( Maternity antenatal

and postpartum Health)

health assessment

Prepared by
Munira Al-dosari
Hessa Al-rafia
Ohoud Al-harbi
Alaa Al-hawsawi
Rawan Al-hazmi
 Content

Ø prenatal and post-natal definition

Ø prenatal and post-natal risk factors and complications

Ø prenatal and post-natal mental and physical needs and assessment

Ø maternity nutrition assessment and need

Ø prenatal and postnatal health education

Ø prenatal and post-natal social support

 ü Define and identify the maternity period and maternity
risk factors and complications

ü How to educate women during the maternity period

ü How to do physical and mental maternity assessment

Objective
ü How to do a maternity nutritional assessment

ü Discuss the importance of social support in the

maternity period .
 Prenatal and postnatal definition

• Prenatal definition
• Prenatal refers to the period of time before a baby is born, from
conception until birth. During this time, the baby develops inside
the mother's womb.
 Postnatal definition

• Postnatal refers to the period of time

after a baby is born. This includes the
first few weeks and months of the baby's
life, as they adjust to their new
environment outside of the womb and
continue to grow and develop.
 Prenatal risk factor
• Prenatal risk factors refer to any conditions or circumstances that may affect the health
and development of a baby during pregnancy. Some examples of prenatal risk factors
include:
• 1. Maternal age: Women who are younger than 18 or older than 35 may have a higher risk of
complications during pregnancy and childbirth.
• 2. Maternal health: Women who have pre-existing medical conditions such as diabetes, high
blood pressure, or infections may be at higher risk for complications during pregnancy.
• 3. Substance use: Women who smoke, drink alcohol, or use drugs during pregnancy may increase
the risk of miscarriage, premature birth, or developmental problems in the baby.
 Cont.…
• Poor nutrition: A lack of essential nutrients during pregnancy can lead to
low birth weight, premature birth, and other complications.
• 5. Environmental factors: Exposure to toxins, pollutants, or radiation during
pregnancy may increase the risk of birth defects, developmental delays, and other
health problems in the baby.
• 6. Genetics: Certain genetic conditions may be passed down from parents to their
children, increasing the risk of birth defects or developmental disorders.
 Postnatal risk factor
• Postnatal risk factors refer to any conditions or circumstances that may
affect the health and development of a baby after birth. Some examples of
postnatal risk factors include:
• 1. Prematurity: Babies who are born prematurely, before 37 weeks of
gestation, may be at higher risk for developmental delays, respiratory
problems, and other health issues.
• 2. Low birth weight: Babies who are born weighing less than 5.5 pounds
may be at higher risk for developmental delays, infections, and other
health problems.
• 3. Neonatal complications: Babies who experience complications at birth,
such as birth asphyxia, jaundice, or infections, may be at higher risk for
long-term health problems.
 Cont.
• 4. Environmental factors: Exposure to toxins, pollutants, or secondhand
smoke after birth may increase the risk of respiratory problems,
developmental delays, and other health issues.
• 5. Nutrition: A lack of essential nutrients after birth can lead to poor growth,
developmental delays, and other health problems.
• 6. Parental factors: Parental factors such as neglect, abuse, or a lack of
bonding may increase the risk of developmental delays, behavioral
problems, and other issues in the baby.
 Prenatal complications
• Prenatal complications refer to any medical or health issues that arise
during pregnancy that may affect the health and development of the baby
or the mother. Some examples of prenatal complications include:
• 1. Gestational diabetes: A type of diabetes that develops during pregnancy
and can lead to high blood sugar levels in the baby.
• 2. Pre-eclampsia: A condition characterized by high blood pressure and
protein in the urine, which can lead to complications for both the mother
and the baby.
• 3. Placenta previa: A condition where the placenta partially or completely
covers the cervix, which can cause bleeding and other complications
during pregnancy.
 Cont.
• 4. Preterm labor: The onset of labor before 37 weeks of gestation, which can lead to
premature birth and associated complications.
• 5. Fetal growth restriction: A condition where the baby does not grow properly during
pregnancy, which can lead to low birth weight and associated health problems.
• 6. Multiple pregnancies: Carrying more than one baby, such as twins or triplets, can
increase the risk of complications during pregnancy and childbirth.
• 7. Infections: Certain infections, such as rubella, toxoplasmosis, and cytomegalovirus, can
be passed from the mother to the baby during pregnancy and lead to complications.
• 8. Genetic disorders: Certain genetic disorders, such as Down syndrome, can be detected
during prenatal testing and may require specialized care during pregnancy and after birth.
 Postnatal complications
• Postnatal complications refer to any medical or health issues that arise
after the baby is born. Some examples of postnatal complications include:
• 1. Respiratory distress syndrome: A condition where the baby's lungs are
not fully developed and they have difficulty breathing.
• 2. Jaundice: A condition where the baby's skin and eyes appear yellow due
to the buildup of bilirubin in the blood.
• 3. Infections: Newborns are at increased risk of infections, such as sepsis,
meningitis, and pneumonia.
• 4. Birth injuries: Some babies may experience birth injuries during delivery,
such as fractures, nerve damage, or bruising.
Pre natal and Post
natal Health
Education
 EARLY PRENATAL CARE

