MATERNAL AND CHILD HEALTH PROGRAMMES
8/24/2021 10:03 PM
INTRODUCTION
• MOTHERS AND CHILDREN NOT ONLY
CONSTITUTE A LARGE GROUP, BUT THEY ARE
ALSO “VULNERABLE” OR SPECIAL GROUP. THEY
COMPRISES 71.4 % OF POPULATION OF THE
DEVELOPING COUNTRIES, IN INDIA ,WOMEN OF
CHILD BEARING AGE (15-44 YEARS) CONSTITUTE
22.2% AND CHLIDERN UNDER 15 YEARS OF AGE
ABOUT 35.3% OF TOTAL POPULATION,
TOGETHER 57.7% OF POPULATION CONSISTS OF
MOTHERS AND CHILDRENS.
THE PRESENT STRATEGY IS TO PROVIDE
MOTHER AND CHILD HEALTH SERVICES AN
INTEGARTED PACKAGE OF “ESSENTIAL HEALTH
CARE” ALSO KNOWN AS PRIMARY HEALTH
CARE
MOTHER AND CHILD - ONE UNIT
1. DURING THE ANTENATAL PERIOD THE
FOETUS IS PART OF MOTHER.
(WE WILL ALSO GIVE PRIORITY TO THE
DEVELOPING FETUS INSIDE THE WOMB OF THE
MOTHER)
2. CHILD HEALTH IS CLOSELY RELATED TO
MATERNAL HEALTH.
(WHATEVER THE NUTRITIONAL STATUS OF THE
MOTHER GREATLY AFFECTS THE HEALTH OF
THE BABY)
3. CERTAIN DISEASES AND CONDITIONS OF THE
MOTHER DURING PREGNANCY ARE LIKELY TO
HAVE EFFECT UPON THE FOETUS. (ANG MGA
SAKIT NI MOTHER IS MAKA AFFECT JUD SA
BABY)
4. AFTER BIRTH THE CHILD IS DEPENDENT ON
MOTHER. (BREAST FEEDING, SECURITY,
COMFORT, LOVE IS DAPAT MA PROVIDE JUD NA
SA MOTHER)
5. THE MOTHER IS ALSO THE FIRST TEACHER OF
CHILD (TEACHES THE BABY ABOUT BASIC)
DEFINITION OF MATERNAL AND CHILD
HEALTH
"MATERNAL AND CHLID HEALTH" REFERS TO
THE PROMOTIVE (PROMOTION OF HEALTH
EDUCATION SUCH AS GOOD NUTRITION &
FAMILY PLANNING), PREVENTIVE (E PREVENT
NA DILI DAPAT SUNOD-SUNOD MAG BUNTIS),
CURATIVE (MEDICAL ADVICES OR MEDICINE TO
CURE MATERNAL HEALTH) PROBLEMS AND
REHABLITATIVE HEALTH CARE FOR MOTHERS
AND CHILDREN, CHILD HEALTH, FAMILY
PLANNING, SCHOOL HEALTH, HANDICAPPED
CHILDREN, ADOLESCENCE AND HEALTH
ASPECTS OF CHILDREN IN SPECIAL SETTING
SUCH AS DAY CARE.
OBJECTIVES OF MCH SERVICES
 REDUCTION OF MATERNAL, PERINATAL,
INFANT, AND CHILDHOOD MORTALITY
AND MORBIDITY (POOR ANG MATERNAL
AND CHILD HEALTH SEVICES SA PINAS)
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 PROMOTION OF REPRODUCTIVE HEALTH
(SINCE BELONG ATUNG COUNTRY SA
CHRISTIAN COMMUNITY ANG GIBAWAL
ANG PAG GAMIT SA CONTRACEPTIVE
ANA SA BIBLE SO GINASUNOD NATO
ANG BIBLE SO CONTRADICTED KAAYO
SYA BUT NAGA PROMOTE OG FAMILY
PLANNING AND HALTH EDUCATION ANG
ATUNG PUBLIC SERVANT)
 PROMOTION OF PHYSICAL AND
PSYCHOLOGICAL DEVELOPMENT OF THE
ADLOSECENT WITHIN THE FAMILY.
MCH SERVICES
(UNSA NA MGA SERBESYO ANG
GINAHATAG SA ATUNG MATERNAL
NEWBORN CHILD HEALTH AND
NUTRITION IN OUR PUBLIC HEALTH)
ANTENATAL CARE:
 THE CARE OF THE WOMEN DURING
PREGNANCY. (ENCOURAGE NA MAGPA
PRENATAL CHECK UP, KAUPAT MAGPA
PRENATAL IN WHOLE DURATION OF
PREGNANCY)
APAT, DAPAT
FIRST TRIMESTER (1-2-3 MONTHS) = 1
PRENATAL CHECK UP
SECOND TRIMESTER (4-5-6MONTHS)
IKA DUHANG PRENATAL
AND LAST TWO PRENATAL DAPAT
MABUHAT WTHIN 7-8-9 MONTHS OF
PREGNANCY
PERO BISAN PAG KAPILA KA MAGPA
PRENATAL AS LONG AS MAKABAYAD
KAS OB IS OKAY RA
AIM
 THE PRIMARY AIM OF ANTENATAL CARE
IS TO ACHIEVE AT THE END OF A
PREGNANCY A HEALTHY MOTHER AND
A HEALTHY BABY
(WITH OUT COMPLICATION SA DUHA).
