ASSESSING THE KNOWLEDGE OF PREGNANT WOMEN ON THE NUTRITIONAL REQUIREMENT DURING PREGNANCY.

A CASE STUDY AT THE NEW JUABENG MUNICIPALITY

Godfred Kwame Abledu1*

Debora Akan2 Esenam Akou Ahoe3
1. School of Applied Science and Technology, Koforidua Polytechnic, PO Box 981, Koforidua, Ghana * E-mail of the corresponding author: godfredabledu@gmail.com (Tel: 233-244705093) 2. Hospitality Department, School of Applied Science and Technology, Koforidua Polytechnic, PO Box 981, Koforidua, Ghana 3. Hospitality Department, School of Applied Science and Technology, Koforidua Polytechnic, PO Box 981, Koforidua, Ghana

1.1. Background of the Study The demand for both energy and nutrients is increased during pregnancy. For well-nourished women, only a small amount of additional energy is required because the body adapts to the increased energy requirements and becomes more energy efficient through reduced physical activity and a lowered metabolic rate. Although the average-sized, well-nourished woman requires about 10460 kJ/d (2000 kcal/d) during the last trimester of pregnancy, many women in developing countries restrict their food intake during pregnancy to have smaller infants, with the idea that smaller infants will carry a lower risk of delivery complications.

According to http://intl.ajcn.org, recent evidence suggests, however, that infants who are small or disproportionate at birth have increased health risks later in life. The hypothesis is that such

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infants have had to adapt to a limited supply of nutrients and that in so doing, their physiology and metabolism are permanently changed, although the rational for this hypothesis has been challenged.

Requirements for many, but not all, micronutrients increase during pregnancy. Deficiencies can exist because of losses or malabsorption associated with disease or inadequate intakes, lack of knowledge about adequate prenatal nutrition, or dietary taboos associated with pregnancy, with potential adverse consequences for both mothers and newborn infants. Anemia in pregnancy and pregnancy-induced hypertension is common and are thought to contribute significantly to maternal mortality and morbidity in developing countries.

1.2. Statement of the Problem

The food that a pregnant woman eats are the main source of the nutrients for the baby. But what foods should pregnant women eat? What foods a pregnant woman should avoid? It is important for pregnant women to understand what kind of food is best for them and their baby. According to Hansjörg et al (1988) nutrition during pregnancy is important. Pregnant women's food has an effect on the pregnancy, on the fetal development and also on the health of the mother and child.

In the first half of pregnancy, nutritional requirements mainly concern quality, while in the second half; quantity is also an issue, to ensure fetal growth. Proper nutritional habits should already be established at the start of this second life - if possible even before conception. Eating nutritious foods before conception and throughout pregnancy is essential for a baby's health. Carbohydrates, protein and fat fuel a healthy pregnancy, and eating a variety of nutritious foods,

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including whole grains, fruits, vegetables, low-fat dairy and lean protein, helps provide the vitamins and minerals needed for the healthy development of a baby. Diets that restrict calories and wholesome carbohydrates are not appropriate for women who are pregnant. Eating nutritious food would prevent miscarriage from occurring and also prevent the delivering of unhealthy babies.

1.2. Objectives of the Study The objectives of the study are: 1. To assess the knowledge of pregnant women about their nutritional requirement during pregnancy. 2. To identify the nutrients in the diet intake of pregnant women. 1.3. Research Questions.

1. Do pregnant women know of their nutritional requirement during pregnancy? 2. What are the nutrients in the diet intake of pregnant women?

1.3. Significant of the Study.

The research has been written with emphases on the nutrient of food intake of pregnant women to enable them understand the value, principles behind its selection and use. Also, it is expected to help pregnant women to improve upon their knowledge of selection, preparation and service of their meal. The research is very significant to the government, stakeholders, NGOs, firms and businesses, the society and the researchers.

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Stakeholders and non-governmental organization (NGOS) to the health care would find this research very useful; this is because the research will equip them with an intensive knowledge about the whole concept of nutritional requirements for pregnant women. They would therefore be able to adopt policies that can enable them to handle all issues associated with nutrient for pregnant women professionally. Firms and private businesses providing health services would also find this research very useful because they would have an in depth knowledge about the whole concept of nutritional requirement for pregnant women. They would therefore be able to strategically formulate policies that will also enable them to tackle all issues associated with nutritional requirements in pregnant women. The society would also benefit from this research in diverse ways, for instance the research will serve as a guide for future reference. Individual in the society who aims at doing any research in the area of nutrition in pregnant women can rely on this document as a guide, besides that, the society would also be enlightened about the whole concept of nutrition in pregnant women after reading this research material. Finally, the researchers would have a broader knowledge about the whole concept of nutrition at pregnancy; they will therefore be able to provide some consultancy services in the area of child malnutrition. The researchers would also be able to contribute meaningful to the media discussions centered on nutrition in pregnant women. 1.5. Scope of the Study

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elaborates on the background of the study. conclusion. significance of the study.7. recommendations and suggestions for further studies. practical work with this project work. 1. Chapter five which is also the final chapter deals with the summary of the findings. 1.6. also talks about research methodologies. Chapter three. 5 . Organization of the Study The project is divided into five chapters. limitation of the study and the rganization of the study.The research was done at Koforidua. The Koforidua Municipality has many hospitals. Limitation of the Study The researchers who are students from the hospitality department had difficulties in combining academic work. Chapter two talks about the literature review. research questions. the problem statement. however with the guidance of the supervisor. Findings are discussed in the fourth chapter. as a result they could not reach a sizeable number of the population. The time was not enough to make the researchers explore so much of the topic. objectives of the study. scope of the study. Chapter one. the scope and the content of the topic covered are quite good for any academic work. Regional Capital of the Eastern region. both private and public. which in the introduction. but this research focused on the Central Hospital.