Is crucial to the health of the woman and her unborn baby.

A recent study found that birth outcomes for women who receive no prenatal
care are two to four times worse than outcomes for the general population
(Taylor, Alexander, &Hepworth, 2005).

As a nurse and trusted health care provider, you play a large role in teaching
women about the importance of early and continued prenatal care.
 GOAL OF PRENATAL CARE
The goal of early prenatal care is to
optimize the health of the woman
and the fetus and to increase the
odds that the fetus will be born
healthy to a healthy mother.
prenatal care allows for the
initiation of strategies to promote
good health and for early
intervention in the event a
complication develops.
 Discuss how women are empowered
to make decisions about their care
GROUP WORK during the antenatal period and
Labour?
 The objectives of educating parents for parenthood are:

Ø To give a couple more confidence.

Ø To help a woman have a happy, healthy pregnancy,

birth, and parenthood experience to persuade them to
adopt a healthy lifestyle.

Purpose of education Ø To help and support the woman to breastfeed through

telling her about successful breastfeeding techniques
for parenthood and management

Ø To assist her to care for her baby regardless of what

feeding method she uses.

Ø To provide a source of support that continues

throughout the couple’s transition to parenthood.

Ø to provide appropriate education and information for

parents about pregnancy, birth, and parenthood.
 Sound knowledge of the process of pregnancy, labour
and the ability to relate this to the changes which the
women and their partners will experience and to the
Skills required to care they receive.

facilitate the Knowledge of fetal and infant growth and

education of development, and health care; sensitivity and
knowledge of the psychological adjustments that most
parents parents will experience as they enter into parenthood.

Understanding of teaching methods, including

lecturing and discussion.
 Effective communication skills so that women
and their families can understand the
information presented, the ability to answer
questions honestly,.

CONT.. Counselling skills and the ability to listen to and

be sensitive to couples’ concerns.

Ability to modify, adapt, change and revise the

content and format of the session to suit the
needs of the couples.
 Discuss how these skills can be
developed and what is needed to
GROUP WORK achieve these goals in your setting.
What can you do to provide these
needs in your setting?
 ■Avoid alcohol. Alcohol harms the fetus;
no amount of alcohol is safe during
pregnancy.

