Maternal and Child Health Nursing Program

 Philosophy

• Pregnancy, labor and delivery and puerperium are part of the continuum of the total life cycle
• Personal, cultural and religious attitudes and beliefs influence the meaning of pregnancy for individuals and make each experience unique
• MCN is FAMILY CENTERED- the father is as important as the mother

Goals

• To ensure that expectant mother and nursing mother maintain good health, learn the art of child care, has a normal delivery and bear healthy children
• That every child lives and grows up in a family unit with love and security, in healthy surroundings, receives adequate nourishment, health supervision and efficient medical attention and is taught the elements of healthy living

Classification of pregnant women

• Normal – healthy pregnancy
• With mild complications- frequent home visits
• With serious or potentially serious complication – referred to most skilled source of medical and hospital care

Home Based Mother’s Record (HBMR)

• Tool used when rendering prenatal care containing risk factors and danger signs

Risk Factors

• 145 cm tall (4 ft & 9 inches)
• Below 18 yrs old, above 35 yrs old
• Have had 4 pregnancies
• With TB, goiter, heart disease, DM, bronchial asthma, severe anemia
• Last baby born was less than 2 years ago
• Previous cesarian section delivery
• History of 2 or more abortions, difficult delivery, given birth to twins, 2 or more babies born before EDD, stillbirth
• Weighs less than 45 kgs. or more than 80 kgs.

Danger Signs

1. any type of vaginal bleeding
2. headache, dizziness, blurred vision
3. puffiness of face and hands
4. pallor

Prenatal Care

Schedule of Visits

• 1st – as early as pregnancy, 1st trimester
• 2nd – 2nd trimester
• 3rd & subsequent visits – 3rd trimester
• More frequent visits for those at risk with complications

Tetanus Toxiod Immunization Schedule for Women

Vaccine	Minimum Age Interval	Percent Protected	Duration of Protection
TT1	As early as possible during pregnancy	0%	None
TT2	At least 4 weeks later	80%	Infants born to the mother will be protected from neonatal tetanus. Gives 3 years protection for the mother from the tetanus.
TT3	At least 6 months later	90%	Infants born to the mother will be protected from neonatal tetanus. Gives 5 years protection for the mother.
TT4	At least 1 year later	99%	Gives 10 years protection for the mother
TT5	At least 1 year later	99%	Gives lifetime protection for the mothers. All Infants born to that mother will be protected.

Dose: 0.5ml
Route: Intramuscular
Site: Right or Left Deltoid/Buttocks

Components of Prenatal Visits

• History – taking
• Determination of obstetrical score- G, P, TPAL, AOG, EDD
• U/A for Proteinuria, glycosuria and infxtn
• Dental exam
• Wt. Ht. BP taking
• Exam of conjunctiva and palms for pallor
• Abdominal exam – fundic ht, Leopold’s maneuver and FHT
• Exam of breasts, face, hands and feet for edema and neck for thyroid enlargement
• Health teachings- nutrition, personal hygiene, common complaints
• Tetanus toxoid immunization
• Iron supplementation – from 5th mo. Of pregnancy – 2 mos. Postpartum
• In goiter endemic areas – iodized capsule once a year
• In malaria infested areas- prophylactic Chloroquine (150 mg/tab ) 2 tabs/ wk for the whole duration of pregnancy