fats. There are five major groups of nutrients. 1995). vitamins.2. 6 . Minerals. which each have their own chemical names. absorbs. According to Townsend(1985). According to Tull(1987). and the process by which organism ingests.1. food is any solid or liquid substance which when taken in by the body provides it with the necessary materials to enable it to grow. 2. foods that pregnant women should eat during pregnancy and to identify the knowledge about diet intake of pregnant women in Koforidua. Proteins.0. uses and excretes food substances (Guthrie . Definition of Terms Nutrition is the science of food nutrient and other substance within food and their action. Each group has several members. nutrients in the diet intake of pregnant women in their right proportion. Introduction The chapter covers the research topic on the following: definition of concept. nutrients are chemical substances found in the food that are necessary for good health. LITERATURE REVIEW 2. to replace worn-out and damaged parts and to function normally. transport. carbohydrate. interaction and balance in relation to health and disease.

Some of the Nutrients in the Diet of Pregnant Women More calcium for pregnant women: According to www.com).com) Pregnant women should consume at least 1200 mg of these pregnancy vitamins a day.. allowing the baby's bone and teeth formation. Calcium builds your baby‟s bones and helps its brain and heart to function. a substantial transfer of calcium occurs between the mother and the fetus throughout pregnancy.babycenter. healthy nerves.A balance diet is one that has all the essential nutrients required by the body for proper growth and development in the appropriate amounts. and muscles. since a calcium deficiency will damage the mother's teeth and make her bones brittle. 1998). In the first six months. the mother stores up calcium in her own bones. Calcium intake increases dramatically during pregnancy. When its skeletal growth reaches its peak in the last three months. A balanced diet also provides the body energy to function (Alphonse. This is when the consumption of high calcium-containing foods such as milk and milk products must be increased. nursing mothers 1000 mg per day. the fetus draws on the mother's store.High calcium intake during pregnancy might reduce non-heme iron absorption. Also develops heart rhythm and blood clotting of the fetus (arabiaenglish. heart. Grows strong bones and teeth. leading to iron deficiency (Robinson et al. protein.healthandage.com. Vitamins. 2. A well balanced diet consists of the right amount of carbohydrates. and minerals. 7 . 2010). Women with calcium deficiency at any point in their lives are more likely to suffer from conditions such as osteoporosis which directly affect the bones.2. (http://www. fats.fitnesstipsforlife.

.gov. More iron for pregnant women: The demand for iron.betterhealth.( http://www. The developing fetus draws iron from the mother to last it through the first five or six months after birth so a woman has an increased need for iron during pregnancy. The amount needed depends on the amount of iron the woman has „stored‟ in her body prior to pregnancy.Good sources of calcium are:       Low-fat milk Yoghurt Cheese Salmon (cooked) Tinned fish Dark green leafy vegetables are good sources of calcium. It is useful to include foods that are good sources of iron in the diet every day (for example. It is important to discuss your need for supplements with your doctor as iron can be toxic in large amounts.au) Iron 8 .vic. you may need to get more from supplements. red meat) and to have foods that are good sources of vitamin C (like oranges) to help absorb the iron. and the fetal red blood cells have to be developed. The recommended daily intake (RDI) of iron during pregnancy is 27mg a day (9mg a day more than that for non-pregnant women). Iron losses are reduced during pregnancy because the woman is no longer menstruating and so loses less iron from menstrual blood loss. If your iron stores are very low. is also increased during pregnancy because the mother's blood volume increases. essential for blood formation.

babycenter. if you ingest vitamin C from raw food during the same meal. fish. preterm birth and delayed offspring neurological development. iron is more easily absorbed. (www. and heal wounds. Iron of plant origin is not as well assimilated as iron of animal origin. and vegetables.com) Makes red blood cells. and functioning of DNA – the body's genetic blueprint and a basic building block of cells. supplies oxygen to cells for energy and growth. repair. Iron is available in meat. and builds bones of the baby (arabiaenglish. This essential mineral also helps support your immune system.. and other problems during pregnancy.deficiency is associated with adverse birth outcomes such as small for gestational age (SGA). Zinc deficiency in pregnancy can lead to congenital malformations as well as abnormal foetal brain development. Your body needs zinc for the production. 1998).com) Foods rich in iron include:       Meat (cooked) Chicken (cooked) Eggs (cooked) Legumes Dark green leafy vegetables (rinsed properly) Fortified breads and cereals More zinc for pregnant women: Zinc is important for the synthesis of DNA and is required for cell division and growth. 9 . maintain your sense of taste and smell.healthandage. toxemia. So getting enough zinc is particularly important for the rapid cell growth that occurs during pregnancy. low birth weight. particularly if present during the first half of pregnancy (Zhou et al. Zinc deficiency is miscarriage. However. whole-grain products. egg yolk.

and circulatory system of pregnant women (arabiaenglish.babycenter. (www.com).Foods that is rich in zinc:             Meat (cooked) Milk Whole grains Liver & shell fish are rich in zinc but to be avoided during pregnancy.7 mg 3 ounces ground beef (85 percent lean): 5.000 g of folate in body stores (Gentili et al.8 mg 1/4 cup raw pumpkin seeds: 2.5 mg 3 ounces roasted turkey. dark meat: 3.k).babycenter. nerves.labor.The recommended daily allowance for zinc is 11mg per day. skeleton. 2009). A complete lack of dietary folate takes months before deficiency develops as normal individuals have about 500–20. fat trimmed: 5.com) . infant 10 .healthandage.This deficiency can result in many health problems. It helps form organs.com) .Folate deficiency during pregnancy may also increase the risk of preterm delivery.6 mg More folic acid pregnant women: This vitamin promotes the development of the fetal central nervous system and prevents developmental defects of the neural tube (spina bifida).5 mg 3 ounces lamb shoulder: 6. the most notable one being neural tube defects in developing embryos( National Health Service U.2 mg 3 ounces braised pot roast. and delivery (http://www. 1 cup fully fortified breakfast cereal: 15 mg 1 cup canned baked beans with pork: 14 mg 3 ounces Alaskan king crab meat: 6.