MAJOR ■ Avoid smoking. Smoking harms the

COMPONENTS fetus. It can lead to lower birth weight
OF PRENATAL and increase the incidence of preterm
SELF-CARE labor.
■ Eat a healthy, well-balanced diet. If
you consume a variety of nutritious
foods daily, you will likely get the
nutrients you need.
 ■ Avoid dieting during pregnancy. Every
pregnant woman with a normal body mass
index should gain 25 to 30 lb during the
pregnancy.
■ Avoid handling raw meat and cat litter. Wear
gloves when gardening to prevent contracting
CONT.. toxoplasmosis from animal droppings, an
infection that is very harmful to the baby.
■ Avoid taking any medication (other than
acetaminophen) or over-the-counter herbal
remedy unless your primary care provider has
approved it.
 “Routine” for you as a midwife nurse is not at
all routine for the women.
ACTIVITY
HOW?
 Being prepared for labor, birth, and
parenting boosts the woman’s confidence
and increases her use of positive coping
measures.
■ Partner’s role in providing support for
Preparing the Woman each stage.
for Labor, Birth, and ■ Comfort measures for labor: relaxation,
movement, breathing, focus, massage,
Parenthood pressure, encouragement, and support.
■ Medication and anaesthesia options for
labor and birth.
■ Possible complications of labor:
prevention and management.
 ■ Hospital admission routine.
■ Medical procedures and
interventions, such as vaginal
examinations, routine laboratory
work, fetal monitoring.
CONT…
■ Cesarean birth .
■ Breastfeeding.
■ Physical and emotional aspects of
the postpartum period.
 Nursing assessment is defined
as the collection of
information related to a
patient's physiological,
Aassessment psychological, social, and
spiritual condition through a
licensed legal nurse. Nursing
assessment is the first step in
the nursing process
 To promote maternal health and help in
normal fetal development
To assess health status of mother and
fetus
Assessment Reduce maternal and infant morbidity
Goals and mortality
Remove anxiety and fear with pregnancy

Maintain health status of mother during

antenatal period
• Before starting the evaluation, a professional and therapeutic
communication pattern with the patient must be established. This
develops his relationship with the patient and lays the foundations of
trust between them in a non-judicial relationship. This also confirms that
the person will feel greatly comfortable disclosing their personal
information. One of the most common ways to start therapeutic
communication between the nurse and the patient is to identify himself
or herself, and the interview begins by asking the patient about his or her
desire to deal and the general nature of the topics that will be covered in
the interview.
Antenatal

HISTORY PSYCHOLOGICAL PHYSICAL

ASSESSMENT ASSESSMENT
 History

Your personal and

Your menstrual your gynecological and any previous
family medical
cycle, medical history, pregnancies
history

Education level
Exposure to any
Medications and knowledge of
potentially toxic Your lifestyle,
you're taking, pregnancy and
substance
prenatal care
 Psychological
• The pregnancy period is accompanied by many feelings affecting the
psyche of the pregnant woman,
• (Joy: Anger: Fear:. Grief)

Causes of changing the psyche of pregnant women

Hormones. Stress: Physical changes: . Pooping:

• feelings toward the pregnancy.

• Negative remarks ?
• Try to understand the woman’s perspective. Note if her anxiety
level increases. Anticipate concern when fetal testing is required.
Solicit questions and correct mis-conceptions the woman may have.
Provide information concerning the treatment plan. Use active
listening and encourage positive coping behavior
 Ø Routine laboratory tests for each pregnant
woman
Ø nutritional status Take measurements: weight
and height
Ø Measure blood pressure and glucose
Ø Examination of the face to monitor changes from
bulges, and examination of the conjunctiva, lips,
Physical and tongue to follow their color and identify
anemia,
Ø Examine the thyroid gland for enlargement.
Ø Examination of the back and limbs.
Ø Examination of the breasts.
Ø Fetal health tests
 List three
Nasal Stuffiness and Nausea and suggestions for
Epistaxis vomiting reducing nausea in
early pregnancy

Pregnant women tend to Feeling Faint Frequent Urination.

Shortness of
experience similar Breath

discomforts because of
Name three actions
the significant bodily Heartburn
the pregnant
Backaches
changes they undergo woman can take to
reduce heartburn

Constipation and
Trouble Sleeping
Hemorrhoids.
Monitor for danger signs of pregnancy

■Headache,
■Fever or severe unrelieved by Tylenol ■Blurred vision or ■Pain in the epigastric
vomiting or other relief spots before the eyes region
measures

■Sudden weight gain ■Sudden gush or

or sudden onset of constant, uncontrollable
■Vaginal bleeding ■Painful urination
edema in the hands leaking of fluid from the
and face vagina