OBJECTIVES OF ANTENATAL CARE
 TO PROMOTE, PROTECT AND MAINTAIN
THE HEALTH OF THE MOTHER DURING
PREGNANCY
( IN ORDER NA WALAY MGA SAKIT ANG
MOTHER DURING PREGNANCY PARA
NORMAL ANG DELIVERY SA BATA AND
WALAY COMPLICATION)
 TO DETECT:" HIGH RISK" CASES AND
SPECIAL ATTENTION.
 TO FORESEE COMPLICATIONS AND
PREVENT THEM
 TO REMOVE ANXIETY AND DREAD
ASSOCIATED WITH DELIVERY.
(PRIMIGRAVIDA IS MA EDUCATE NATO
ANG MOTHER ABOUT WHAT WILL
HAPPEN IN PERINATAL)
 TO REDUCE MATERNAL AND INFANT
MORTALITY AND MORBIDITY
 TO TEACH THE MOTHER ELEMENTS OF
CHILD CARE, NUTRITION BREASTMILK IS
GOOD FOR 6 MONTHS UP TO 2 YRS)
 MATERNAL AND CHILD HEALTH PROGRAMMES
PAG 7 MONTHS AND UP YOU WILL
INTRODUCE FOOD, ONE FOOD AT A
TIME) RICH IN CARBOHYDRATES AND
PROTEIN OG GLUCOSE SAD
GO, GROW AND GLOW
ENERGY GIVING FOODS (GO)
BODY BUILDING FOODS (GROW)
BODY REGULATING FOOD (GLOW)
-PERSONAL HYGIENE AND
ENVIRONMENTAL SANITATION.
 TO SENSITISE THE MOTHER TO NEED
FOR FAMILY PALNNING
(DURING PREGNANCY DAPAT MAG
INTRODUCE NAG FAMILY PLANNING)
3-5 YEARS ANG AGWAT SA BATA BEORE
MANGANAK NAPUD)
 ACCOMPANYING THE MOTHER TO
1TO ATTEND TO THE UNDER-FIVES
(UNDER 5 YRS OLD NA MGA BATA IS
DAPAT MAGPA VACCINE)
BCG VACCINE = TO PROTECT THE BABY FROM
TUBERCULUSIS KAY PA DEVELOP PA ANG
RESPRATORY & IMMUNE SYSTEM SA BATA SO
HIGH RISK SILAG AIRBORNE DISEASES SUCH AS
TB
VIT. K = TO PREVENT BLEEDING
POLIO VACCINE= PREVENT POLIO
MMR = MEASLES, MUMPS AND RUBELLA
ANTENATAL SERVICES
1. ANTENATAL VISITS: MOTHER SHOULD
ATTEND THE ANTENATAL CLINIC ONCE A
MONTH DURING THE FIRST 7 MONTHS, TWICE A
MONTH, DURING THE NEXT MONTH AND THERE
AFTER ONCE IN WEEK IF EVERYTHING IS
NORMAL,
A MINIMUM OF 3 VISITS COVERING THE ENTIRE
PEROID OF PREGNANCY SHOULD BE
 1ST VISIT AT 20TH WEEKS
 2ND VISIT AT 30TH WEEKS
 3RD VISIT AT 36TH WEEKS
PREVENTIVE SERVICES FOR MOTHERS
(BEFORE DELIVERY)
A. THE FIRST VISIT:
- HEALTH HISTORY
(ASK FOR HEATH HISTORY, NAA BAY
KALIWAT NA GI TB, HIGHBLOOD, DIABETES,
SMOKER BA OR GA TAKE OG DRUGS AND
ALL)
-PHYSICAL EXAMINATION (CHECK WEIGHT IF
BELOW 40-75 ABOVE KILOS IS NOT ALLOWED
FOR PREGNANCY)
- LABORATORY EXAMINATION (PRIMARY LAB
TEST SUCH AS CBC (CHECK HEMOGLOBIN
LEVEL (HEMOGLOBIN CONTENT TO DETERMINE
KUNG BABA ANG RBC LEVEL) OF THE MOTHER
TO AVOID HEMORRAGE DURING DELIVERY AND
ALSO IT SERVE AS FOOD AND NUTRIENTS FOR
THE DEVELOPING FETUS & URINALYSIS TO
DETECT IF NAAY UTI OR SEXUALLY
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TRANSMITTED INFECTION THAT CAUSES
ABORTION OR TRANSFER OF VIRUS)
NSVD = NORMAL SPONTANEOUS VAGINAL
DELIVERY
B. ON SUBSQUENT VISITS:
-PHYSICAL EXAMINATION
- LABORATORY TESTS
C. IRON (FOR INCREASE HEMOGLOBIN AND
FOLIC ACID SUPPLEMENTATION (BRAIN
DEVELOPMENT SA BABY)
D. IMMUNISATION AGAINST TETANUS (SA
MOTHER)
E. INSTRUCTION ON NUTRITION, FAMILY
PLANNING, SELF CARE, DELIVERY AND
PARENTHOOD
(FIRST TRIMESTER= OKAY LANG MO KAON OG
DAGHAN
SECOND & THIRD TRIMESTER= HINAY2 LANG OG
KAON PARTICULARLY ANG GLUCOSE BASIN
MAKA DEVELOP OG GESTATIONAL DIABETES
OR PERTING DAKOA SA BATA PAG ANAK)
F. HOME VISITING BY A FEMALE HEALTH
WORKER (USUALLY MIDWIFE OF BHW)
G. REFERRAL SERVICES
(REFERRAL SA LYING IN OR SA HOSPITAL PAG
RISKY ANG DELIVER)
RISK APPROACH FOR HIGH RISK CASES LIKE
ELDERLY PRIMI, MALPRESENTATIONS,
ANTEPARTUM HEMORRAHAGE, PRE-
ECLAMPSIA(HIGH BLOOD), ANAEMIA, TWINS,
PREVIOUS CEASAERIAN DELIVERY, AND
GENERAL DISEASES LIKE KIDNEY DISEASE,
DIABETES, TUBERCULOSIS, LIVER DISEASES
ETC.