2008).2000).low birth weight and fetal growth retardation. as well as increasing homocysteine level in the blood. 2010). routine nutrition does not always supply enough folic acid (vitamin B9) to meet the requirements of a pregnant woman. A chronic lack of iodine can enlarge the 11 . which may lead to spontaneous abortion and pregnancy complications. Folic acid is contained in vegetables. wheat germ. and in eggs. tropical fruits.Women who could become pregnant are advised to eat foods fortified with folic acid or take supplements in addition to eating folate-rich foods to reduce the risk of serious birth defects (Scholl et al. Folic acid supplements may also protect the fetus against disease when the mother is battling a disease or taking medications or smoking during pregnancy(McGuire et al. Folic acid supplements consumed before and during pregnancy may reduce the risk of heart defects in infants (Bazzano et al.com)Foods rich in folic acid include:       Spinach Brussels sprouts Cabbage Beans Lentils Fortified cereals Iodine Iodine is an important mineral needed for the production of thyroid hormone. Additional folic acid intake is necessary in the months before pregnancy and during the first trimester. such as placental abruption and pre-eclampsia (Goh et al. However. which is important for growth and development. 2011 Aug). (www. Inadequate iodine intake during pregnancy increases the risk of mental impairment and cretinism in the newborn baby.healthandage.

meat and dairy products. sweat. Most of this added weight (6 to 9 L) is water because the plasma volume increases.g. taking the total adequate water intake (from food and fluids) to 2. saliva. or approximately 1. digestive juices. the European Food Safety Authority recommends an increase of 300 mL per day compared to the normal intake for non-pregnant women. 2007). 70% of the human body is water. fertility and for women the ability to carry a pregnancy. 12 . Keep linings of mucus membranes.850 mL/ day from fluids alone( EFSA Journal . mucus.birth.vic. and urine.2010).  Required for all body fluids e. blood lymph. Women who are pregnant should also use iodized table salt when cooking or adding salt to food (http://www. Water is life. one's mass increases by about 12 kg (Institute of Medicine 2004). eggs. affecting their general health.    Required as part of many metabolic reaction.300 mL.betterhealth.(http://www.thyroid gland in the throat (known as goitre) creating low thyroid hormones (hypothyroidism).gov. This means that hydration should also be considered an important aspect of nutrition throughout pregnancy. 85% of the placenta is water and the fetus itself is 70-90% water (Beall MH.au) Water During pregnancy. causing a person to become sluggish and gain weight. To ensure healthy hydration during pregnancy.com) Foods that are good sources of iodine include seafood and seaweed (including nori and kelp). Some nutrients dissolve in water for proper absorption. digestive tract and bronchial tube moist.

Lack or insufficient intake of protein can result in giving your child to be born 13 . helping your muscles contract. and carbohydrates. and abnormal heart rhythms. and chloride. a mineral found in many types of food. muscle cramps. Potassium Lubricates joints and membranes. you might take a look at your potassium intake. Since your blood volume expands by up to 50 percent during pregnancy. or magnesium) could be the culprit.babycenter. Protein can also be used to provide the body with energy once it has been used for its main functions of growth and repair (Tull. A shortage of potassium could cause weakness. (Tull. 1987). because a lack of potassium (or sodium. Protein Protein is vital for growth. plays an important role in maintaining fluid and electrolyte balance in your body's cells. repair and maintenance of the body. 1987). Potassium is also important in sending nerve impulses. or the use of certain diuretics. fatigue. working together) to keep the extra fluid in the right chemical balance. rather than a shortage in your diet. If you suffer from leg cramps during pregnancy.com) Low potassium is most often the result of chronic or severe vomiting or diarrhea. constipation. (http://www. calcium. and releasing energy from protein. fat. Talk with your doctor if you suspect that you're short on potassium or any other nutrient. potassium. you'll need slightly more electrolytes (sodium. Potassium.

and as such it is very important to the growth and development of every part of your baby‟s body during pregnancy. but taking a magnesium supplement while pregnant may also help prevent premature labor. eggs. Pregnant and nursing women should consume at least 70g of protein per day. poultry. This is especially important in the second and third trimester. shellfish.com) Magnesium There are many benefits to ensuring that you are receiving sufficient magnesium in your diet.fitnesstipsforlife. Protein is the building block of the body‟s cells.kwashiorkor. fortified cereals and protein bars. It is also available in supplements. cheese. when both Mom and baby are growing the fastest.( www. teeth. Not only will Magnesium help with those developmental functions. milk. which is about 25g more than the average women needs before pregnancy. fish. Manganese plays an important role in the formation of bone. development of your baby‟s inner and outer ears as well as the assists certain enzymes to function properly. Protein can be found naturally in beans.org ) Some of the food sources are:   Whole grain breads Eggs Vitamins A 14 . red meats. tofu and yogurt. cartilage.americanpregnancy. One other pleasant effect of taking magnesium is that it could possibly reduce pregnancy related leg cramping and heartburn. (http://www.