■Signs of preterm labor

Uterine contractions (four or
■Decreased fetal more per hour)Lower, dull A feeling that
movement back ache Pelvic pressure something is not right
Menstrual-like cramps
Increase in vaginal discharge
Teaching Self-Care During Pregnancy

Maintaining a
Balanced Dental Hygiene Exercise. Hygiene. Breast Care
Nutritional Intake

Medications and
Clothing. Sexual Activity Employment Travel.
Herbal Remedies.
 Expected Outcome

The woman will feel

The woman’s symptoms
The woman’s anxiety is confident in her ability to
and discomforts of
reduced care for herself
pregnancy are managed
throughout pregnancy

The woman and fetus The woman will express

remain free from confidence in her ability
preventable injury to go through the labor
throughout the and birth experience and
pregnancy assume the parenting
 Packing for the Hospital or Birthing Center

• WHAT TO PACK FOR THE HOSPITAL OR

BIRTHING CENTER?

Ø Communicating Expectations About Labor

and Birth
Preparing the Ø Choosing the Support Person
Woman for Labor, Ø Childbirth Education Classes
Birth, and Ø Pregnancy and Postpartum Exercise
Classes
Parenthood
Ø Pregnancy and Postpartum Exercise
Classes
Ø . Baby Care Classes
Ø Breast-feeding Classes
Ø Siblings Classes
 The postpartum period covers the time period
from birth until approximately six week after
delivery

So, it is important to remember the mnemonic

POSTPARTUM BUBBLE-HE to denote the components of the
AND NEWBORN postpartum maternal nursing assessment

effect of culture and habits ?!

Nurses need to be aware of the normal
physiological and psychological changes that take
place in women's bodies and minds in order to
provide comprehensive care during this period
 The acronym Bubble-He stands for:

B: breasts U: uterus B: bladder B: bowels

E: episiotomy H:
L: lochia E: emotions
and perineum hemorrhoids
 • Your nipples should point
out, and you should see tiny
drops of colostrum when you
express your breast tissue
B: breasts before your milk comes in
entirely. Ideally, you
shouldn’t have extreme pain
while breastfeeding, and no
cracking or bleeding should
develop.
 • It can take up to six weeks for
your uterus to slowly shrink back
to size.

• While not often discussed,

afterpains – or pains after birth
U: uterus caused by the contraction of your
uterus – are common, especially
when breastfeeding.

• Your care team will most likely

offer pain medications, but some
herbal options can ease cramping
as well. Make sure to ask your
provider.
 • If everything is healing normally, you
should have full function of your bladder
once your nurse removes your foley
catheter. In most cases, you’ll only have a
catheter if you have an epidural.

• It’s critical to empty your bladder

frequently and stay hydrated. You may
B: bladder find that you pee out a lot more in the
postpartum period – that’s because
you’re flushing out all the retained fluids
from pregnancy.

• Also, if you have a sense of frequency,

urgency, burning while voiding, or foul-
smelling urine, these are signs of
infection and must be reported to your
nurse or provider immediately.
 • The first postpartum bowel
movement can be intimidating,
especially if you experienced:

• Hemmorhoids
• Vaginal tearing
B: bowels
• An episiotomy
• To help ease yourself into your
first bowel movement, make sure
to eat plenty of fiber and stay
hydrated. Also, make sure to take
the stool softeners offered to you
and have some available at home,
too.
 • Lochia is the bleeding after birth as your
uterine wound – where the placenta
attached to your uterus – begins to heal.

• Most women have moderate period-like

bleeding for up to six weeks, but this can
L: lochia depend on how they give birth. If you
find that your bleeding tapers off and
then picks back up, it could be a sign that
you’re doing too much too quickly.

• Bleeding should gradually become

scanter; it is normal to see small clots and
see more bleeding when you are up and
about, physically active, or breastfeeding.
 • Even if your perineum is intact and
you suffered no tears, swelling and
inflammation are common in the
early weeks.

• To best support your perineum,

E: episiotomy make sure to have the below items
at home:
and perineum
• Peri bottle
• Sitz bath
• Sitz bath soak
• Cold packs
• Healing spray
 • While uncomfortable,
hemorrhoids are common
during the late part of
pregnancy and early
postpartum.

