thin and white. It stops pulsing.
3. Now tie the cord in 2 places with very clean dry strips of cloth, string or ribbon.
a. These should have been recently heated or ironed.
4. Cut between the ties
a. Cut the cord with a new clean, unused razor. Before unwrapping it, wash your
hand well or wear gloves. If a razor blade is not available, use freshly boiled
scissors.
b. Always cut the cord close to the body of the newborn baby. Leave about only 2
centimeters attached to the baby. This helps prevent tetanus.
5. Keep the cord stump clean and dry.
a. Always wash your hands before touching the cord stump
b. If the cord becomes dirty, or has a lot of dried blood on it, clean it gently with
alcohol. Do not put anything else on the cord
c. The stump usually falls off 5 to 7 days after birth.
Cleaning the Newborn Baby:
1. With a warm, soft, damp cloth, gently clean away any blood or fluid
2. After the cord falls off, then bathe the baby daily in warm water, using a mild soap

Put the Newborn Baby to the Mother’s Breast at Once:

1. If the baby nurses, this will help make the afterbirth come out sooner and to prevent or
control heavy bleeding

The Delivery of the Placenta (Afterbirth):

1. Normally the placenta comes out 5 minutes to an hour after the baby is born, but
sometimes it is delayed for hours.
2. When the afterbirth comes out, exam it and see if it is complete.
a. If it is torn, or seems to be missing pieces, get medical help immediately. A piece
of placenta inside the womb can cause infection and continued bleeding

Dangerous Signs During Birth:

1. If any of the following actions occur during birth, seek medical attention immediately:
a. Hemorrhaging (Heavy Bleeding)
b. Breach Deliveries
c. Tearing of the Birth Opening
d. Presentation of an Arm
e. Cord is Wrapped Around the Baby’s Neck
f. Feces in the Baby’s Mouth and Nose
g. Twins

Dangerous Problems that Result after the Baby is Born (in the first days or weeks):
1. If any of the following occur, seek medical attention immediately:
a. Pus or a bad smell from the navel (cord)
b. Either low temperature or high fever
c. Fits (convulsions)
d. The baby does not gain weight
e. Vomiting
f. The baby stops sucking well
g. Dehydration

***Ask participants to share any stories they might have concerning Pre-natal Care. Then ask
others to comment on the stories. Facilitate the discussion by directing participants through
highlighting key factors contributing to the acquisition, transmission, signs and treatment of Pre-
natal Care.***
Useful Facts:

A) In 1999, 82% of population had At Least 1 Visit to discuss Antenatal Care in

Senegal
1. 64% of population had At Least 4 Visits to discuss Antenatal Care in
Senegal
B) In 2000, 58% of births were attended by skilled health personnel in Senegal