and that number almost doubles when nursing to 1300 micrograms (4.9 mg of this pregnancy vitamin per day of Vitamin B6. that overdosing on Vitamin A can cause birth defects and liver toxicity. Vitamin B6 can be found in fortified cereals.mayoclinic.betterhealth.com). (www. Vitamin A deficiency has been associated with vision problems. eggs and margarine.Vitamin A improves vision and maintains the integrity of cells. Although vitamin A requirements do increase during pregnancy. The best way to increase your intake of vitamin A. Your maximum intake should be 3000 mcg (10. B6 has been known to help alleviate morning sickness in some pregnant women. That amount rises slightly when nursing to 2.gov. fish. eggs.com). mangos and peas. carrots. vitamin A supplements are rarely recommended for pregnant women. watermelon. (http://www. Be aware. if it is low. (http://www. chick peas and chicken breast. Vitamin A can be found in liver. as well as their heart. however. . It also helps Mother and baby develop new red blood cells.fitnesstipsforlife.au/bhcv).com/health/pregnancy).0 mg per day. is through food sources like milk. 15 . sweet potatoes.fitnesstipsforlife. (http://www. Vitamin B6 Also known as Pyridoxine. This is because an excessive intake of vitamin A may cause birth deformities. Vitamin A helps the development of baby‟s bones and teeth. Oddly enough. baked potatoes. Vitamin B6 helps your baby‟s brain and nervous system develop. as it is labeled on nutritional labels) of Vitamin A per day. kale spinach collard greens. Pregnant women should consume at least 770 micrograms (or 2565 IU. as well as bananas.vic. eyes and immune system (the body system that fights infection). Getting enough Vitamin A during pregnancy will also help your body repair the damage caused by childbirth.000 IU) per day. cantaloupe. ears. Pregnant women should consume at least 1.330 IU).

fitnesstipsforlife. green beans. nursing mothers 2. Vitamin C can be found in citrus fruits. (http://www. eggs and dairy foods. Pregnant women should consume at least 80-85 mg of Vitamin C per day. shellfish. Since the Daily Recommended Allowance of Vitamin C is so easy to consume by eating the right foods supplementation is rarely needed. bell peppers. 16 .com). as well as in many cough drops and other supplements. Vitamin C during Pregnancy Vitamin C helps the body to absorb iron and build a healthy immune system in both mother and baby. potatoes.8 mcg (112 IU). papaya.fitnesstipsforlife. Other foods are fortified at the manufacturer‟s discretion. raspberries. It also holds the cells together. so unless you are a vegan or suffer from pernicious anemia the likelihood of a B12 deficiency is very slim. broccoli and tomatoes. poultry.com). and it helps develop the fetal brain and nervous system. strawberries. If you are a vegan you will be able to find B12 fortified tofu and soymilk.6 mcg (104 IU) of B12per day.Vitamin B12 during pregnancy Vitamin B12 works hand in hand with folic acid to help both Mother and baby produce healthy red blood cells. The body stores years‟ worth of B12 away. nursing mothers no less than 120 mg per day.Vitamin B12 can be found in red meat. helping the body to build tissue.(http://www. fish. Pregnant women should consume at least 2.

Vitamin E overdose has been tentatively associated with stillbirth in mothers who “self medicated” with supplements.Vitamin E during pregnancy Vitamin E helps baby‟s body to form and use its muscles and red blood cells. On the other hand.(http://www. however. Lack of Vitamin E during pregnancy has been associated with pre-eclampsia (a condition causing excessively high blood pressure and fluid retention) and low birth weight. 17 . so if your doctor recommends this don‟t worry. so women and children found to have a mild Vitamin D deficiency may be told to spend more time in the sun. It can.fitnesstipsforlife. be found in milk (most milk is fortified) as well as fortified cereals. so if you are bottle feeding or supplementing with formula your baby is probably getting sufficient amounts of this vital nutrient.Women who are pregnant or nursing should consume at least 2000 IU of Vitamin D per day.com) . Since babies need more Vitamin D than adults babies that are only breastfeeding may need a Vitamin D supplement. Vitamin D is also found in sunshine. You haven‟t done anything wrong! Formula is fortified with Vitamin D. eggs and fatty fish like salmon. leading to healthy bones for both mother and baby.Vitamin D during pregnancy Vitamin D helps the body absorb calcium. catfish and mackerel. Vitamin D is rarely found in sufficient amounts in ordinary foods.

pork and poultry.(http://www. dairy products. Riboflavin during pregnancy Also known as Vitamin B2. wheat germ. (http://www.Pregnant women should consume at least 20 mg of Vitamin E per day but not more than 540 mg. so be sure to eat lots of Vitamin E rich foods before you reach for your bottle of supplements. Riboflavin can be found in whole grains. nursing mothers 1. digestive problems. making it more vulnerable to infection.com).fitnesstipsforlife. a disease which may affect the baby‟s cardiovascular system (lungs and heart) or the nervous system. muscles and nervous system.4 mg of Thiamin a day.fitnesstipsforlife. Vitamin E can be found in naturally in vegetable oil. and when baby is delivered it will be prone to anemia. Riboflavin helps the body produce the energy it needs to develop your baby‟s bones. (http://www.6 mg. thiamin helps develop your baby‟s organs and central nervous system. Pregnant women and nursing mothers should consume at least 1. spinach and fortified cereals as well as in supplemental form.com). Natural Vitamin E is better for your baby than synthetic. fortified cereals. fish.4 mg of Riboflavin per day. pork. Thiamin can be found in whole grain foods. nuts. Nursing mothers who are Thiamin deficient are at risk for having babies with beriberi. Pregnant women should consume at least 1.fitnesstipsforlife. red meat. fortified cereals and eggs. Women with Riboflavin deficiency may be at risk for preeclampsia. wheat germ and eggs.com) 18 . Thiamin during pregnancy Also known as Vitamin B1. poor growth and a suppressed immune system.