H: hemorrhoids • Make sure to communicate

your discomfort with your
care team as needed or if it
becomes alarming. Use
witch hazel pads, organic
hemorrhoid balm, and a
stool softener to help
encourage healing at home.
 E: Emotions

• The first thing we want to know is whether you’re in

physical pain. If so, know that you have options, so it’s
essential, to be honest and upfront about how you’re
feeling.

• Secondly, how are you feeling? Know that it’s normal to be

overwhelmed and experience a range of emotions during
this time.

• If you are worried, you’re experiencing the baby blues,

know that they’re expected for the first two weeks. If these
feelings progress longer than two weeks, talk to your
provider about postpartum depression and anxiety.
 Expected Outcomes

The woman remains The woman has normal

The woman’s pain is
free from the signs and bowel elimination and
manageable
symptoms of infection avoids constipation

. The woman and her

partner demonstrate
The woman does not
signs of healthy
develop DVT
attachment to the
newborn
 Ø Breastfeeding.
Ø postnatal exercises.
Postpartum care of Ø psychological adjustments to
the mother marriage and life with a new baby.
Postpartum care of the baby: care
of the baby/equipment needed.
immunization for babies.
Maternity Nutrition Assessment
and Needs
A lot of physical and hormonal changes occur in the
pregnant woman’s body throughout the pregnancy
to maintain the health of the fetus, and the
mother’s nutritional needs increase as she is the
only source of nutrition for her fetus, so it is better
to follow a healthy and balanced diet throughout
the pregnancy to contribute to the proper growth of
the child’s brain and weight, and reduce Among the
risks of congenital malformations and other health
complications that may appear in the future
 Objective:

This study was carried out to evaluate the dietary nutrient intake of

pregnant women. The relationship between dietary intake and pregnancy

outcome was also studied.

Results:

The percentages of the mean nutrient intake below the recommended dietary

allowances (RDA) for pregnant women were as the follows: 51.8%, 93.9%, 82.5% and

98.2% for energy, vitamin B1, calcium and iron, respectively. Moreover, 13.2% of the

women experienced some form of pica. Using height and mid-arm circumferences,

about 2.8% and 4.4% were seen to be undernourished respectively.

q Summary of study recommendations
• A problem of low birth weight that affects about 20 million newborns
annually
• The effect of malnutrition during pregnancy on the health of the
mother and child.
• Increased risk of serious complications such as the birth of a baby with
a low birth weight
• The dietary habits of the Saudi people have been affected by the influx
of foreign labor, and the availability of a wide range of imported goods
• The majority of women (74.6%) married under the age of twenty.
• The prevalence of anemia in this study was 19%.
• The high prevalence of teenage pregnancy leads to an increased risk of
spontaneous abortion
• Increased consumption of tea and coffee during pregnancy and can
affect iron.
• The results of this study concluded that pregnant women need:
• Increase their intake of foods rich in iron, calcium, vitamin B1 and
energy
• Pregnant women need guidance in choosing nutrient-dense foods.
• Nutritional assessment of pregnant and adolescent women
• Provide balanced nutrition education
Nutritional Status
The nutritional status is influenced by food intake, quantity & quality, & physical
health.
 When a pregnant woman's body receives all the

nutrients in the right amounts to meet the body's needs

When there is a lack or excess intake of one or more

nutrients , it leads to the state of imbalance in the body

Types of malnutrition
 Do you know why
malnutrition occurs?
Some of the important factors responsible for causing it

Economic conditions
Ignorance
 Nutrition Assessment and Need

A nutrition assessment is an in-depth evaluation of

both objective and subjective data related to an

individual's food and nutrient intake, lifestyle, and

medical history.
 The purpose of a nutritional assessment is:

To identify pregnant women who are at risk of malnutrition.

To Select pregnant women who suffer from malnutrition

 Methods of Nutritional Assessment
Nutrition is assessed by two types of methods direct and indirect.

The direct methods deal with the individual and measure objective

criteria, while indirect methods use community health indices that

reflects nutritional influences.

