This document provides information on antenatal care, including its definition, objectives, components, types of visits, high risk factors, advice, and indicators of maternal and child health care. The key aspects of antenatal care are monitoring the health of the mother and baby during pregnancy, detecting high-risk cases, educating mothers on family planning and child health, and aiming for a healthy delivery outcome. Components include medical history, examinations, tests, and visits scheduled throughout pregnancy. High-risk pregnancies require specialized care. The goals of maternal health care are reducing mortality rates and ensuring healthy mothers and babies.

1. REPRODUCTIVE
HEALTH
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2. family
planning
Antenatal care
Clean safe
delivery Essential
Obstetric
care
Basic Maternity Care
PRIMARY HEALTH CARE
EQUITY FOR WOMEN
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3. Maternal Health
Antenatal Care
 Definition
 Care of mother during pregnancy
 Aim
 To achieve a healthy baby & healthy mother at the end of
the pregnancy
 Objectives;
a) To promote, protect & maintain health of the mother
b) To detect ‘high risk ‘ cases & give them special attention
c) To foresee complication & prevent them
d) To sensitize mother for need of family planning
e) To teach mother the art of child health care
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4.  COMPONENTS:
a) Careful & complete obstetric history (total no of
pregnancies, live birth, mode of delivery, no of
abortions, any complications during pregnancy,
puerperium. Breastfeeding history)
b) Investigation; haemoglobin, blood group & Rh factor,
blood sugar, urine for protein and sugar. Evaluation for
diabetes mellitus, hypertension, renal disease, etc
c) Physical examination ; height, weight, blood pressure,
pelvic examination. 4

5. Antenatal Visits( types)
Routine Visits
• 1st visit ---asap
• after every 4 weeks--- till 28 weeks
• after every 2 weeks---till 38 weeks
• once a week------------till delivery
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6.  Minimum antenatal visit
at least 4 weeks
 1st visit---before 12 weeks to confirm pregnancy
 2nd visit---at 24th week for base line of health profile
 3rd visit ---at 32-34 weeks to find out position or
presenting part
 last visit –around 36th week –for delivery
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7.  Home visits
 Act as the back bone of MCH service
1/3 visits should be home visit if the mother is
attending antenatal clinics
 1st visit is to confirm pregnancy ,base line
investigations etc, & subsequent visits to
monitor pregnancy
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8. HIGH RISK APPROACH
Identify high risk cases & arrange skilled care for
them as they are prone to complications. Following
is a list of high risk
 Too young (<18 yrs) or too old ( >35 yrs)
primigravida
 Short structure (<5 feet) primigravida
 Pre-maturity(<37 week), post maturity(>41weeks)
 Grand multi para ( more than 5 term deliveries)
 Twin pregnancy, hydraminos, malpresentation
 Pre-eclamptic toxaemia, bad past obstetric history
 Diseases like DM, HT, epilepsy, heart disease, renal
disease 8

9. ante natal ADVICE
 Good diet with a total weight gain of 10 to 12 kg
 maintenance of good hygiene, light exercise, refrain
from smoking & drugs
 Avoid tetrogenic drugs like tetracycline,
streptomycin, corticosteroid
 Immunization against tetanus. TT at 1st contact ,then
at 4thweek, 6thmonth, after 1 year & then again after
an year. This gives life long protection
 Anemia- haemoglobin of less then 11gm ,due to
poor diet ,iron & folic acid deficiency. Is corrected
by oral iron intake .
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10. INTRANATAL CARE
AIMS;
 clean delivery through aseptic measures. It is
achievable by clean delivery surface ,clean
hands & clean cutting and care of cord(3Cs)
 Delivery with minimum injury to the baby &
mother
 Readiness to deal with complications like
prolonged labour, antepartum haemorrhage,
convulsions, malpresentations
 Care of the baby at the time of delivery
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11.  Types of Intranatal care
 Domiciliary care;
mothers with normal obstetric history are advised for
home delivery by a trained Dai .
-It is less expensive , chance of cross infection is
very low
-There is less medical care , mother resumes her
duties soon thus she gets less tome to rest
 Institutional care;
is recommended for all high risk cases .at least3-4
days or as required
-It is well organized with aseptic measures , diet and
health is looked after Baby & mother are monitored
for emergency conditions
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12. Emergency / complication during
delivery
 Sluggish or no pain after rupture of membrane
 Prolonged first sage
 obstructed labour
 Meconium stained liquor
 Post partum haemorrhage
 Ensure referral System for complicated cases from
BHU /homes to the DHQ/THQ or tertiary care
centre
 Routine ,regular training for the LHVs, dais, MHW
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13. POST NATAL CARE
 Care of mother after delivery as well as the baby .Done by
the obstetrician & the paediatrician.
 OBJECTIVES;
a) to prevent postnatal complications
b) Care for rapid restoration of mother to optimum health
c) To provide family planning service
d) To provide basic health education to mother/family
e) encourage breast feeding
Postnatal Complications
-puerperal sepsis (UTI), retained placenta & membranes,
thrombo-phelbitis( infection of the leg veins), secondary
haemorrhage, mastitis
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14. Care of baby
-care for the aseptic measures for the infant care for
the proper breathing, eyes, skin, feeding etc
- Home visit by a trained dai at least once a month
- - baby friendly hospital as recommended by the
WHO
- -coordinated school service
- -immunization, growth monitoring, nutrition
monitoring
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15.  Indicators of MCH care
 Maternal mortality rate;
MMR= total no of death of women due to
pregnancy, child birth & puerperal causes at
a place during a year______________*1000
total no of live birth recorded at the same year
5/1000 live birth
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16.  Neonatal Mortality Rate
NMR= total no of death of children under 1 yr
of age________________________
total no of live birth recorded at same
place during same year
86/1000 live birth
main causes; immaturity, birth trauma,
congenital anomalies, haemolytic disease,
ARI, malnutrition, diarrhoea, whooping
cough, measles, low birth weight etc
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17. Peri-natal mortality rate
 PMR=sum of total no of death of foetus
after 28 weeks of preg & death of children
under 1 wee of age at a place during 1yr
_______________________________ *1000
total no. of birth recorded at same place during
same yr
Main causes ; placental insufficiency, Rh
incompatibility, anaemia, birth injury, asphyxia,
obstetric complication , prematurely, respiratory
distress syndrome, congenital anomalies
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18.  Post natal mortality rate
PMR =no of death of children between 28 days
& 1 yr of age in given yr____________*1000
No of live birth in the same year at same place
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