The foods a pregnant woman eats are the main source of the nutrients for the baby. But what foods should pregnant women eat? What foods a pregnant woman should avoid? It is important for pregnant women to understand what kind of food is best for them and their baby. If followed. while in the second half.betterhealth. A pregnant woman's nutrition directly influences the course of the pregnancy and normal fetal development.au/bhcv) 2. quantity is 19 .vic. tobacco and alcohol) Obese pregnant women who are restricting their energy intake to prevent large weight gains.3. The Importance of Eating Well During Pregnancy Nutrition during pregnancy is important.gov. (Swiss Association for Nutrition) Here is the Swiss Association for Nutrition's recommendations for correct nutrition for pregnant women. on the fetal development and also on the health of the mother and child. In the first half of pregnancy. (http://www. and also the long-term health of the mother and child. nutrition requirements mainly concern quality.Multivitamin supplements Multivitamin supplements may be recommended for the following groups of pregnant women:    Vegetarians Teenagers who may have an inadequate food intake Substance misusers (of drugs. Pregnant women's food has an effect on the pregnancy. they will fully protect the health of the mother and provide optimal growth and development of her unborn baby.

Some Foods Pregnant Women Should Eat During Pregnancy Many factors affect our eating behavior: individual needs and wants.healthandage.g. 2. (www. Oils and Fats during Pregnancy: Daily consumption: 2 teaspoons (10 g) nutritious vegetable oil such as sunflower oil. social environment.com/nutrition-for-pregnant-women) Fibres A common problem during pregnancy is constipation. shortcake or pastry dough. etc. Daily consumption: at most 2 teaspoons (10 g) grease or cooking oil. butter or margarine. to ensure fetal growth. it is no possible to follow them exactly day by day.healthandage. and therefore represent healthy nutrition.mayoclinic. The listed amounts and portions are averages. health status. i.. whole grain cereals. e. bratwurst or hot dogs. cold cuts.if possible even before conception. advertising. cheese dishes. vegetable soups and whole pulses. cake.e.com/nutrition-for-pregnant-women meal heavy in fat such as deep fried or breaded foods. corn oil. 20 . dishes with sauces. for salad dressings. or olive oil for hot meal preparation. pies. (www. etc. and nutritional and protective elements. unprocessed olive or canola oil.4. selection of available foods. Daily maximum: one m www. thistle oil. Therefore the diet should contain plenty of fibres in the form of whole fruits and vegetables.. chocolate. Daily consumption: at most 2 teaspoons (10 g) spread.also an issue. fried potato cakes. The following recommendations (a sort of Nutrition Guide for Pregnant Women) ensure (in the form of a balanced diet) an adequate supply of energy. such as peanut oil.com/health/pregnancy). Proper nutritional habits should already be established at the start of this second life .

or 3½ -4 oz). 2-3 eggs per week. one meal per month of offal. less is permitted. Meat. Avoid liver 1-2 portions fish per week (1 portion = 100-120 g. or brains (1 portion = 80-120 g. More is unnecessary. At most. such as kidney. chickpeas. an ice cream). or 3½ -4 oz) Milk and Milk products: Per day: 3-4 portions of milk products (1 portion = 0. The portion size depends on the frequency and amount of physical activity practiced.g. Eggs. dry weight). lentils. Legumes: 2 .most sweets contain hidden fat. 1 piece of cake or a pastry. one meal of cured meats such as ham. or 3-4 oz). They should be cooked to avoid food poisoning: Per week: 1-2 portions legumes and derivates e. or 30 g= 1 oz hard cheese or 60 g = 2 oz soft cheese). potatoes. Grain Products and Potatoes: Daily consumption: eat 3-4 portions of starchy foods such as bread. At most eat 1 small portion of sweet snacks daily (e. including those used in baked goods. or 1 cup of yogurt. tripe. soufflés. At most. 21 . preferably whole-grain products. or 1½ -2 oz. Fish. beans (1 portion = 40-60 g. or cream sauces. tofu (1 portion = 100-120 g. sausage or bacon in place of meat.4 times per week: 1 portion meat (1 portion = 80-120 g.2 liter or ½ pint of milk. cereals or pastas..g. 1 chocolate bar.Pastries/Snacks: Use them in moderation . rice. or 34 oz).

Replace fluids in the case of vomiting. or heavy perspiration. Alcohol: for her own benefit and that of her unborn child. preferably unsweetened nonalcoholic drinks. the pregnant mother should avoid alcohol consumption. Vegetables Per day: 2-3 portions of vegetables.com/6692240) Listeria infection and pregnancy Listeria infection.5 liters (3¼ pints) of liquid per day. (http://EzineArticles. Some foods are more prone to contamination with listeria than others. or 150-200 g = 5-7 oz cooked vegetables. raw if at all possible (1 portion = 1 apple. diarrhea. The greatest danger is to the unborn baby. one of which should be raw. e.. as it is assimilated by the fetus. but the risks are substantial for pregnant women. Alcoholic and Nonalcoholic Drinks: Drink at least 1. or listeriosis. Healthy people may experience no ill-effects from listeria infection at all. 1 banana. A listeria infection is easily treated with antibiotics. 50 g = 1¾ oz green salad or 100 g = 3½ oz mixed salad). stillbirth or premature labour.g.Fruits for Pregnant Women: Per day: 2-3 portions of fruit. Exclude these foods from your diet if you are pregnant: 22 . 3 plums or a bowl of berries). with increased risk of miscarriage. is an illness usually caused by eating food contaminated with bacteria known as Listeria monocytogenes. but prevention is best. as a dip vegetable or a mixed salad (1 portion = 100 g = 3½ oz raw vegetables.