 Full Nutrition Assessment

Nutritional Assessments are summarized as ABCD

• Anthropometric or body composition measurements.

• Biochemical analyses.

• Clinical examination is usually performed by the physician or other health

care provider

• Dietary analysis and assessment

 Step 1…Data collection

Anthropometric measurements:

Include the measurement of height and weight and,

the calculation of the body mass index [BMI]

 Biochemical assessment/markers:
It is the examination of the following biochemical

parameters: albumin, albumin, CRP, transferrin, hemoglobin,

urea, creatine, lymphocytes, and hypo-cytosis.

 LifeHelp Nutrition and Diabetes Center
Pregnancy Nutrition Assessment Form
Today’s Date: _________________________

Name: __________________________________________________________ Date of Birth: ________________________________

Address: _______________________________________________________ City/Zip: _____________________________________

Home Phone: _______________________ Other Phone: __________________________ Insurance: __________________________

Health History
The clinical component of the nutrition assessment: When were you diagnosed with gestational diabetes? _____________________________________

Is this your first pregnancy? Yes No Second? Third? Other ______

Consists of the history of the present illness, the past medical history, and an Were you diagnosed with gestational diabetes in other pregnancies? (If applicable) _____________

Have you ever received diabetes education before? ___________________________________________________________________

inquiry into the family history. It includes a measurement of blood pressure as Please list any medical conditions: ________________________________________________________________________________

Recent ER/hospital visits: When? ______________Why? ______________________________________________________________

well as the presence of any physical limitations/restrictions regarding physical Social History
Do you smoke? Yes (packs per day______) Never Quit (When?_____________)

Do you drink alcohol? Beer Wine Liquor How many times per week? ____________
movement/activity. For example, the review of systems (ROS) is a head-to-toe
Does anyone provide you with practical and/or emotional support for managing your gestational diabetes? Yes No
(Specify: ___________________________________________________________________________________________________)
examination looking for signs of malnutrition and/or disease Do you have any possible barriers to learning? Yes No

Hearing: Visual: Language: Education: Other: (Specify: ___________________________________

_________________________________________________________________________________________________________)

Do you have financial concerns that affect your health care? Yes No (Explain: _______________________________________

___________________________________________________________________________________________________________)

Years of school completed: ___________

Do you have any cultural or religious customs that may affect your diabetes care? Yes No

LifeHelp Nutrition and Diabetes Center

1200 Seventh Ave. N., Suite 120
St. Petersburg, FL 33705
(727) 820-7910

StAnthonys.org/LifeHelp
 The most dietary assessment tools are:

1. Diet Record: Recording all food and beverages consumed

over 3 days (commonly 2 weekdays and 1 weekend)

2. 24-Hour Dietary Recall: Reporting all food and beverages

CONT… consumed over last 24 hours in an interview

3. Food Frequency Questionnaire: Reporting frequency of

consumption and portion sizes of a range of foods and

beverages over a long-term period (commonly over 1 year).

q Food Frequency Questionnaire
• A food frequency questionnaire is a tool that helps you record how

often you eat certain foods on a regular basis.

• It also asks questions about your eating habits

• A food frequency questionnaire will help you keep track of what you

eat regularly.

When filling out a food questionnaire, write down everything you ate

during the past 24 hours. Include all beverages, water, milk, juice, soda,

tea, coffee, and any other drinks. Also, note if you skipped meals. If

you’re not sure whether something was eaten, just put an “X” next to

the item.
q Calorie Calculator
A calorie calculator allows you to fill in the number of calories you

consume in a day. Then, based on your weight, age, gender, height,

and activity level, it determines the number of calories you need

each day for a healthy life.

A calorie calculator is only as good as the measurements you input.

