Routine checkups vital during pregnancy
Routine checkups vital during pregnancy
Tantri Yuliandini, The Jakarta Post, Jakarta
Pregnancy is always an exciting period of a woman's life as it
is a time to bring a new life into the world, someone who will
continue her family line.
It is also a time when a woman, and indeed her whole family,
becomes anxious -- with good cause, as 21 percent of all deaths
of women between the age of 15 and 25 in Indonesia are caused by
complications during pregnancy, while giving birth or after
birth.
A routine check up at least once a month, or more, during
pregnancy helps to cut down the risks.
According to Anne Hyre, a midwifery advisor to JHPIEGO, an
organization for international education and training in
reproductive health, a routine check up performed by a doctor or
midwife only needs to be done about four times during a
pregnancy.
At the same time, she also suggested that the practice of
classifying women into high and low risk birth groups should be
abandoned, as there were always risks associated with giving
birth.
Making predictions before the actual labor would only alarm
the woman or, even worse, lull her into thinking falsely that
everything was all right, she said.
Hyre said that many practices and approaches to antenatal care
were unnecessary, such as weighing and measuring the height of
the mother during pregnancy.
"We used to think that a mother's weight could indicate signs
of eclampsia, especially a sudden gain of weight. But now we have
found there are other indications that are more reliable in
determining eclampsia," she said, referring to a condition of
internal poisoning and convulsions that may occur late in a
pregnancy.
There is also a myth that shorter women are more liable to
birth complications due to the shapes of their bodies.
"Complications at birth can happen to anyone of any shape or
size, that's why it is important for the midwife or doctor to
monitor a birth closely at all times," Pancho Hekagery Amilo
Kaslam, a clinical training advisor of Maternal & Neonatal
Health (MNH), said.
He explained that a woman with narrow hips, often thought
incapable of a normal delivery, could give birth normally
provided she had no history of polio or accidents that had
altered her bones. "There's no need for a caesarean birth just
because someone has narrow hips," Pancho said.
Hyre said the most important component of a consultation with
a midwife or doctor was the establishment of rapport.
"A woman should be comfortable with whoever will deliver her
baby. She should be able to trust that person," she said. She
added that the first consultation, between the 12th and 14th
weeks of pregnancy, was an opportunity to establish such a
relationship.
During the first visit, the doctor or midwife should discuss
the woman's preparations for birth, talk about contingency plans
in the event of complications, tell her how to detect the early
signs of problems, and encourage a healthy lifestyle.
"At this time there are very few other risks the woman might
face besides bleeding," Hyre said, adding that a professional
should ask the patient about her history of miscarriages.
The second visit should be done sometime before the pregnancy
reaches seven months, and the most important thing to watch out
for here is hypertension caused by pregnancy.
"Hypertension could indicate signs of pre-eclampsia and the
midwife or doctor should be aware of its symptoms," Hyre said.
Pancho said that 45.2 percent of deaths during pregnancy were
caused by bleeding, 12.9 percent by eclampsia, 11.1 percent by
complications during a miscarriage, 9.6 percent by infection, 6.5
percent by delayed labor, and 1.6 percent by anemia.
"The rest, or 13.1 percent, are the result of indirect causes
such as accidents," he added.
When the pregnancy reaches its seven month, the expectant
mother should again consult with her doctor or midwife to
determine the number of babies she is carrying.
"Before seven months this procedure is not necessary, and at
this time it is also important to watch out for complications,"
Hyre said.
The last consultation should take place when the pregnancy
reaches eight or nine months to determine whether the baby is in
the right position.
Of course, Hyre said, should there be any complications during
one of the check-ups, special attention should be paid. But for
85 percent of all pregnancies, four consultations will do.
"It is not necessary to go to a gynecologist at all during a
normal pregnancy -- a midwife is more than capable of handling
it."
Things to watch out for during a pregnancy:
* Bleeding
* Abnormal headaches
* Nausea and stomach ache
* Baby's movements are unusually infrequent
* Fever
* Color of ruptured membranes is murky
When these symptoms occur, it is best to quickly consult your
doctor or midwife.
