Topic 4 - Pregnancy and Child Care - Sessions 1-5 (Mr. Moises Villacorta)

Topic 4:
• Session 1: Safe Pregnancy and Prenatal

Care
• Session 2: Facility-Based Delivery
• Session 3: Post-Natal Care
• Session 4: Caring for the Baby
• Session 5: Services Available for MNCHN
TOPIC 1- SESSION 1: SAFE PREGNANCY
AND PRENATAL CARE
Session Objective:
At the end of the session, would-be
married couples will be able:
• To explain the concepts of
pregnancy, male involvement,
prenatal care, and the importance
of building a family.
Time Allotment: 15 minutes
AND PRENATAL CARE
Key Message
1. Pregnancy, also known as gestation, is
the time during which one or more
offspring develop inside a woman.
Childbirth typically occurs around 40
weeks from the last menstrual period
(LMP).
Video Presentation
AND PRENATAL CARE
Signs of Pregnancy
 Tender, swollen  Headaches
breast  Constipation
 Fatigue  Mood swings
 Slight bleeding or  Faintness and
cramping dizziness
 Nausea with or  Raised basal body
without vomiting temperature
 Food aversions or  Missed Period
cravings
AND PRENATAL CARE
Key Message
2. First trimester (1-3 months) is the
most critical stage of pregnancy.
Prenatal care promotes safe pregnancy
and delivery of a healthy baby.
AND PRENATAL CARE
Schedule of Pre Natal Care

