TOPIC 4

PREGNANCY
and
CHILDCARE
Pregnancy and Child Care

Session 1
SAFE PREGNANCY
and
PRENATAL CARE
 Pregnancy and Child Care

Pregnancy, known as gestation, the

time in which one or more offspring
develop inside a woman.
Childbirth typically occurs around 38-40
weeks from the last menstrual period
(LMP).
 Pregnancy and Child Care

Key message:
 First trimester (1-3 months) is the most critical stage
of pregnancy.
 Prenatal care promotes safe pregnancy and delivery
of a healthy baby.
 Pregnant women should have at least one (1) visit
on her 1st & 2nd trimesters and at least 2 visits on the
3rd trimester of her pregnancy
Three Trimesters of Pregnancy
 Signs of Pregnancy

 Tender, swollen breast  Headaches

 Fatigue  Constipation 
 Slight bleeding or cramping  Mood swings
 Nausea with or without  Faintness and dizziness
vomiting  Raised basal body
 Food aversions or cravings temperature
 Missed Period
Weight Gain in Pregnancy
 Maternal Nutrition
 The ability of mother to provide nutrients and oxygen
for her baby is a critical factor for fetal health and its
survival.

 There’s a negative impact of having poor nutritional

status and inadequate nutritional intake for women
during pregnancy on birth weight and early
development of the baby.
 Essential Micronutrients for Pregnant Women
• Iron- for the synthesis of hemoglobin, cellular functions,
oxygen transport, respiration, growth, gene regulation
• Vitamin A - a fat-soluble vitamin from retinoids (animal
sources) or carotenoids/beta carotene (plant sources) for
vision, growth, bone metabolism, immune function and gene
transcription, maternal metabolism and antioxidant activities.
• Iodine - for regulating growth, development and metabolism.
Iodine passes the placenta for fetal thyroid hormone
production to regulate the fetal brain and nervous system.
 Other Essential Micronutrients
• Folate / Folic Acid
• Vitamin B Complex - Vitamin B1 (Thiamine), Vitamin
B2 (Riboflavin), Vitamin B3 (Niacin), Vitamin B6 (Pyridoxine) and
Vitamin B12 (Cyanocobalamin)
• Vitamin C & D
• Calcium

Note:
These nutrients can be availed from the prenatal multivitamins
prescribed or given by the health care provider.
 How to maintain a healthy pregnancy?
 Eat enough, right kind and nutritious food plus 8-
10 glasses of water everyday
 Avoid salty foods and raw meat
 Do light body exercises such as walking
 Have enough sleep and rest
 Maintain clean body and dental hygiene
 How to maintain a healthy pregnancy?

 Avoid smoking, drinking liquor and too much

caffeine
 Avoid taking medicines without a doctor’s
advice/prescription
 Take prenatal multivitamins
 Avoid cleaning your cat’s litter
 Pregnancy and Child Care

7
SUGGESTED WAYS TO
KEEP INTIMACY IN YOUR
PREGNANCY
 Pregnancy and Child Care

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.
 Pregnancy and Child Care

Key message:

“WE ARE PREGNANT.”

Pregnancy is a shared responsibility.
Male involvement in pregnancy and childbirth
influences pregnancy outcomes.
Pregnancy and Child Care

Husband’s
Contribution to
Ensure his Wife’s
“Safe Pregnancy”
Pregnancy and Child Care

1.Wife’s companion during prenatal check-up

which includes:
 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
with the preparation of birth plan,
breastfeeding, family planning/ birth
spacing and fetal development.

17
Pregnancy and Child Care

2. Formulate birth plan with your wife.

 When encounters emergency signs (i.e.,
bleeding, spotting, and other health-
related risk factors), bring your wife to
the hospital.
 Ensure that your wife will give birth
through the help of a health care service
provider.
 Ensure that wife is enrolled with
PhilHealth to avail of its benefits and
packages and look for the nearest
PhilHealth-accredited facility.
 Plan out beforehand when, where and
how to safely travel to the accredited
facility.
* For immediate referral and treatment 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.

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 Pregnancy and Child Care

NOTE:

The husband should also have available

contact numbers of the service provider or
facility in cases of emergency or due time
for delivery.

20
How to maintain a good and safe delivery?
 Plan for a facility-based delivery.
 Have a post partum care (within 24-
48 hours & within 1 week after
delivery)
 Have assessment for signs of any
infection or complication
 Initiate breastfeeding after delivery
 Take the micronutrient
supplementation (iron & vitamin A)

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Pregnancy and Child Care

SESSION 2

FACILITY-
BASED
DELIVERY
 Pregnancy and Child Care

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.
Pregnancy and Child Care

Husband’s
Contribution to
Ensure his wife’s
safe delivery
Pregnancy and Child Care

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.

