The importance of Antenatal Care

Antenatal care is essential for protecting the health of women and their unborn children.-UNICEF

In the last three months, I have had the blessing and privilege to attend to mothers in their pregnancy journey in the Department of reproductive health at Kenyatta National Hospital. I have interacted with many patients and I thought I should write an article on a simple but overlooked topic.

As I always say to myself, let's go back to the basics.

Antenatal care is different from preconception care which is care that is offered before a couple has even conceived. It provides an opportunity to prevent and manage existing and potential causes of maternal and neonatal morbidity and mortality. In simple terms, this means reducing the risk of danger to the mother and the baby.

So what is Antenatal Care?

Antenatal Care is care provided by a skilled healthcare professional to pregnant women in order to ensure the best health conditions and outcomes for the mother and the baby during pregnancy.

So what does it entail?

It entails identifying risks in the pregnancy, prevention, and management of any concurrent illness in pregnancy, health action, and health promotion.

Why is it a problem?

In Sub-Saharan Africa and South East Asia, we have the highest rates globally of maternal mortality, yet in contrast, we have the poorest uptake of ANC coverage. Only 62% that is 3 in 5 receive at least four antenatal visits.

What does the World Health Organisation recommend?

In 2016, the World Health Organisation (WHO)released its comprehensive recommendations on routine ANC for pregnant women and adolescent girls and it entailed 8 visits.

As you can see in the new model, the first contact is within the first trimester.

The new recommendation is in the second trimester, two visits should be undertaken.

In the third trimester, becasue of increasing complications, more visits are recommended.

So what are the recommended interventions?

They are the following

1.?????Nurtitional interventions

-?????????Counselling about healthy eating and being physically active during pregnancy.

-?????????Daily oral and folic acid supplementation

2.?????Maternal and fetal assessment

-?????????Full blood count to diagnose anemia in pregnancy

-?????????Detection of high glucose levels (hyperglycemia)

-?????????Alcohol and substance use detection and prevention

-?????????Provider initiated Testing and Counselling (PITC) for HIV

3.?????Fetal assessment (Assessing the baby)

-?????????An early obstetric ultrasound to estimate the gestational age, improve the detection of fetal anomalies and detect multiple pregnancies.

4.?????Preventive measures

-?????????Prophylaxis with anti-D immunoglobulin in Rhesus negative mothers.

-?????????Treatment for intestinal worms

-?????????Tetanus toxoid vaccination to prevent mortality from tetanus

-?????????In malaria endemic areas, preventive anti-malarials

This is a brief summary, of course each needs more elaboratie discussions which I will cover later.

The importance and benefits of antenatal care can be summarized as

1.?????Reducing perinatal deaths.

2.?????Improved safety during pregnancy through increased frequency of maternal and fetal assessment to detect complications.

3.?????Improved support and communication around pregnant women and families.

4.?????A positive pregnancy experience.

Thank you so much for reading my article and hope to see you again next week!?