Pre-Natal Visit Period of Pregnancy
1ST visit From last menstruation up to
3 months
2nd visit From 4-6 months
3rd and 4th visit From 7 to 9 months
AND PRENATAL CARE
Maternal Nutrition
•The ability of mother to provide nutrients and
oxygen for her baby is a critical factor for fetal
health and its survival.
•The consequences of poor nutritional status
and inadequate nutritional intake for women
during pregnancy have a negative impact on
birth weight and early development.
•Maternal overnutrition also has long-lasting
and detrimental effects on the health of the
offspring.
AND PRENATAL CARE
Micronutrient Supplementation
Micronutrient supplementation is vital
for pregnant women. This is necessary
to prevent anemia, vitamin A deficiency
and other nutritional disorders.
AND PRENATAL CARE
Maternal Nutrition
VITAMIN A
PREPARATION DOSE DURATION REMARKS
10,000 I.U. 1capsule/ Start from Vitamin A 10,000 I.U.
tablet of the 4th should NOT be given to
10,000 month of pregnant women who are
I.U.twice a pregnancy already taking prenatal
week until vitamins or multiple
delivery micronutrients that
contain vitamin A.
AND PRENATAL CARE
Maternal Nutrition
IRON
PREPARATION DOSE/DURATION REMARKS
Tablet 1 tablet once a day for 6 A dose of 800
(preferably months or 180 days mcg. is safe
coated) during the pregnancy for pregnant
containing 60 period or 2 tablets per women.
mg. elemental day (120 mg EI) if pre-
iron (EI) with natal consultations are
400 mcg. Folic done during the 2nd and
acid 3rd trimester
AND PRENATAL CARE
Maternal Nutrition
IODINE
TARGET PREPARATION DOSE/
DURATION
Women Iodized oil 1 capsule for
(15-45 capsule with 200 1 year
years old) mg. iodine
AND PRENATAL CARE
What Should a Pregnant Woman
Eat?
o Eating a balanced diet is important during pregnancy. Pregnant woman
should be careful of the following foods and drinks during pregnancy:
Meat, eggs, and fish. Should not be taken more than two (2) or three
(3) servings of fish per week (including canned fish).
Fruit and vegetables. Need to be washed properly before eating.
Cutting boards and dishes should be kept clean.
Dairy. Eating four (4) or more servings of dairy each day is
recommended for pregnant woman. This will give her enough calcium
for herself and her baby. Unpasteurized milk or eat unpasteurized milk
products should not be taken. These may have bacteria that can cause
infections.
Sugar substitutes. Some artificial sweeteners are okay in moderation.
Caffeine. Should not be taken more than one (1) or two (2) cups of
coffee or other drinks with caffeine each day.
AND PRENATAL CARE
Key Message
3. Pregnancy is a natural
phenomenon and not a sickness.
AND PRENATAL CARE
7 Suggested Ways to Keep
Intimacy in Your Pregnancy
1. Don't take each other -- or sex -- for granted.
2. Revive the art of flirting.
3. Have a "date night" at least once a week -- with no talk
of painting the nursery or what to name the baby.
4. Add some mystery to your relationship and surprise
your partner now and again.
5. For Men: Court your pregnant wife!
6. For Women: Keep him a part of your pregnancy.
7. For both of you: Remain proactive about keeping
intimacy alive.
AND PRENATAL CARE
Key Message
4. Pregnancy is a shared
responsibility:
“We are pregnant.”
Male involvement in pregnancy and
childbirth influences pregnancy
outcomes.
AND PRENATAL CARE
How the Husband Can Contribute to Help
Ensure the Safe Pregnancy of His Wife
1. Accompany your wife during pre-natal check-
up. During check-up ensure that she receives
the following:
Health history and physical check-up
Blood pressure and weight
Laboratory check-up (e.g. urine and CBC)
Iron and folic Acid supplements
Anti-Tetanus Vaccine
Advice for a healthy life style together the
preparation of birth plan, breastfeeding, family
planning/ birth spacing and fetal development.
18
AND PRENATAL CARE
2. Formulate birth plan with your wife.
 Bring your wife immediately to the hospital when she
encounters emergency signs such as bleeding, spotting, and
other health related risk factors
 Ensure that your wife will give birth through the help of a
health care service provider e.g. midwife, nurse, doctor in a
health center, clinic or a hospital
 Ensure that wife is enrolled with PhilHealth to avail of its
benefits and packages
 Know the nearest Philhealth-accredited facility in your place
for convenience during delivery.
 Plan out beforehand when, where and how to safely travel
to the accredited facility 19
AND PRENATAL CARE
• For immediate referral and treatment, the husband should
know and learn the emergency signs of pregnancy, such as:
• Convulsions and/or faint;
• Severe headache with blurry eyesight;
• High fever and feeling of weakness;
• Severe abdominal pains;
• Difficulty in breathing/fast breathing; and
• Rupture of the water bag.
• The husband should also have available contact numbers of the
service provider or facility in cases of emergency or due time
for delivery.
20
AND PRENATAL CARE
3. Support your wife to maintain a good and healthy
