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Things to check

Signs of anemia

Anemia is lack of iron in the blood. Anemia is especially dangerous for pregnant women because blood is lost during birth. This can make the anemia so severe the woman can die.

Signs of anemia

If a woman has signs of anemia she should eat foods with a lot of iron. Or she can take 300 mg of ferrous sulfate (or enough to provide 60 mg iron), 2 times a day until the baby is born. If she takes iron tablets with fruit, her body will use the iron better.

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Baby is lying sideways (transverse)

Do not try to change the position of the baby once labor has started. This can separate the placenta from the womb wall.

If a baby is sideways near the end of the pregnancy, make a plan for the mother to give birth in a hospital. A baby lying sideways cannot be born without an operation.

If labor has already started and the baby is sideways, take the mother to a hospital to save her and her baby's life.

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Bleeding after birth

It is normal for a woman to bleed a little after birth. But treat immediately for bleeding if she:

Even if you do not see a lot of blood, watch for these signs: feeling faint, pale skin, feeling like she lost too much blood.

These are signs of shock. Take the mother to the hospital right away. Treat for bleeding and shock on the way.
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Too much bleeding
after the placenta has come out

A woman who is bleeding a lot is in danger of shock. Check her for signs
of shock.
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Too much bleeding
before the placenta comes out

A woman who is bleeding a lot is in danger of shock. Check her for signs of shock.
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Bleeding during labor, before the baby is born

Some light, pink-colored fluid, or mucus and brown blood during labor is normal. But if the mother is bleeding bright red blood, it could mean that the placenta is separating from the womb wall or is covering the opening of the womb.

This is very dangerous. Take the mother to the hospital right away. Watch the mother for signs of shock.
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Bleeding During Pregnancy

Healthy signs:

Warning signs: There is a lot of blood. Where is the woman in her pregnancy?

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Bleeding during the first half of pregnancy: miscarriage

When a woman bleeds about the same as having her monthly bleeding, it is probably a miscarriage (losing the pregnancy). This is not normally dangerous to the physical health of the mother. But watch for danger signs like too much bleeding, or signs of infection such as fever, feeling faint, or a bad smell from the vagina.

Women who have had miscarriages or abortions may feel afraid, sad, or upset. This emotional pain is just as important as the pain women have in their bodies.

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Bleeding during the second half of pregnancy

Bleeding during the second half of pregnancy could mean the placenta is in the wrong place or has detached from the womb. Both are serious problems.

Bleeding during the second half of pregnancy is very dangerous. Get medical help to save the mother and the baby. Watch the woman for signs of shock.
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Things to avoid

Chemicals and fumes

Chemicals used for cleaning and to kill pests are very dangerous to pregnant women. A pregnant woman should avoid getting chemicals on her skin or breathing their fumes. Chemical containers should never be used to carry or store food or water.

Chemicals can cause:

Poisonous chemicals are found in:

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Common complaints
during pregnancy

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Common complaints

Cravings

A food craving is a strong desire to eat a certain food, or even something that is not food at all, like dirt, chalk, or clay. If a woman gets a craving for nutritious foods (like beans, eggs, fruits, and vegetables), it is OK for her to eat as much as she wants.

A woman who wants a lot of "junk food" (like candy, soda, or packaged snacks) should eat nutritious food first.

A woman who craves things that are not food, like dirt or clay, should not eat them. They may poison her and her baby, or make her sick. This may be a sign that she needs more protein and iron-rich foods in her diet.

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Danger Signs
After Birth

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Danger Signs
During Birth

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Danger Signs
During Pregnancy

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Eating well

A woman who eats well is much more likely to have a healthy pregnancy and healthy baby.

Pregnant women need to eat more than usual. The extra food gives them enough energy and strength, and helps their babies grow.

Pregnant women should eat a variety of foods, some foods from each of these 3 groups every day:

Carbohydrates: such as rice, maize, wheat, millet, cassava, taro, or plantains.

Proteins: such as beans, peas, lentils, eggs, nuts and seeds, cheese, milk, yogurt, meat, fish, or insects.

Fruits and vegetables: such as leafy greens, carrots, cabbage, peppers, oranges, melons, pineapples, papayas, or mangoes.

If a woman is not getting enough to eat, encourage her family, neighbors, and friends to share with her. Perhaps they can help tend her garden, bring her eggs from their chickens, or cook a bit extra to bring to her.

Iron and folic acid: A pregnant woman also needs to get enough iron to prevent anemia, and folic acid to prevent birth defects in her baby. She should take supplements of these to make sure she gets enough. Each day she should take 400 to 500 mcg folic acid, and
300 mg ferrous sulfate (60 mg iron), until the baby is born.

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Fever after birth

If the mother has a fever during the first weeks after the birth, she may have an infection of the womb. Other signs of womb infection are:

Womb infection is very dangerous. It must be treated or the woman can die.

Give antibiotics on the way to the hospital.

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Fever during labor

It can be normal for a woman to get warm in labor. This may be because she is dehydrated. Give rehydration drink.