MAINTENANCE OF RECORDS:
THE ANTENATAL CARE IS PREPARED AT THE
FIRST EXAMINATION, IT INCLUDE
REGISTRATION NUMBER, IDENTIFYING DATA,
PREVIOUS HEALTH HISTORY, AND MAIN
HEALTH EVENTS. MO GAWAS SA IMONG
RECORD KUNG UNSA IMNG MGA POSSIBLE
HEALTH PROBLEM DURING LABOR AND
DELIVERY
HOME VISITS: IS BACK BONE (MOST
IMPORTANT) OF MCH SERVICES SA MGA BUNTIS
OR SA MGA HUMANAG PANGANAK. HOME VISIT
BY THE HEALTH WORKER FEMALE OR PUBLIC
HEALTH NURSE.
MIDWIFE, BHW, NURSE DEPLOYMENT PROGRAM
(NDP) = ASSIGN PER BARANGAY PARA MO
TABANG SA BHW AND MIDWIFE NAGA HATAG
PROPER EDUCATION, VACCINATION AND ALL
2. PRENATAL ADVICES:
A. DIET: LACTATION DEMAND ABOUT 550 Kcal A
DAY. TOTAL WEIGHT GAIN 12KG, AT 1
TRIMESTER 2 KG, 2 TRIMESTER 5 KG& 3
TRIMESTER 5KG OF WEIGHT
B. PERSONAL HYGIENE:
 MATERNAL AND CHILD HEALTH PROGRAMMES
 PERSONAL CLEANLINESS
 REST AND SLEEP: 8 HRS SLEEP AND 2
HRS REST (TO AVOID VERTIGO)
 BOWELS (EAT HIGH FIBER FOODS PARA
DALI MATUNAWAN)
 EXERCISE (PREPARATION FOR LABOR
LABON NA ANG CERVICAL OPENING)
 SMOKING AND ALCOHOL SHOULD BE
AVOIDED (HIGH IN TERATOGENIC
EFFECT POSSIBLE ANG BABY GAMAY OR
NAAY ABNORMALITIES OR DELAY ANG
DEVELOPMENT)
 DENTAL CARE (MO BABA ANG CALCIUM
BECASE IT WILL BE DIVIDE TO CONSUME
BY THE MOTHER AND THE BABY= FOR
BONE DEVELOPMENT) ADVICE TO DRINK
MILK OR HIGH CONSUME OF CALCIUM
 SEXUAL INTERCOURSE: RESTRICTED
ESPECILLY DURING LAST TRIMESTER
(FIRST AND SECOND TRIMESTER OKAY
PA PERO PAG DI MASILAN ANG
PAGBUNTIS)
SEXUAL POSITION
1. DOG STYLE OR SEX IN BEHIND
2. YOU IN TOP (NAG ATUBANG NA COW
GIRL)
3. SPONNING
4. REVERSE COW GIRL (NAGTALIKOD)
5. STANDING
6. FLOATING PREGNANT
7. SEATED PREGNANCY SEX
8. PREGNANT ORAL SEX
9. ANAL SEX
10. SIDE BY SIDE
C. DRUGS MOST SERIOUS EFFECT ON FOETUS
SHOULD BE AVOIDED
D. WARNING SIGNS: SWELLING OF FEET, FITS,
HEADCHE, BLURRED VISION (ECLAMPSIA OR
HIGHBLOOD), BLEEDING OR DISCHARGE IN
VAGINA
E. CHILD CARE SPECIAL CLASSESS MOTHER -
CRAFT EDUCATION CONSISTS OF NUTRITION
EDUCATION ADVICES ON HYGIENE AND CHILD
REARING ETC.