Tantri Yuliandini, The Jakarta Post, Jakarta
Pregnancy is always an exciting period of a woman's life as it
is a time to bring a new life into the world, someone who will
continue her family line.
It is also a time when a woman, and indeed her whole family,
becomes anxious -- with good cause, as 21 percent of all deaths
of women between the age of 15 and 25 in Indonesia are caused by
complications during pregnancy, while giving birth or after
birth.
A routine check up at least once a month, or more, during
pregnancy helps to cut down the risks.
According to Anne Hyre, a midwifery advisor to JHPIEGO, an
organization for international education and training in
reproductive health, a routine check up performed by a doctor or
midwife only needs to be done about four times during a
pregnancy.
At the same time, she also suggested that the practice of
classifying women into high and low risk birth groups should be
abandoned, as there were always risks associated with giving
birth.
Making predictions before the actual labor would only alarm
the woman or, even worse, lull her into thinking falsely that
everything was all right, she said.
Hyre said that many practices and approaches to antenatal care
were unnecessary, such as weighing and measuring the height of
the mother during pregnancy.
"We used to think that a mother's weight could indicate signs
of eclampsia, especially a sudden gain of weight. But now we have
found there are other indications that are more reliable in
determining eclampsia," she said, referring to a condition of
internal poisoning and convulsions that may occur late in a
pregnancy.
There is also a myth that shorter women are more liable to
birth complications due to the shapes of their bodies.
"Complications at birth can happen to anyone of any shape or
size, that's why it is important for the midwife or doctor to
monitor a birth closely at all times," Pancho Hekagery Amilo
Kaslam, a clinical training advisor of Maternal & Neonatal
Health (MNH), said.
He explained that a woman with narrow hips, often thought
incapable of a normal delivery, could give birth normally
provided she had no history of polio or accidents that had
altered her bones. "There's no need for a caesarean birth just
because someone has narrow hips," Pancho said.
Hyre said the most important component of a consultation with
a midwife or doctor was the establishment of rapport.
"A woman should be comfortable with whoever will deliver her
baby. She should be able to trust that person," she said. She
added that the first consultation, between the 12th and 14th
weeks of pregnancy, was an opportunity to establish such a
relationship.
During the first visit, the doctor or midwife should discuss
the woman's preparations for birth, talk about contingency plans
in the event of complications, tell her how to detect the early
signs of problems, and encourage a healthy lifestyle.
"At this time there are very few other risks the woman might
face besides bleeding," Hyre said, adding that a professional
should ask the patient about her history of miscarriages.
The second visit should be done sometime before the pregnancy
reaches seven months, and the most important thing to watch out
for here is hypertension caused by pregnancy.
"Hypertension could indicate signs of pre-eclampsia and the
midwife or doctor should be aware of its symptoms," Hyre said.
Pancho said that 45.2 percent of deaths during pregnancy were
caused by bleeding, 12.9 percent by eclampsia, 11.1 percent by
complications during a miscarriage, 9.6 percent by infection, 6.5
percent by delayed labor, and 1.6 percent by anemia.
"The rest, or 13.1 percent, are the result of indirect causes
such as accidents," he added.
When the pregnancy reaches its seven month, the expectant
mother should again consult with her doctor or midwife to
determine the number of babies she is carrying.
"Before seven months this procedure is not necessary, and at
this time it is also important to watch out for complications,"
Hyre said.
The last consultation should take place when the pregnancy
reaches eight or nine months to determine whether the baby is in
the right position.
Of course, Hyre said, should there be any complications during
one of the check-ups, special attention should be paid. But for
85 percent of all pregnancies, four consultations will do.
"It is not necessary to go to a gynecologist at all during a
normal pregnancy -- a midwife is more than capable of handling
it."
Things to watch out for during a pregnancy:
* Bleeding
* Abnormal headaches
* Nausea and stomach ache
* Baby's movements are unusually infrequent
* Fever
* Color of ruptured membranes is murky
When these symptoms occur, it is best to quickly consult your
doctor or midwife.