pregnancy. Encourage her to:
 Eat enough and nutritious food
 Drink 8-10 glasses of water
 Avoid salty foods
 Do light body exercises such as walking
(appropriate)
 Maintain clean body and dental hygiene
 Avoid smoking and drinking liquor
 Avoid taking medicines without a doctors’
advice/prescription 21
TOPIC 1- SESSION 2:
FACILITY-BASED DELIVERY
Session Objective:
married couples will be able
• To explain the importance of
facility-based delivery.
TOPIC 1- SESSION 2:
KEY MESSAGE
Delivering the baby in an accredited
birthing facility ensures not only more
hygienic delivery procedures but
efficient management of emergencies
and complications, thus lessening the
risk to the life and health of both
mother and baby.
TOPIC 1- SESSION 2:
Ensure the Safe Delivery of His Wife
1. Ensure that your wife delivers in a health facility.
2. At the time of your wife’s delivery, consider the following:
Give your wife the liberty to choose whom she wants to be at her
side during the delivery.
Be able to drink, walk, sit and stand whenever she wants to
during labor
After delivery, request that the baby be placed (in a lying
position) on top of mommy’s tummy (skin to skin), and put a
blanket on them
Within an hour after the delivery, allow the baby to be fed from
the mother’s breast milk for as long as the baby wants.
Request that that baby stays with your wife the whole time,
except for medical instructions
TOPIC 1- SESSION 2:
Ensure the Safe Delivery of His Wife
3. Encourage your wife to do breastfeeding.
4. Within 48 hours after delivery, in cases of
emergency such as bleeding, high fever, and
other health related problems bring her
immediately to the doctor
5. After one week of giving birth, accompany
your wife to the doctor for post natal check-
up
TOPIC 1- SESSION 3:
POSTNATAL CARE
Session Objective:
• To explain the importance and
specific activities for postnatal
care.
TOPIC 1- SESSION 3:
POSTNATAL CARE
Key Message
1. During the postpartum period, which
is the period beginning immediately
after the birth of a child and delivery of
placenta and continuing until about six
weeks after, the mother and the baby
need to be seen by the doctor or health
worker for needed postnatal care.
TOPIC 1- SESSION 3:
POSTNATAL CARE
Birth Registration
Registration of birth at the Local Civil
Registry Office (LCRO) covering the area,
must be accomplished by the parents or
the health facility worker to ensure
child’s right to be named and recognized
is upheld. Also, this is a compulsory to all
births to enable the country to have
proper data on its citizenry.
TOPIC 1- SESSION 3:
POSTNATAL CARE
Post-Partum Visit
The postpartum visit usually done within 72
hours and on the 7th day postpartum to
check for :
conditions such as bleeding or infections
Vitamin A supplements to the mother
counseling on family planning and
available services
maternal nutrition and lactation
counseling
postnatal visit of the newborn
TOPIC 1- SESSION 3:
Post-Partum Family Planning POSTNATAL CARE
Postpartum IUD (PPIUD)
When to Start?
 Immediate postpartum: within 10 minutes after placental
expulsion in a normal vaginal delivery or during caesarean
section (intracaesarean)
 Early postpartum: within 48 hours postpartum after a
normal vaginal delivery. If possible, perform the procedure
within 24 hours postpartum.
How effective is PPIUD?
 Perfect use: 99.4% Typical use: 99.2%
What is the mechanism of action?
 Copper released from the CopperT-380A inhibits sperm
and ovum transport. The spermatozoa and the ovum do not
meet therefore fertilization does not take place.
TOPIC 1- SESSION 3:
POSTNATAL CARE
Post-Partum Family Planning
Hormonal: PROGESTIN-Only Method
Progestin-only pill and injectable can
be used both by breastfeeding and non-
breastfeeding women. Many studies
show that progestin do not have adverse
effects on breast milk production and
quality of milk produced as well as on
infant health, growth and development.
TOPIC 1- SESSION 3:
POSTNATAL CARE
Post-Partum Family Planning
Single Rod Sub Dermal Implant
When to start?
For breastfeeding, partially breastfeeding and non-
breastfeeding clients: the etonogestrel implant may
be inserted immediately after delivery, before she is
discharged from the birthing facility.
 Later than 21 days, a client who is not on LAM is
advised to use back up protection for 7 days after
insertion. If the client were already sexually active
and has not been using LAM, pregnancy should be
excluded or the first natural period is awaited prior
to insertion.
TOPIC 1- SESSION 4:
CARING FOR THE BABY
Session Objective:
married couples will be able:
• To explain the importance and
proper provision of breastfeeding.
TOPIC 1- SESSION 4:
CARING FOR THE BABY
Key Message
Breast milk can supply all the
nutrition the baby needs for the first
6 months. Start giving
complementary foods only at 6
months but continue to breastfeed
until the baby is 2 years old.
TOPIC 1- SESSION 4:
CARING FOR THE BABY
 Breast milk is the best