3. SPECIFIC PROTECTION:
 ANAEMIA
 NUTRITIONAL DEFICIENCES
 TOXEMIAS OF PREGNANCY
 TETANUS
 SYPHILLIS
 GERMAN MEASLES
 Rh STATUS
 HIV INFECTION
4. MENTAL PREPARATION: MOTHER CRAFT
CLASSES AT MCH CENTRES HELP A GREAT DEAL
IN ACHIVING THIS OBJECTIVE
(MENTALLY RETARDENT MOTHER DAPAT E
ENROLL SA MGA PROGRAM PARA MA
TABANGAN SAD SILA)
5. FAMILY PLANNING
6. PAEDIATRIC COMPONENT: ALL ANTENATAL
CLINICS TO PAY ATTENTION TO THE UNDER-
FIVES ACCOMPANYING THE MOTHERS
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(WHITE CARD IT WILL SERVE AS ASSESTMENT
SA BATA SUCH AS HEAIGHT, WEIGHT,
VACCINATION AND ALL)
INTRANATAL CARE
CHILD BIRTH IS A NORMAL PHYSIOLOGICAL
PROCESS BUT COMPLICATIONS MAY ARISE,
SEPTICEMIA MAY RISE AS A RESULT FROM
UNSKILLED AND SEPTIC MANIPULATIONS
(PATAKA RAG BIRA) AND TETANUS
NEONATARUM FROM THE USE OF UNSTERILED
INSTRUMENTS. THE EMPHASIS ON THE
CLEANLINESS.IT ENTAILS:
 CLEAN HANDS AND FINGERNAILS
 CLAEN SURFACE FOR DELIVERY
 CLEAN CUTTING AND CARE OF CORD
AIMS OF INTRANATAL CARE
 THOROUGH ASEPSIS
 DELIVERY WITH MINIMUM INJURY TO
THE INFANT AND MOTHER
 READINESS TO DEAL WITH
COMPLICATIONS SUCH AS PROLONGED
LABOUR (PRONE FOR HEMORRAGE AND
DEHYDRATION AND BODY WEAKNESS),
ANTEPARTUM, HAEMORRHAGE,
CONVULSIONS, MALPRESENTATION
S,PROLAPSE OF CORD(MAGAED ANG
CORD SA LIOG SA BATA, LED TO SEVERE
BLEEDING OR HEMORRAGE) ETC
 CARE OF THE BABY AT DELIVERY-
RESUSCITATION, CARE OF THE CORD,
CARE OF THE EYES (ERETHROMICINE)
INTRANATAL CARE INCLUDES
1. MOTHER WITH NORMAL OBSTETRIC
HISTORY MAY BE ADVISED TO HAVE
THEIR CONFINEMENT IN LYING IN. IN
SUCH CASES THE DELIVERY MAY BE
CONDUCTED BY THE" HEALTH WORKER
FEMALE OR TRAINED DAI" THIS IS
KNOWN AS "DOMICILLARY MIDWIFERY
SERVICE".
ADVANTAGES OF DOMICILLARY
SERVICE:
-MOTHER DELIVERS IN THE FAMILIAR
SURROUNDINGS OF HER HOME
-LESS CHANCE OF CROSS INFECTION
-MOTHER IS ABLE TO KEEP AN EYE
UPON HER CHILDREN AND
DOMESTIC AFFAIRS.
DISADVANTAGES:
-MOTHER MAY HAVE LESS MEDICAL
AND NURSING SUPERVISION
-MOTHER MAY HAVE LESS REST
-MOTHER RESUME HER DUTIES TOO
SOON
-DIET MAY BE NEGLECTED
 MATERNAL AND CHILD HEALTH PROGRAMMES
RESPONSIBILITIES OF FEMALE
HEALTH WORKER
IN DOMICILLARY CARE
SHE SHOULD BE ADEQUATELY TRAINED
TO RECOGNISE THE” DANGER SIGNALS”
ARE
• SLUGGISH PAINS OR RUPTURE OF
MEMBRANES
• PROLAPSE OF THE CORD OR HAND
• MECONIUM STAINED LIQUOR
• EXCESSIVE SHOW OR BLEEDING
DURING LABOUR
• LATE PALCENTAL SEPARATION
• POST-PARTUM HEMORRAHGE OR
COLLAPSE
• INCREASED TEMPERATURE
2. INSTITUTIONAL CARE:
AT ABOUT 1% OF DELIVERIRES TEND TO
BE
ABNORMAL, REQURING THE SERVICES
OF A DOCTOR INSTITUTIONAL CARE IS
RECOMMENDED FOR ALL HIGH RISK’
CASES AND WHERE HOME CONDITIONS
ARE UNSUITABLE.
3. ROOMING IN: KEEPING THE BABY‘S
CRIB THE SIDE OF THE MOTHER ‘S BED IS
CALLED “ROOMING-IN” IT ALSO ALLAYS
THE FEAR IN THE MOTHER MIND THAT
THE BABY IS NOT MISPALCED IN THE
CENTRAL NURSERY
3. POSTNATAL CARE
CARE OF THE MOTHER (AND THE NEW
BORN)
AFTER DELIVERY IS KNOWN AS POST-
PARTAL CARE.
OBJECTIVES:
• TO PREVENT COMPLICTIONS OF THE
POSTPARTAL PERIOD.
• TO PROVIDE CARE FOR THE RAPID
RESTORATION OF THE MOTHER TO
OPTIUM HEALTH.
• TO CHECK ADEUQUACY OF BREAST
FEEDING.
• TO PROVIDE FAMILY PLANNING
SERVICES.
• TO PROVIDE BASIC HEALTH
EDUCATION TO MOTHER\FAMILY.
COMPILCATIONS OF POSTPARTUM
PERIOD
• PUERPERAL SEPSIS (VAGINAL AREA GA
HUBAG)
• THROMBO-PHELBITIS (MANGHUBAG
ANG UGAT)
• SECONDARY HEMORRAGE (NAGLUYA
KAG TAMAN KAY DAGHANG BLOOD
LOSS)
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• URINARY TRACT INFECTION AND
MASTITIS (MAGHUBAG ANG TOTOY)
-SHOULD DETECT EARLY TREAT WITH
PROMPT MEASURE.
RESTORATION OF MOTHER TO OPTIMUM
HEALTH:
PHYSICAL: 1. POSTNATAL EXAMINATIONS:
(CHECK THE BLEEDING)
SOON AFTER DELIVERY, THE HEALTH CHECK-UP
MUST BE FREQUENT .i.e
TWICE A DAY DURING THE FIRST 3 DAYS AND
SUBSEQUENTLY ONCE A DAY TILL UMBILICAL
CORD DROPS OFF. FHW CHECKS VITALS,
BREASTS, CHECK PROGRESS OF NORMAL
INVOULTION OF UTERUS, EXAMINES LOCHIA
FOR ANY ABNORMALITY, CHECK URINE AND
BOWELS AND ADVISES ON PERINEAL CARE
FURTHER VISITS SHOULD BE DONE ONCE IN 2
OR 3 MONTHS DURING FIRST 6 MONTHS, AND
AFTER ONCE IN 2 OR 3 MONTHS TILL THE END
OF 1 YEAR.