au) Nausea and vomiting These symptoms are common. quiches and delicatessen meats like ham and salami  Raw seafood such as oysters and sashimi or smoked seafood such as salmon (canned varieties are safe)   Unpasteurized foods Soft-serve ice-cream. pate. fried foods. Eat some dry bread. preprepared salads.  Drink liquids between rather than with meals to avoid bloating as this can trigger vomiting. and hot spices. avoiding sudden movements. The organism that causes listeria infection is destroyed by heat. biscuits or cereal before getting up in the morning. (http://www.vic. highly spiced foods. Small carbohydrate snacks (a sandwich or fruit) every two to three hours may provide some relief. such as brie. Avoid fatty foods. Have breakfast 15 minutes before getting up to offset morning sickness. Suck something sour like a lemon. 23 . so properly cooked foods are not a risk. sauces. camembert and ricotta – these are safe if served cooked and hot  Precooked or pre-prepared cold foods that will not be reheated – for example.   Avoid large meals and greasy. especially at the beginning of pregnancy. Soft cheeses.gov. Get up slowly.betterhealth.     Plan light and more frequent meals.

coffee and cola drinks. there is more pressure on the abdomen.vic. frequent meals may be better than large meals. You can do this by putting a folded blanket or pillow under your mattress. at least 2 hours before going to bed.vic.gov.betterhealth. Eat in the evening. Avoid fatty foods. You may also like to try sleeping with your bedhead raised a few inches. Keep rooms well ventilated and odour free.au)    Eat light and more frequent meals.gov. (http://www. 24 . lifting or lying down after meals Excessive consumption of tea or coffee. Try food and drinks containing ginger as these sometimes relieve nausea.   Slowly sip a fizzy drink when feeling nauseated. (http://www. Relax rest and get into the fresh air as much as possible.au) Try to avoid:    Eating late at night Bending. as the baby grows.au).gov. Small.betterhealth. Heartburn Heartburn is common in pregnancy because.betterhealth. (http://www.vic.

leeks. Eat slowly and in peace and quiet. and this may result in. or worsen. 25 . Constipation Intestinal movement is slowed during pregnancy. arms. fruit. fruit juice.  Drink at least 1. herbal tea.Flatulence  Avoid foods with a fermentative effect.5 liters (3¼ pints) daily Food cravings for Pregnant Women  Maintain a regular schedule of meals. and legumes. milk).5 liters (3¼ pints) of fluids per day (water. such as cabbage.   Eat fiber-rich food: whole-grain bread. Do not go without salt except in special cases. Drink a glass of cold water when you get up in the morning. and legumes. and sometimes the face are due to water retention. vegetables.  Drink 1.   Drink tap water or non-carbonated mineral water. garlic. digestive disorders. and eat dried fruits (prunes). Edema This swelling of the legs. onions.

 Eat only well-cooked meat. bread with cottage cheese. eating. yogurt. milk. congenital deformities and effects on the baby‟s intelligence. Food Poisoning/ infections: toxoplasmosis. listeriosis some infections have serious effects on the embryo. 26 . meat fondue. milk. Consuming alcohol during pregnancy increases the risk of miscarriage. low birth weight. as it affects the physical and mental development of the fetus. basil). and eggs. Always wash your hands carefully before cooking. There is no known completely safe level of alcohol consumption for women who are pregnant. Alcohol Consumption of alcohol during pregnancy should be avoided if possible.   Do not eat uncooked fish. or have touched sand or soil.  Avoid cats and their litter.   Always carefully peel and wash raw vegetables. Carpaccio. after you have handled raw meat. rare steak. but they can be prevented by observing the rules of hygiene. or whey. Take small snacks between meals consisting of fruit. The risk of injury is particularly high in the early months. Do not eat cheese rind. meat. fried sausage. as toxoplasmosis pathogens propagate in the cats' intestines. and herbs (parsley. Avoid tartar steak. fruit.

nicotine enters the mother's circulatory system and also that of the fetus through the placenta.au) Caffeine Caffeine is found in coffee. tobacco is contraindicated during pregnancy (and this includes secondhand smoke). and cocoa (chocolate) as well as other foods. A standard drink contains 10g of alcohol. Tobacco With each inhalation from a cigarette.Australian Alcohol Guidelines advise women who are pregnant or who are considering pregnancy that they:    Consider not drinking at all Should never become intoxicated (drunk) If they choose to drink. Caffeine in the blood of a pregnant woman affects the heartbeat of the baby. cola drinks. which almost doubles. energy drinks.betterhealth. including the time from conception to the first missed period. (http://www. For this reason. It has a stimulating effect and therefore speeds up the heart rate. black tea.gov.vic. 27 . Pregnant women may take two cups of coffee or four cups of tea a day without endangering the fetus. The blood vessels contract and the oxygen supply of the fetus is compromised. should have less than seven standard drinks over a week and no more than two standard drinks on any one day (at least two hours apart)  Should note that the risk is highest in the earlier stages of pregnancy.

Main Theater. 3. sampling technique as well as how the data would be analyzed. and double as the Municipal hospital for the New Juabeng municipality with its 155000 inhabitants.1. 2005). Dental unit. X Ray Department. Laboratory department. sample population. Profile of Eastern Regional Hospital-Koforidua. sources and methods of data collection. In 1998 additional Kitchen. This section will discuss the research. Kids. There has been neither rehabilitation nor additional structures since then. Laundry and Mortuary Departments were included. The first was in 1972 when an Administration block.0. as the branch of philosophy that analysis the principles and procedures of inquiry in a particular (word net. The 323-bed hospital compared to 314 in 2004 now serves as a referral point for about sixteen district hospitals in the Eastern Region. RESEARCH METHODOLOGY 3. Adult OPD with Medical Records. The Eastern Regional hospital was established in 1926.3. There have been two major structural additions to it since its establishment. The hospital offers the following services: 28 . whilst the second part outlined the profile of the institution under study. This chapter is divided into two main parts: the first part would deal with the research methodology. Introduction Methodology can be defined. Internal Medicine. Surgical and Maternity Wards with Theater were added.

