Pregnancy Care – Choosing Antenatal Hospitals

A newly pregnant woman wonders who to trust with her unborn baby. Which hospital is capable of taking care of her? Which Doctors can give her the best care and advice?

This article is to help with the difficult task of choosing antenatal hospitals. Some of the common questions are:

 

Q: What is the minimum requirement for an antenatal health care facility?

A: For a healthcare facility to be considered appropriate for antenatal services, it must have the following:

  1. Health Care Personnel: a nurse, a trained community health officer, a midwife or a doctor.
  2. Hospital equipment: An examination couch, a blood pressure measuring machine (sphygmomanometer), a weighing scale, a consulting room, a thermometer, and consumables such as syringes for tetanus injections, gloves, cotton wool, etc.
  3. Laboratory equipment for urinalysis, blood sugar, HIV, Hepatitis B, Syphilis, Packed cell volume, and blood group assessments.

Q: What are the most important factors to consider when choosing a hospital?

A: First the facility must have all listed in Question 1

Second, an ideal facility should be close to the residence of the expectant mother.

In addition, all facilities classified as primary or secondary should have good referral services, like ambulances, in case of emergencies.

Q: How important is proximity when choosing antenatal hospitals?

A: Proximity is key to successful antenatal services. Clients are more likely to meet all clinic appointments when the healthcare facilities are nearby. Also in cases of emergencies, time spent on getting the patient to the hospital is shorter and complications are better prevented.

Q: How soon should a woman begin antenatal visits?

A: In the developed countries of the world, antenatal care begins when the couple decides to have a baby. In other words, antenatal care should begin before conception. During the period before conception takes place, the healthcare providers can prepare the woman by placing her on haematinics. These are vital for red blood cell formation and development of healthy children.

In Nigeria, however, it is advisable for women to commence antenatal care as soon as she realizes she pregnant.

Q: What happens during antenatal visits? I.e. what should a pregnant woman expect?

A: First trimester (from 0 to 14 weeks of pregnancy)

When a pregnant woman attends the health facility for the first time:

  • Her antenatal history is taken.
  • She will be clinically examined by an experienced healthcare personnel.
  • Her vital signs including her blood pressure, weight, respiratory rate, temperature are taken and recorded.
  • Some laboratory tests are done. The basic tests include packed cell volume, urinalysis, blood sugar, HIV, Hepatitis B virus, Syphilis, and blood group tests.
  • She is given health education on the common experiences in pregnancy, the danger signs in pregnancy, the dietary requirements in pregnancy, and the need to be vaccinated against tetanus as well as the benefits of taking the haematinics daily as prescribed by the health caregiver.

-Second trimester (from 14 to 27 weeks of pregnancy)

A short history is taken.

  • She is clinically examined and attention is given to the growing fetus in the abdomen.
  • She is given the first dose of Tetanus immunization which will be repeated after 4 weeks.
  • Her vital signs are taken and recorded and laboratory tests such as blood sugar, packed cell volume, and urinalysis are conducted. Health education is given.
  • Any complaints she has will also be treated.

-Third trimester (from 28 to delivery)

  • History is taken as usual to find out if there are problems to be attended to.
  • She is examined and vital sounds are recorded.
  • Basic laboratory tests are repeated.
  • An obstetrics ultrasound scan is advised before 37 weeks gestation. And the plan for delivery is discussed between the mother-to-be and her doctor.

Q: Why is it important that a pregnant woman attends all the sessions?

A: It is important to attend all antenatal appointments to allow for early detection of danger signs and complications that might arise during pregnancy.

Q: What happens if she chooses not to go regularly for antenatal?

A: Health caregivers will miss the opportunity to detect danger signs early.

Q: How important is it for the spouse to come along for antenatal visits?

A spouse’s presence will go a long way in reassuring the expectant mother and generally improving the antenatal outcomes. It is highly encouraged for the spouse to accompany the mother-to-be to the clinic at least on one occasion.

 

Contributed by Dr. Luke Oghweniale

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