2. ANEMIA: ROUTINE HB ESTIMATION CAN BE
DONE WHEN ANAEMIA DISCOVERED. IF ITS
THERE IS, CONTINUE TREATMENT FOR 1 YEAR.
3. NUTRITION: THE NUTRITIONAL NEEDS OF THE
MOTHER MUST BE ADEQUATELY MET (KAY
GAPA BREASTFEED SA BABY
4. POSTNATAL EXERCISES: IS TO BRING
STRETCHED ABDOMINAL AND PELVIC MUSCLE
BACK TO NORMAL
PSYCHOLOGICAL: FEAR AND INSECURITY MAY
BE ELIMINATED BY PROPER PRENATAL
INSTRUCTION.
3. BREAST FEEDING (NO BOTTLE FEEDING)
4.FAMILY PLANNING: MOTHER SHOULD ATTEND
POSTNATAL CONTACTS TO ADOPT A SUITABLE
METHOD FOR SPACING THE NEXT BIRTH.
5. BASIC HEALTH EDUCATION: HYGIENE,
FEEDING FOR MOTHER AND INFANT,
PREGNANCY SPACING (3-5 YEARS GAP),
IMPORTANCE OF HEALTH CHECK-UP, BIRTH
REGISTRATION.
NEONATAL CARE
• EARLY NEONATAL CARE:
THE FIRST WEEK OF LIFE THE MOST CRUCIAL
PERIOD OF AN INFANT. (KAY NAGA ADJUST PA
ANG BATA SA ENVIRONMENT)
OBJECTIVES:
1. ESTABLISH & MAINTENANCE OF
CARDIORESPIRATORY FUNCTIONS
2. MAINTENANCE OF BODY TEMPERATURE
 MATERNAL AND CHILD HEALTH PROGRAMMES
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3. AVOIDANCE OF INFECTION
4. ESTABLISH OF SATISFACTORY FEEDING
REGIMEN
5. EARLY DETECTION AND TREATMENT OF
CONGENITAL AND ACQUIRED DISORDERS.

APGAR= NEXT

3. CARE OF THE CORD: THE CORD SHOULD BE

CUT & TIED WHEN IT HAS STOPPED PULSATING.
CARE MUST BE TAKEN TO PREVENT TETANUS
OF NEWBORN BY UNSTERILISED INSTRUMENTS
NAD
CORD TIES (AIR DRY LANG JUD AND DLI APILON
ANG PUSOD SA DIAPER)

4. CARE OF THE EYES: BEFORE THE EYES ARE

OPEN, THE LID MARGINS OF THE NEWBORN
SHOULD BE
CLEANED WITH STERILE WET SWABS, ONE FOR
EACH EYE FROM INNER TO OUTER SIDE.
5. CARE OF THE SKIN: THE FIRST BATH IS GIVEN
WITH SOAP AND WARM WATER TO REMOVE
VERNIX, MECHONIUM AND BLOOD CLOTS.SOME
PREFER TO APPLY WARM OIL BEFORE THE
BATH. (USE HYPOALLERGENIC SOAP)

6. MAINTAINANCE OF BODY TEMPERATURE:

THE NORMAL BODY TEMPERATURE OF A
NEWBORN IS BETWEEN 36.5 deg C TO 37.5 deg C IT
IS IMPORTANT THAT IMMEDIATELY AFTER
BIRTH THE CHILD IS QUICKLY DRIED WITH A
CLEAN CLOTH AND WRAPPED IN WARM CLOTH
AND GIVEN TO THE MOTHER FOR SKIN-TO SKIN
CONTACT AND BREAST FEEDING.

7. BREAST FEEDING
• NEONATAL EXAMINATIONS
• MEASURING THR BABY: Wt, Ht, HEAD
CIRCUMFERENCE
• IDENTIFICATION OF “ AT RISK” INFANTS
• LATE NEONATAL CARE AND NEW BORN
SCREENING (NBS)

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(if mabuslot ang amniotic sac, maka anak sa wala sa
kabulanan, naay possible na naay opening sa cervix and
prone for bleeding and dehydration.)

Accessory structures of pregnancy

Placenta
-Temporary organ of pregnancy
Present only during pregnancy.
-Provides for fetal respiration, nutrition, excretion
-Made of blood umbilical cord supplies it
Made up of arteries and veins
responsible for the delivery of
nutrition and it serves as
respiration and excretion.