Mortuary. patients. Laundry. staff and employers to Ghana Health Service and Ministry of Health. 29 . nose and Throat. The hospitals intention is to satisfy their numerous customers. Ultrasound. The Regional hospital is a Ghana Health Services facility-A secondary referral level not for profit healthcare organization. Ear. and Primary Health care services. Corporations. Laboratory. Pediatric. contented staff in a well maintained hospital infrastructure. Ophthalmology.  MISSION To provide comprehensive secondary level inpatient and out patients health care services of high quality to the people and communities in and around Eastern Region in a patient friendly atmosphere by a motivated. Dental. Pharmacy.  VISION To develop the hospital into a modern medical center of „BEST‟ practice in health care provision in Ghana. Physiotherapy. inpatients. XRay. Surgical. catering and Hospital. Vision to patients.Internal Medical including Anti-Retroviral Therapy. Medicine. Suppliers maintenance team.

REGIONAL DIRECTOR OF HEALTH SERVICES LEVEL 1 1 LEVEL 2 1 MATRON HD OF NURSING MEDICAL DIRECTOR/SUPERINTENDENT ADVISORY CME COORDINAT OR DIRECTOR OF ADMINISTRA TION DIRECTION ADMINISTRA TION HEAD OF FIANANCE LEVEL 3 1 DEPARTMEN T/SUPERVISO RS/BLOCK LEADERS HEAD OF DEPARTMEN T SUPREVISOR S SUPERVISOR S OF DEPARTMEN T SUPERVISOR S WARD IN CHARGE UNITS HEADS UNITS HEADS UNITS HEADS UNITS HEADS LEVEL 4 1 LEVEL 5 1 NURSING STAFF/MIDW IVES/STAFF ROTATION/S TUDENTS MEDICAL STAFF/RESID ENTS/HOUSE OFFICER ADMINISTRA TIVE AND OTHER SUPPORT 30 PHARMACY DISPENSERY STAFF ACCOUNTIN G STAFF . Hospital Organizational Structure Regional hospital – Foforidua .3.2.

31 . 3. Sampling Technique The researchers adopted random sampling in selecting the respondents. The simple random method was adopted because the target population does not require any stratification. a sample population of 50 people was selected as the total respondents from the total population for the study. articles and the internet. Target Population Population is a set of unit under consideration and can be people. objects or events.6. In all. Data Collection Technique The secondary source of information was drawn from textbooks.4. questionnaires and interviews would be appropriate. The researchers decided to use questionnaires and interviews because. journal. 2007).The research design used was case study. The target population was pregnant women within the Koforidua Regional Hospital. 3. Sample Size Taking into account time and academic pressure. taking into knowledge the level of literacy of the respondents Pregnant women in Koforidua Regional hospital.3. 3.7. The researchers used case study because they identified a problem within the case study area and would love to find a solution to it. (Bowerman and O‟Connell. (Giddens. 2005). The secondary data constituted the core of the literature review. Research Design Research design involves how the research materials are to be collected.3. 3. there were 100 pregnant women at the time of the research.5.

7.9. dissertation of past students.7.2 Secondary Sources Sources of information are textbooks.3. 3. government publications. The researchers will interview the illiterate and write the information obtained down.8.3. 3. If surveys are carried out on the internet or phone. 3. Sources Of Data Collection Information for the study will be obtained from both primary and secondary sources. Data Analysis Excel was used to draw all the bar charts.7. histogram. consistency and completeness since any deficiency may render the resultant findings inaccurate. published journal. Data Collection Procedure The data collected will be carefully examined to ensure accuracy. 32 . 3. pie chart and all diagrams related to the data. The researchers will approach respondents personally to explain things to them before delivering the questionnaires.1 Primary Sources Is firsthand information obtained by the researchers on the variables of interest for a specific purpose of the study. the information received is also a primary data. industry analysis offered by media and web sites. Surveys administered by the author are examples of primary source.

These represent 60% of the total distribution. Table 4. Data Presentation and Analysis The data analysis focuses on the examination of the data obtained through administering of questionnaire and interviews conducted. Both statistical and descriptive analyses were employed in analyzing the data collected.4. this accounted for 40%. 4. Table 4.0.1 QUESTIONNAIRES Number Percentage (%) RECEIVED 30 60 NOT RECEIVED 20 40 TOTAL 50 100 Out of the total number of 50 questionnaires administered. 20 out of the 50 were not received.2: Age Distribution of Respondents 33 .1 below shows the number of questionnaires administered by the researcher. 30 were returned completed. Statistical tools such as tables and diagrams were used to aid quick visual display of the results. Data is presented in simple tables and the corresponding responses converted into percentages. The table 4.1. Introduction This chapter gives the presentation and analysis of data and findings through questionnaire and interviews. ANALYSIS OF DATA 4.

From the findings the researchers noticed that.3: Dishes intake of Respondents DISHES RICE DISHES CORN DOUGH DISHES FUFU AMPESI DISHES Total NUMBER OF RESPONDENTS 15 13 12 10 50 PERCENTAGE (%) 30 26 24 20 100 34 . Table 4.AGE 18 . 15 respondent were in the range of 26 to 33years representing 30%. respondents aging from 18-25years mark the highest age of respondents. 7 out of 50 respondent were in the range of 34 to 41years representing 14% and out of the 50 respondent 3 were in the range of 42 years and above representing 6%. This implies that women at this age get pregnant more than that of the ages above. 25 respondent were in the range 18 to 25 years representing 50%.25 years 26 – 33 yeas 34 – 41 years 42 above Total NUMBER OF RESPONDENTS 25 15 7 3 50 PERCENTAGE (%) 50 30 14 6 100 Out of the 50 respondents.