food for the baby.
 Encourage breastfeeding
on demand, day and
night, as long as the baby
wants.
 Feed baby day and night,

8 or more times in 24
hours from birth.
 Encourage the baby to

feed, day and night, at
least 8 times in 24 hours
from birth
TOPIC 1- SESSION 4:
CARING FOR THE BABY
Benefits of Breastfeeding
 provides optimum nutrition
 protects baby from illness
 enhances the mother’s health.
 lowers the danger of ovarian and
breast cancer
 saves money
TOPIC 1- SESSION 4:
CARING FOR THE BABY
Benefits of Breastfeeding
Breastfeeding promotes child spacing
because it delays ovulation and
menstruation if the following criteria
are met:
 No menstruation (amenorrhea)
 Fully exclusive breastfeeding; and
 Child is less than six (6) months
old
TOPIC 1- SESSION 4:
Infant Nutrition CARING FOR THE BABY
Ten Steps to healthy feeding of infants younger than two (2) years old
Step 1 Feed the infant exclusively with human milk up to six (6) months. DO NOT offer water,
tea or any other kind of food.
Step 2 After six (6) months, gradually introduce other kinds of food. Keep providing human
milk up to two (2) years or longer.
Step 3 After six (6) months, give complementary food (cereals, vegetables, meat, fruits) three
times a day if the child is being breastfed, and five (5) times a day if the child is no
longer breastfed.
Step 4 Complementary food must be offered on demand, always respecting the child’s appetite.
Step 5 Complementary food must be thick and it must be offered with a spoon; in the
beginning it should have a pasty consistency) porridge/ mashed food) and, gradually, it
should get thicker up to the time when the child is able to eat a family meal.
Step 6 Offer the child with different kinds of food throughout the day. A varied diet is colorful.
Step 7 Stimulate the daily intake of fruits and vegetables
Step 8 Avoid sugar, coffee, canned food, fried food, soft drinks, candies, and treats in the first
years of life. Use a moderate amount of salt.
Step 9 Make sure to wash your hands before handling food; make sure the food is
appropriately stored.
Step 10 Stimulate the sick child to eat. Offer the usual and favorite meals and respect the child’s
appetite.
TOPIC 1- SESSION 5:
AVAILABLE MNCHN SERVICES
SESSION OBJECTIVE
• To identify government services
and programs for maternal,
newborn, and child health and
nutrition (MNCHN).
TOPIC 1- SESSION 5:
Key Message
The health centers provide a variety of
free services before, during and after
pregnancy, including family planning,
prenatal and postnatal care, child care,
and counseling
TOPIC 1- SESSION 5:
Newborn Screening - a simple

procedure to find out if a baby has a
congenital metabolic disorder that may
lead to mental retardation or even death if
left untreated.
 Ideally done on the 48th to 72nd hour of
life (first 2-3 days of life)
 May also be done 24 hours from birth
since some disorders are not detected if
the test is done earlier than 24 hours
from birth.
TOPIC 1- SESSION 5:
TOPIC 1- SESSION 5:
Immunization
 Immunization against 5
preventable diseases:
 BCG
 Hepatitis B
 Pentavalent Vaccine
 Inactivated Polio
Vaccine
 Pneumococcal
Conjuigate
 MMR
 Growth Monitoring
TOPIC 1- SESSION 5:
Birth Plan
The quality of care
given to children
during the first year
of their life is most
crucial not only for
their survival but also
for determining their
health for the rest of
their lives.
TOPIC 1- SESSION 5:
Tetanus Diptheria Immunization Schedule
Vaccine Minimum Interval Duration of Protection
TD1
At first contact with woman no protection
15-49 years or at first ANC
visit
TD 2
At least 4 weeks after TT1  Infants born to mother is protected
from neonatal tetanus
 3 years protection for the mother
TD 3
At least 6 months after  Infants born to mother is protected
TT2 from neonatal tetanus
TD 4
At least 1 year after TT3  Infants born to mother is protected
TD 5
At least after 1 year TT4  Infants born to mother is protected
 Lifetime protection for the mother
TOPIC 1- SESSION 5:
Antenatal Care Package

Maternal Care Package
NSD Package
Newborn Care Package
Remember:
MNCHN concerns mainly the health
and nutritional well-being of the
mother and baby.
A couple must be aware of the
delicate condition of both the
mother and the baby, special care
and nutrition to ensure safe
pregnancy and childbirth.
Remember:
 During pregnancy, the mother needs to go for prenatal
checkups to monitor the progress of the pregnancy and
promptly manage any irregularities. At the time of birth,
the mother must deliver the baby in an accredited
health facility under the care of a trained birth
attendant. And after delivery, the mother and the baby
need to go for postnatal checkups to check for any
infections and other problems, and to give the baby
needed immunizations.
 Postnatal visits are also occasions for the mother to
receive micronutrient supplements and advice on
breastfeeding, and for the couple to receive
counseling regarding family planning.
 It is important for couples to be aware of these
conditions and care requirements before they get
married.

Topic 4 - Pregnancy and Child Care - Sessions 1-5 (Mr. Moises Villacorta)

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Topic 4 - Pregnancy and Child Care - Sessions 1-5 (Mr. Moises Villacorta)

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Topic 4:

• Session 1: Safe Pregnancy and Prenatal

Schedule of Pre Natal Care

 Breast milk is the best

 Feed baby day and night,

 Encourage the baby to

Newborn Screening - a simple

Antenatal Care Package

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