-Functions as an endocrine gland by producing hormones
necessary for normal pregnancy
Human chorionic gonadotropin (HCG), estrogen,
progesterone, and human placental lactogen (HPL)
(mo taas ang HCG causing 2 lines sa pt)
Positives sa pt is not 100% sure
Obstetrics Basin naa lay abnormalitie
(We are not only dealing with pregnancy, but also in the
whole duration of pag plano sa pregnancy, prenatal Presence of HCG
period, delivery of the baby and the first 6 weeks after the Blood and urine
delivery or the post partum delivery)
could determine level of HCG and if naay
*Field of medicine that deals with pregnancy (prenatal),
reproductive problems or ectopic pregnancy
delivery of the baby, and the first six weeks after delivery
(postpartum period)
Maternal side of placenta
Pregnancy *Attached to wall of uterus
-Nine calendar months or 10 lunar months *Has a “beefy” red appearance
-38-40 weeks AOG or 280 days
-Divided into trimesters Fetal side of placenta
*Three intervals of three months each *Has shiny, slightly grayish appearance
-Known as gestational period *Contains arteries and veins that intertwine to form
1-2-3 months- is the first trimester umbilical cord
4-5-6 months- is the second trimester
7-8-9 month- is the third trimester Umbilical cord
*arises from center of placenta and attaches to umbilicus
Fertilization or conception of fetus
-Union of a sperm and a mature ovum
*Takes place in outer third of the fallopian tube Physiological
Normal tubo sa baby Changes During Pregnancy
Ectopic pregnancy= Fertilized egg implanted inside of the
fallopian tube. There are three types of physiological changes during
pregnancy
Zygote 1. Presumptive = MACFLUQ (not sure kung
-Initial name for fertilized ovum pregnant)
-wala pa kaabot og 2 weeks of pregnancy -Changes observe by the women
M= morning sickness (nausea, vomiting)
Embryo A= amenorrhea (absence of menstruation or
-Name of product of conception from second through 8th menstruation stops as a result of hormonal
week of pregnancy influence during pregnancy
-2 weeks to 8 weeks of pregnancy C= Changes in breast size
F= Fatigue
L= latitude
Fetus
U= urinary frequency
-Name of product of conception from 9th week through
Q= quickening
duration of gestational period
-9 weeks of pregnancy
2. Probable= CHADWICKS- bluish discoloration
of the vaginal wall.
Two major accessory structures of pregnancy -Changes observe by the examiner
Amniotic sac (temporary organ) If naay bluish discoloration ang vaginal wall sa isa ka
-Is a strong, thin-walled membranous sac that envelops pregnant woman it’s because naa nay kabug–atun sa
and protects the growing fetus tiyan, arteries and vein is affected.
(Sya mo balot sa bata during the duration of pregnancy so NOTES: And naa say nag bluish discoloration sa vaginal
that, infections and other maternal problem is dli maka sa babae bisan dli pa sya buntis
adto didto sa bata)
-Also known as the fetal membrane H= Hegar softening of the lower uterine segment for
-Outer layer of sac is called the chorion preparation sa delivery kaykong dli soft unsaon pag
-Inner layer of sac is called the amnion stretch sa vaginal area dako ang ang ma episiotomy
-Amniotic fluid within sac cushions and protects fetus U= Uterine enlargement magdako ang tiyan during 12
during pregnancy weeks AOG start above symphesis pubis
P= Positive pregnancy test= presence of HCG in urine

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Ballottment= mo dako ang tiyan then pag e duot naay – May experience hypotension during
mag sink and rebound. second and third trimesters (4th – 9th
month)
Outlining of fetal body- naay ma feel na fetal body pero – Weight of pregnant uterus presses
ang uban mayuma ra diay or mga internal bukol-bukol. against descending aorta and inferior
vena cava
Goodell= softening of the lower uterine segment for • When woman is lying on her
preparation sa delivery back (supine)
Souffle, contraction= painless contraction during 28 • May complain of faintness,
weeks AOG lightheadedness, and dizziness
• Physiological
3. Positive= definitive sign of pregnancy Changes During Pregnancy
-Positive for pregnancy • Changes in urination
-naay FHT, heard 10 weeks by doppler – First trimester
18-20 weeks • Urinary frequency due to
Movement felt by the examiner usually 20 weeks increasing size of uterus,
Skeleton can be seen by the used of ultrasound creates pressure on bladder
– Second trimester
• Physiological • Uterus rises up out of the
Changes During Pregnancy pelvis and pressure on bladder
• Amenorrhea is relieved
– Absence of menstruation – Third trimester
• Menstruation stops as a result • Frequency returns due to
of hormonal influence during pressure of baby’s head on the
pregnancy bladder
• Changes in the uterus • Physiological
– Small, pear-shaped organ before Changes During Pregnancy
pregnancy • Changes in posture
– Grows to accommodate growing fetus, – Waddling gait- pina pato mo baklay
placenta, amniotic sac, and amniotic • Manner of walking in which
fluid during pregnancy the feet are wide apart and the
• Physiological walk resembles that of a duck
Changes During Pregnancy • Due to softening of pelvic
• Changes in the cervix joints and relaxing of pelvic
– Chadwick’s Sign ligaments
• Cervix and vagina take on a • Pregnant woman’s center of
bluish-violet hue due to local gravity is offset
venous congestion • Physiological
– Goodell’s Sign Changes During Pregnancy
• Cervix softens in consistency • Changes in the skin
in preparation for childbirth – Possible increased feeling of warmth
• Physiological and sweating
Changes During Pregnancy • Due to increased activity of the
• Changes in the vagina sweat glands