The ampesi contains iron and carbohydrates whiles the kontomire contains vitamins.Fufu contains starch and iron as carbohydrates and the soup contains protein. Table 4. Rice dishes-Most pregnant women eat rice and stew. 12 respondent take in fufu dish representing 24% and 10 respondent take in Ampesi dishes representing 20%.4: Fruits intake of Respondents FRUITS Pineapple Orange Babanna Water – melon Mango Apple Paer TOTAL RESP ONDENTS 15 10 8 6 5 5 1 50 PERCENTAGE % 30 20 16 12 10 10 2 100 35 . Ampesi and kontomire stew. protein and calcium. This shows that the food pregnant women eat are well balanced. Fufu with goat light soup. The banku contains starch in the form of carbohydrates and the soup contains vitamins.From the table out of the 50 respondents of women who are pregnant 15 take in rice dishes representing 30%. iodine and calcium. The rice contains carbohydrates and the stew contains protein. 13 respondent take in corn dough dishes representing 26%. vitamins and mineral elements. mineral elements and protein. Corn dough dishes-Example banku and okro soup.

5 respondents take mango representing 10%. 15 respondents take Pineapple representing 30%. some mineral elements and water. 13 respondents takes Nkontomire and Garden Eggs representing 26%.The table above depicts fruits distribution that women take during pregnancy. 5 respondents take Apple representing 10% . 12 respondents takes Cabbage representing 24%. It also contains fibre which prevents constipation.and 1 respondent takes pear representing 2%. 4 respondents take Lectuce 36 . it regulates the body processes and protects the body against diseases. 10 respondents takes orange representing 20%. Out of the 50 respondents. 6 respondents take water – melon representing 12%. 7 respondents take French beans and Cucumber representing 14%. 8 respondents take Banana representing 16%. 10 respondents take Carrots representing 20%.5: Vegetables intake of Respondent VEGETABLES Nkontomire and Garden eggs Cabbage Carrots French beans and Cucumber Lectuce Green peper Total RESPONDENTS 13 12 10 7 4 4 50 PERCENTAGES (%) 26 24 20 14 8 8 100% The table above depicts Vegetables intake of respondente during pregnancy. out of the 50 respondents. All the fruits contain the same nutrients which is vitamins. Table 4.

6 respondents take Vitamins representing12%. ii. 5 respondents take Folic Acid representing 10%. and 4 respondents take Iodine representing 8%. Table 4. 15 respondents take Carbohydrate representing 30%.6 above shows nutrients in take of pregnant women. Some contain carotene and others also give blood. They also perform the same duty as for fruits. 10 respondents take Proteins representing 20%. 37 RESPONDENTS 15 10 6 5 5 5 4 50 PERCENTAGES 30 20 12 10 10 10 8 100% 30 . out of the 50 respondents. field study 2012 (%) Table4.representing 8%.6: Nutrients intake of the Respondents NUTRIENTS Carbonhydrate Proteins Vitamins Folic Acid Calcium Iron Iodine Total Source. It contains fibre and vitamin which promote the development of the central nervous system and prevent developmental defect of the neutral tube. These are the functions of the above nutrientsi. 5 respondents take Calcium representing 10%. example kontomire and carrot. Protein helps in the growth and repair of worn-out tissues. and 4 respondents take Green paper representing 8%. 5 respondents take Iron representing 10%. Carbohydrates provide heat and energy for the body.

Calcium helps build strong bones and teeth Iron is essential for blood formation and also increases in fetal red blood cells developments. iv. Iodine is an important mineral needed for growth and development and prevents goiter deficiency. vi. vii. Folic acid promotes the development of the fetal nervouse and prevents developmental defect of the neutral tube. v. 38 .iii. Vitamins give vitality to the body and protect the body against diseases.

Conclusion The following conclusions were drawn based on the findings of the study.0.  The researchers noticed that most pregnant women do not have the knowledge about nutritional intake at pregnancy. Especially include more fruits and vegetables each day in their diet.  The researchers observed that some pregnant women do not know the nutrients they should eat during pregnancy. identify some of the food that pregnant women should eat during pregnancy and identify some of the factors that can be adopted in order to reduce the incidence of pregnant women resulting in giving birth to unhealthy new born babies in Koforidua. SUMMARY CONCLUSIONS AND RECOMMENDATIONS 5.5.  Pregnant women should eat a balanced diet. The study was conducted because the researchers wanted to identify some of the nutrients in the diet intake of pregnant women in their right proportion.1.2. Introduction This chapter contains the summary. 39 . the following findings were discovered upon assessing the knowledge of pregnant women on their nutritional intake during pregnancy. recommendations and conclusions in relation to the findings from the research work. 5. Summary After the data presentation and analysis. 5.

 The revealed that. 40 . Although the hospital has an anti-natal care department. nutrition and cooking processes.natal will provide a quality service for pregnant women so that they can be healthy and strong resulting in giving birth to healthy babies. We also recommend that there should be training programmes for management and staff at least once a year in order to abreast them with current changing techniques with various types of food. the main problem faced by pregnant women is that they do not eat well during pregnancy. We also appeal to NGOs to the hospital that there should be effective counseling or conversation between the pregnant women and management so as to identify their problems and help them solve. We say that nutrients are useful to pregnant women during pregnancy. it should be renovated with a well planned or structured block and should be given the same recognition accorded to other departments. the researchers seek to recommend the following to the Koforidua Central Hospital.4. Recommendations In respect of the findings. It is the wish of the researchers that various food stuffs should be introduced to the pregnant women during anti.natal care. value and their uses. 5. such as fruits and vegetables because some do not know their names.  We hope that the ante.

women should be able to give birth at the early ages from 18-35years so that proper care and attention will be given to the children.Due to pregnancy discomfort and scientific research. 41 . We also congratulate the staff and management for their good work done.

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