25
Pregnancy and Child Care

 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.
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 postnatal check-up.

26
 Pregnancy and Child Care

SESSION 3

POSTNATAL CARE
 Pregnancy and Child Care

Key message:
During the post-partum 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.
 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.
 Pregnancy and Child Care

Post-partum Visit
The post-partum visit usually done within 72 hours and
on the 7th day post-partum 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.
 Pregnancy and Child Care

Post-partum Family Planning

1. Post-partum 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.
 Pregnancy and Child Care

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.
 Pregnancy and Child Care

2. PROGESTIN-only Method (Hormonal)

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.
 Pregnancy and Child Care

3. 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 is
already sexually active and has not been using LAM, pregnancy
should be excluded or the first natural period is awaited prior to
insertion.
Pregnancy and Child Care

SESSION 4

CARING for
the BABY
 Pregnancy and Child Care

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.
 Pregnancy and Child Care

 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.
 Pregnancy and Child Care

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
 Pregnancy and Child Care

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.
 Pregnancy and Child Care

STEPS TO HEALTHY

10
FEEDING OF INFANTS
YOUNGER THAN
TWO (2) YEARS OLD

#NutritionOfInfant
 Pregnancy and Child Care

EXCLUSIVE BREASTFEEDING up to six (6) months. DO NOT offer water, tea or

1
any other kind of food.
After six (6) months, gradually introduce other kinds of food. Keep providing
2
human milk up to two (2) years or longer.
After six (6) months, give complementary food (cereals, vegetables, meat, fruits)
3 three times a day if the child is being breastfed, and five (5) times a day if the child
is no longer breastfed.
Complementary food must be offered on demand, always respecting the child’s
4
appetite.
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,
5
gradually, it should get thicker up to the time when the child is able to eat a family
meal.
 Pregnancy and Child Care

Offer the child with different kinds of food throughout the day. A varied diet is
6
colorful.

7 Stimulate the daily intake of fruits and vegetables.

Avoid sugar, coffee, canned food, fried food, soft drinks, candies, and treats in the
8
first years of life. Use a moderate amount of salt.

Make sure to wash your hands before handling food; make sure the food is
9
appropriately stored.

Stimulate the sick child to eat. Offer the usual and favorite meals and respect the
10
child’s appetite.

#NutritionOfInfant
 Pregnancy and Child Care

SESSION 5

SERVICES AVAILABLE
for MNCHN
 Pregnancy and Child Care

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.
Newborn Screening
This is 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.
 Pregnancy and Child Care

 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.
Six disorders detected through Newborn Screening:
congenital hypothyroidism (CH)
congenital adrenal hyperplasia (CAH)
phenylketonuria (PKU)
glucose-6- phosphate dehydrogenase (G6PD) deficiency
galactosemia (GAL)
 maple syrup urine disease (MSUD)
Expanded NBS - include 22 more disorders such as
hemoglobinopathies and additional metabolic disorders, namely,
organic acid, fatty acid oxidation, and amino acid disorders.
 Pregnancy and Child Care

Immunization
 Immunization against six preventable diseases:
 BCG
 Hepatitis B
 Pentavalent Vaccine
 Inactivated Polio Vaccine
 Pneumococcal Conjugate
 Measles, Mumps, Rubella
 Growth Monitoring
 Pregnancy and Child Care

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.
 Pregnancy and Child Care

Tetanus Diptheria Immunization Schedule

Vaccine Minimum Interval Duration of Protection
At first contact with

Td 1 woman 15-49
years or at first
No protection
ANC visit
 Infants born to mother is protected from
Td 2 At least 4 weeks
after Td1
neonatal tetanus
 3 years protection for the mother
 Pregnancy and Child Care

Tetanus Diptheria Immunization Schedule

Vaccine Minimum Interval Duration of Protection
 Infants born to mother is protected from
Td 3 At least 6 months
after Td2
neonatal tetanus
 5 years protection for the mother
 Infants born to mother is protected from
Td 4 At least 1 year
after Td3
neonatal tetanus
 10 years protection for the mother
 Infants born to mother is protected from
Td 5 At least after 1
year after Td4
neonatal tetanus
 Lifetime protection for the mother
Pregnancy and Child Care

Antenatal Care Package

Maternal Care Package
NSD Package
Newborn Care Package
 Pregnancy and Child Care

Things to 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.
 Pregnancy and Child Care

During pregnancy, prenatal checkup is a must to

monitor the progress of 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.
 Pregnancy and Child Care

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.
 Pregnancy and Child Care

Thank you!