– Vagina takes on same bluish-violet hue – Possible problems with facial blemishes
of the cervix during pregnancy • Due to increased activity of
– Increase of glycogen in vaginal cells sebaceous glands
• Causes increased vaginal – Chloasma
discharge and heavy shedding • Hyperpigmentation (brown
of vaginal cells patches) seen on forehead,
– Leukorrhea cheeks, and bridge of nose
• Thick, white vaginal discharge • Known as the “mask of
during pregnancy pregnancy”
• Physiological • Physiological
Changes During Pregnancy Changes During Pregnancy
• Changes in breasts • Changes in the skin
– Increase in size and shape – Linea Nigra
– Nipples increase in size and become • Darkened vertical midline
more erect between the fundus and the
– Areola become larger and more darkly symphysis pubis on the
pigmented abdomen
• Montgomery’s tubercles – Areola
become more active and • Becomes darker as pregnancy
secrete substance that progresses
lubricates the nipples – Stria Gravidarum
• Physiological • Stretch marks on the abdomen,
Changes During Pregnancy thighs, and breasts that occur
• Changes in breasts during pregnancy
– Colostrum is secreted • Physiological
• Thin, yellowish discharge from Changes During Pregnancy
nipples throughout pregnancy • Changes in weight
• Forerunner to breast milk – Recommended weight gain during
• Physiological pregnancy
Changes During Pregnancy • Ranges from 25 to 30 pounds
• Changes in blood pressure – Pattern of weight gain is important

7
 MATERNAL AND CHILD HEALTH PROGRAMMES
• 1st – 3rd month = 3 - 4 pounds
total
• 4th – 9th month = 1 pound per
week
– Critical to monitor weight gain for
unexpected increases
– Fluid retention
– Pregnancy-induced
hypertension
• Signs and
Symptoms of Pregnancy
• Presumptive signs
– Expectant mother
• Suggests pregnancy but are not
necessarily positive
• Include amenorrhea, nausea
and vomiting, fatigue, urinary
disturbances, and breast
changes
– Quickening
• Movement of fetus felt by the
mother
• Occurs around 18 – 20 weeks
gestation
• Described as a faint abdominal
fluttering
• Signs and
Symptoms of Pregnancy
• Probable signs
– Observable by examiner
• Much stronger indicators of
pregnancy, but can be due to
other pathological conditions
• Should not be used as sole
indicator of pregnancy
• Include Goodell’s sign,
Chadwick’s sign, uterine
enlargement,
hyperpigmentation of skin,
abdominal stria, palpation of
fetal outline, positive
pregnancy tests
• Signs and
Symptoms of Pregnancy
• Probable signs
– Hegar’s sign
• Softening of the lower segment
of the uterus
– Braxton Hicks contractions
• Irregular contractions of the
uterus
• May occur throughout the
pregnancy and are relatively
painless
• Signs and
Symptoms of Pregnancy
• Probable signs
– Ballottement
• Technique of using the
examiner’s finger to tap
against the uterus, through the
vagina, to cause the fetus to
“bounce” within the amniotic
fluid and feeling it rebound
quickly
• Signs and
Symptoms of Pregnancy
• Positive signs
– Fetal Heartbeat
• Detected by ultrasound at
approximately 10 weeks
gestation
• Detected by fetoscope at 18 to
20 weeks gestation
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• Rate can vary from 120 to 180
beats per minute
• Signs and
Symptoms of Pregnancy
• Positive signs
– Identification of embryo or fetus by
ultrasound
• Can be detected as early as 5 to
6 weeks with 100 percent
reliability
• Provides earliest positive
confirmation of a pregnancy
– Fetal movements felt by examiner
• Palpable by
physician/examiner by the
second trimester of pregnancy
• Calculation of Date of Birth
• Birth date for the baby
– Expected Date of Confinement (EDC)
– Expected Date of Delivery (EDD)
– Expected Date of Birth (EDB)
• Nagele’s rule for calculation of date
– Subtract three months from beginning
of last menstrual period (LMP)
– Add seven days to date = expected date
of delivery
• Discomforts of Pregnancy
• Temporary discomforts of pregnancy
– Backache
• Common during second and
third trimester
– Edema
• Swelling of lower extremities
not uncommon
– Fatigue
• Usually occurs during first
trimester
• Discomforts of Pregnancy
• Temporary discomforts of pregnancy
– Heartburn
• Mainly during last few weeks
of pregnancy
– Hemorrhoids
• Develop as result of increasing
pressure on area
– Nausea
• Usually occurs during first
trimester
– Varicose veins
• Occur as result of blood
pooling in the legs
• COMPLICATIONS
OF PREGNANCY
• Obstetrics
• Abortion
• Pronounced
– (ah-BOR-shun)
• Defined
– Termination of a pregnancy before the
fetus has reached a viable age, that is,
an age at which the fetus could live
outside of the uterine environment
• Abruptio Placenta
• Pronounced
– (ah-BRUP-she-oh pla-SEN-tah)
• Defined
– Premature separation of a normally
implanted placenta from the uterine
wall
• After the pregnancy has passed
20 weeks gestation or during
labor
• Ectopic Pregnancy
• Pronounced
– (ek-TOP-ic PREG-nan-see)
 MATERNAL AND CHILD HEALTH PROGRAMMES
8/24/2021 10:03 PM
• Defined – Abnormal condition of pregnancy
– Abnormal implantation of a fertilized characterized by severe vomiting that
ovum outside of the uterine cavity results in maternal dehydration and
– Also called a tubal pregnancy weight loss
• Approximately 90 percent of • Incompetent Cervix
all ectopic pregnancies occur • Pronounced
in the fallopian tubes – (in-COMP-eh-tent SER-viks)
• Gestational Diabetes • Defined
• Pronounced – Condition in which cervical os dilates
– (jess-TAY-shun-al diy-ah-BEE-teez) before the fetus reaches term, without
• Defined labor or uterine contractions
– Disorder in which women who are not • Usually occurs during second
diabetic before pregnancy develop trimester of pregnancy