For instance, some people might forget to include snacks, such as

cookies, crackers, chips, etc., when they count calories. And they

might underestimate the calories they burn while exercising. These

inaccurate measurements affect the quality of information you get

from the calculator in the end.

q Create mobile-friendly forms

Form plus allows you to create mobile responsive food rubrics that

can be filled out on any device including smartphones, laptops and

notebooks. Form plus Forms provide an enhanced user experience

and are suitable for any devices on which they are viewed
q Pyramid diet

The food pyramid shows how many servings of grains, vegetables, fruits, dairy

products, meats and oils a pregnant woman should eat each day. Each section

represents a specific type of food. For example, the top of the pyramid shows

how much whole grain bread, pasta, rice, cereal, oatmeal and potatoes you

should eat. The lower part shows the amount of fruits, vegetables, fish, meat

and eggs that a pregnant woman should eat.

 After the assessment, the information obtained from all aspects A-D is summarized for a complete

nutritional assessment and reviewed by the medical professional

or other healthcare professional to determine: - Nutrition diagnosis, nutrition intervention design and

implementation, followed by monitoring and evaluation

In 2011, the “My Plate” approach to healthy eating

was unveiled.

This approach is intended to encourage persons to be

mindful of the foods they eat in terms of both portion

size and proportion to other foods.

One-half of the plate should consist of fruits and

vegetables, with one-quarter each for meats/proteins

and grains, preferably whole grains.

Recommendations also include eating less sodium and

fewer sugary foods

 • 1st trimester: During 1st trimester there
is no significant increase in the size of
fetes thus only qualitative improvement in
nutrients intake is required during this
time.

Nutritional needs during

pregnancy
 2nd & 3rd trimester: An increased nutrient
intake is suggested in second & third
trimester of pregnancy thus need for almost
all the nutrients is increased during
pregnancy.
Nutrition on pregnancy and lactation

Nutrition requirements increases

tremendously during pregnancy and lactation

as the expectant or nursing mother not only

has to nourish herself but also growing fetus

and the infant who is being breast fed”.

Common nutritional complications During Pregnancy
Maternity social support
 Maternity social support

Pregnancy is an important milestone in the birth and postpartum period of a

woman’s life and is also defined as a period of developmental crisis. This
period is a complex process where biological, physiological, social, and
spiritual changes are experienced.
The social support to be given to the woman during the pregnancy, birth, and
postpartum period positively affects the adaptation process to the
motherhood role, increases her sensitivity to her baby and facilitates the
relationship with her relatives
 Importance of maternity social support
Social support has been reported to play a crucial role in maternal health and well-being that include :

v Influencing women’s ability to cope with events during specific periods

v Social support is characterized by the manner in which connections exist between people who have recurring
interactions and fulfill the needs of individuals.

v Pregnancy is generally viewed as a period coupled with various physiological and emotional changes, which can
significantly affect maternal and infant health outcomes and the close relations with other individuals play an
integral role in influencing individuals’ quality of life, which promotes positive well-being, resulting in expectant
mothers perceiving pregnancy-related changes as less stressful

v Mothers who have the support of a companion during labor and delivery experience fewer childbirth complications
and less postpartum depression.

v The care and support that pregnant women receive contributes greatly to how they experience their pregnancy
 Types of maternity support

v Material support: Assistance with chores, meals, managing

finances

v Emotional support: Affection, approval, encouragement, and

feelings of togetherness

v Informational support: Sharing information, and helping

women investigate new sources of information

v Comparison support
 Based on knowledge and
experience mention examples
of maternity social support
Discussion Sources?
 v Family and husband

v Friends
Source
of maternity v Coworker

social support
v Health professionals

v Online support program

v Support group
Social support during
v Antenatal period

v Delivery period

v Postpartum period
Antenatal period

• Pregnancy is an important but emotionally sensitive time

for most women, and it is also accompanied by changes in
physical appearance, role, and lifestyle. Such changes may
have an impact on the attitude, decision-making, and
behavior of the pregnant mother in undertaking the social
responsibility that comes with pregnancy and motherhood.