diabetes during the pregnancy • Results in spontaneous
• Develop an inability to abortion of fetus
metabolize carbohydrates • Placenta Previa
(glucose intolerance), with • Pronounced
resultant hyperglycemia – (plah-SEN-tah PRE-vee-ah)
• Gestational Diabetes • Defined
• Risk factors – Condition of pregnancy in which the
– Obesity placenta is implanted in the lower part
– Maternal age over 30 years of the uterus
– History of birthing large babies • Precedes the fetus during the
• Usually over 10 pounds birthing process
– Family history of diabetes • Pregnancy-Induced Hypertension (PID)
– Previous, unexplained stillborn birth • Pronounced
– Previous birth with congenital – (PREG-nan-see induced high-per-
anomalies (defects) TEN-shun)
• HELLP Syndrome • Defined
• Pronounced – Development of hypertension during
– HELLP SIN-drom pregnancy, in women who had normal
• Defined blood pressure readings prior to
– Serious obstetrical complication that pregnancy
occurs in approximately 10 percent of • Pregnancy-Induced
pregnant women with pre-eclampsia or Hypertension (PID)
eclampsia • Three categories of PID
• HELLP stands for Hemolytic – Gestational hypertension
anemia, Elevated Liver • Develops after 20 weeks
enzymes, and Low Platelet gestation with no signs of
count edema or proteinuria
• HELLP Syndrome – Pre-eclampsia
• Early diagnosis is critical • Develops after 20 weeks
– Any woman who presents with malaise gestation with proteinuria or
or a viral-type illness in third trimester edema
of pregnancy should be evaluated for – Eclampsia
possibility of HELLP Syndrome • Most severe form of
• Laboratory diagnosis necessary to confirm hypertension during pregnancy
HELLP syndrome • Evidenced by presence of
– Complete blood cell count seizures
– Liver function tests • Rh Incompatibility
• Hydatidiform Mole • Pronounced
• Pronounced – (Rh Incompatibility)
– (high-dah-TID-ih-form mohl) • Defined
• Defined – Incompatibility between and Rh
– Abnormal condition that begins as a negative mother’s blood with her Rh
pregnancy and deviates from normal positive baby’s blood
development very early • Causes mother’s body to
• Diseased ovum deteriorates develop antibodies that will
(not producing a fetus) destroy the Rh positive blood
• Chorionic villi of placenta • SIGNS AND
changes to a mass of cysts SYMPTOMS OF LABOR
resembling a bunch of grapes • Obstetrics
• Hydatidiform Mole • Signs and Symptoms of Labor
• Hydatidiform mole • Bloody show
– Molar pregnancy – Vaginal discharge that is a mixture of
– Hydatid mole thick mucus and pink or dark brown
– Growth of this mass progresses much blood
more rapidly than uterine growth with a • Occurs as a result of the
normal pregnancy softening, dilation, and
• Hyperemesis Gravidarum thinning (effacement) of the
• Pronounced cervix in preparation for
– (high-per-EM-eh-sis grav-ih-DAR- childbirth
um) • Signs and Symptoms of Labor
• Defined • Braxton Hicks contractions

9
 MATERNAL AND CHILD HEALTH PROGRAMMES
– Mild, irregular contractions that occur
throughout pregnancy
• Increased vaginal discharge
– Clear, nonirritating vaginal secretions
– Occurs as result of congestion of
vaginal mucosa
• Signs and Symptoms of Labor
• Lightening
– Settling of the fetal head into the pelvis
• Occurs a few weeks prior to
the onset of labor
• Rupture of the amniotic sac
– Rupture of fetal membranes, releasing
amniotic fluid inside
• May result in a sudden gush of
amniotic fluid
• Women may say their “water
broke”
• Signs and Symptoms of Labor
• Sudden burst of energy
– Occurs in some women shortly before
onset of labor
– May have energy to do major
housecleaning duties
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• DIAGNOSTIC
TECHNIQUES, TREATMENTS AND
PROCEDURES
• Obstetrics
• Diagnostic Techniques, Treatments, and
Procedures
• AFP screening
– Serum screening test for birth defects
such as spina bifida, Down syndrome,
and Trisomy 18
• Test is offered to pregnant
women between 15 and 21
weeks gestation
• Diagnostic Techniques, Treatments, and
Procedures
• Amniocentesis
– Surgical puncture of the amniotic sac
for the purpose of removing amniotic
fluid
• Cesarean section
– Surgical procedure in which the
abdomen and uterus are incised and a
baby is delivered transabdominally
• Diagnostic Techniques, Treatments, and
Procedures
• Contraction stress test
– Stress test used to evaluate ability of
fetus to tolerate stress of labor and
delivery
• Also known as oxytocin
challenge test
• Fetal monitoring
– Use of an electronic device to monitor
fetal heart rate and maternal uterine
contractions
• Diagnostic Techniques,
Treatments, and Procedures
• Nipple stimulation test
– Noninvasive technique that produces
same results as contraction stress test
• Pregnant woman stimulates the
nipples of her breasts by
rubbing them between her
fingers
• Causes natural release of
oxytocin that causes
contractions of uterus
• Diagnostic Techniques,
Treatments, and Procedures
• Obstetrical ultrasound
– Noninvasive procedure that uses high-
frequency sound waves to examine
internal structures and contents of the
uterus
– Ultrasonography
• Diagnostic Techniques,
Treatments, and Procedures
• Pelvic ultrasound
– Noninvasive procedure that uses high-
frequency sound waves to examine the
abdomen and pelvis
• Pelvimetry
– Process of measuring the female pelvis,
manually or by x-ray to determine its
adequacy for childbearing
• Diagnostic
Techniques and Procedures
• Pregnancy testing
– Tests performed on maternal urine
and/or blood to determine presence of
hormone HCG (human chorionic
gonadotropin)
• HCG is detected shortly after
first missed menstrual period