• These changes during pregnancy may be exacerbated by

financial problems, relationship issues, and lack of social
support. Thus, to tackle these challenges the need for social
support during pregnancy is vital
Delivery period

• Labor can be a very frightening experience for

women, especially first births. In addition,
women will experience physical sensations
ranging from discomfort to severe pain.
Helping the woman to be as relaxed as possible
and aware of her situation can help minimize
the physical pain and emotional distress of
labor and birth

• Women can be helped with this by receiving

adequate care, timely information, comfort,
support, and reassurance during labor and birth.
 Postpartum period

• Mothers across all racial/ethnic groups identified

fulfilling basic personal care needs, household chores,
and getting sleep as the major challenges during the
postpartum period and additional challenges with caring
for other children and work-related stress.

• Mothers mentioned physical symptoms such as post-

delivery c-section pain or breastfeeding discomfort as
obstacles to their postpartum recovery.

• Social support was associated with a decreased likelihood

of postpartum depression, indicating the importance of
social support, especially for women experiencing
multiparity, pregnancy loss, negative body image, as well as
for employed women.
 Discussion

Based on your experiences and opinions, how can this scenario

be dealt with? A woman who is three months pregnant lives in
a village far from the city where there are women’s health
services. She lost her previous pregnancy two years ago and
has concerns about her previous pregnancy

• What are her needs?

• How can this situation be supported and educated?
• What is the possible complication if neglect in this case
physical and mental consequences?
Barrier of social support

LACK OF ACCESS EDUCATIONAL SOCIOECONOMIC LANGUAGE

TO SERVICES LEVEL STATUS BARRIER
 Another barrier related to the maternity period

v Some women felt that asking for help reflected negatively on their capacity to
take care of their household and their children.
v Fear of judgment by family and friends if they asked for help was reported by
many of the mothers.
v Women also decided not to make their needs known to others if they felt the
people around them could not offer the kind of support they needed.
v Asking for help was a perceived criticism of parenting skills
v Pride and independence were two barriers to mobilizing support
Assessment of social support

• The nurse needs when assessing the women

during prenatal, natal, and postnatal stages
to assess the women’s social support to
determine the women’s needs and achieve
optimum physical and mental health.
• One way that can nurses do the assessment
is by using valid and measurable assessment
tools or scales.
• The Multidimensional Scale of Perceived Social
Support: it is one social support assessment tool
example that can be used during the maternity
stage
The social support scale

• In this approach, any mean scale score :

• A score of 1 to 2.9 could be considered low

support.
• A score of 3 to 5 could be considered
moderate support.
• A score from 5.1 to 7 could be considered
high support.
 Example of
supported
maternity services
in Saudi Arabia
Thank you …
 References
• Xavier, C., Benoit, A., & Brown, H. K. (2018). Teenage pregnancy and mental health
beyond the postpartum period: a systematic review. Journal of epidemiology and
community health, 72(6), 451–457. https://doi.org/10.1136/jech-2017-209923
• Davis, N. L., King, C. C., & Kourtis, A. P. (2017). Cytomegalovirus infection in
pregnancy. Birth defects research, 109(5), 336–346.
https://doi.org/10.1002/bdra.23601
• David, M., Hcini, N., Mandelbrot, L., Sibiude, J., & Picone, O. (2022). Fetal and
neonatal abnormalities due to congenital syphilis: A literature review. Prenatal
diagnosis, 42(5), 643–655. https://doi.org/10.1002/pd.6135
 References

• Negron, R., Martin, A., Almog, M., Balbierz, A., & Howell, E. A. (2013). Social support during the postpartum period:
mothers' views on needs, expectations, and mobilization of support. Maternal and child health journal, 17(4), 616–623.
https://doi.org/10.1007/s10995-012-1037-4
• Wongpakaran, T., Wongpakaran, N., & Ruktrakul, R. (2011). Reliability and Validity of the Multidimensional Scale of
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161–166. https://doi.org/10.2174/1745017901107010161
• Bedaso, A., Adams, J., Peng, W., & Sibbritt, D. (2021). Prevalence and determinants of low social support during
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https://doi.org/10.1186/s12978-021-01210-y
• Mabetha, K., Soepnel, L., Klingberg, S., Mabena, G., Motlhatlhedi, M., Norris, S. A., & Draper, C. E. (2022). Social
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• Introductory maternity & pediatric nursing / N. Jayne Klossner, Nancy T. Hatfield. — 2nd ed.