A fever above 38°C (100.4°F) is usually a sign of infection. Give antibiotics on the way to the hospital.

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Fever during pregnancy

If a woman has a fever during pregnancy, it could be caused by malaria, a sickness like flu, a kidney infection, or dehydration. Find the cause of the fever and treat it.

Along with the fever does she also:

Along with treating the cause, a high fever needs to be lowered right away.

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Foods with iron

Pregnant women are especially at risk for anemia (weak blood). Eating more foods with iron will help prevent and treat anemia. Foods with a lot of iron include:

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Green or brown waters

Green or brown waters mean that the baby has passed stool inside the womb. He may be in trouble. The stool can get in the baby's mouth and nose, and it can be hard for him to get enough air.

What to do if the waters are green or brown

If it is still early in labor or if the mother has not started pushing, it is best for this baby to be born in a hospital.

If the mother is already pushing and the birth is coming soon, be ready to clean the baby's mouth at birth. As soon as the baby's head is born, wipe his mouth and nose with a clean cloth or use a suction bulb to suck the mucus out. Keep the baby's head lower than his body to help the mucus come out. If the baby has difficulty breathing, or his skin stays blue after a few minutes, take him to a hospital.

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Things to check

Blood pressure

Check the mother's blood pressure at each visit during pregnancy. Write it down so you can look for changes over time.

Healthy sign: Blood pressure stays between 90/60 and 140/90 and does not go up much during pregnancy.

Warning sign: High blood pressure. The woman has high blood pressure if the top number is over 140 or the bottom number is over 90.

This can be a sign of pre-eclampsia which is a dangerous disease of late pregnancy.

If her blood pressure is very high (160/110) she has severe pre-eclampsia and needs medical help right away.

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Things to check

Temperature

Healthy sign: If the woman's temperature is close to 37°C (98.6°F). She does not feel hot to touch.

Warning sign: Woman has fever - a temperature of 38°C (100.4°F) or above. She feels hot to touch.

If a woman has a fever during pregnancy, it could be caused by malaria, a sickness like flu, a kidney infection, or dehydration. Find the cause of the fever and treat it.

Along with the fever does she also:

Along with treating the cause, a high fever needs to be lowered right away.

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How to change the baby's position

During the last month of pregnancy, it may be possible for a pregnant woman to change the baby's position by lying in this position for 10 minutes, 2 times a day:

Lie on the floor with pillows under the hips. Try to get the hips higher than the head. Do this every day with an empty stomach, until the baby changes to a head-down position. Then stop.

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How to check for
protein in urine

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Protein in the urine is a sign of pre-eclampsia. There are 2 methods to check for protein
in urine.

Method 1: Use small plastic strips called Uristicks, Albusticks, or Labsticks to check for protein.

You may be able to get a bottle of these sticks from the local health authority or pharmacy. The strips have different color squares that turn from yellow to dark green. Ask the mother to urinate on the stick, and then compare the color of the squares with the color chart on the bottle.

If the square turns dark green, there is protein in the urine. This is the most accurate way to check for protein.

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How to check for
protein in urine

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Method 2:
Heat the mother's urine to check
for protein.

Ask the mother to wash her genitals well and then urinate into a clean container. Then pour the urine into a test tube to within
2 centimeters (or one inch) of the top of
the tube.

Heat the upper part of the tube over a small burner, low flame, or candle until the urine boils. (Keep turning the test tube or the glass will break.)

If the urine is clear, there is no protein in it. If the urine becomes cloudy and white, add a few drops of vinegar (2% acetic acid). If the cloudiness goes away, there is no protein in the urine. If it stays cloudy or gets whiter, there is protein in the urine.

If the woman has protein in her urine and high blood pressure, she has pre-eclampsia. When a woman has severe pre-eclampsia, the urine may become very cloudy, white, and thick.

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How to check
the baby's position

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Firmly grasp the top of the womb, and gently move it back and forth.

The baby's bottom is soft and wide. When you move it from side to side, the whole body moves with it.

The baby's head is harder and smaller. When you move the head, the neck bends, and the body does not move much.

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How to check
the baby's position

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Push firmly against one side of the belly. With the other hand, feel up and down along the other side of the belly. What do you feel?

The back feels firm. The arms and legs feel like small parts and may move away when you push on them.

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How to check
the baby's position

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Ask the mother to slowly blow out. As she is blowing, press deeply into each side of the lower belly, just above the pubic bone.

The head feels hard. Toward the end of pregnancy it "drops" into the pelvis. If the bottom is down, it will feel softer and wider.

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How to check
the baby's position

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If the baby is breech (butt down) at the time of birth, problems are more likely. This baby should be born with the help of an experienced midwife or in a hospital.

If the baby is sideways, you can feel it's head and bottom on each side of the belly. If the baby is sideways at the time of birth, it must be born by surgery in a hospital.

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How to give castor oil

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A drink of castor oil and fruit juice can sometimes start or strengthen labor. If castor oil is going to help start a labor, it should work within 4 hours.

Castor oil causes stomach cramps and diarrhea (watery stool). Sometimes it also causes vomiting. Having diarrhea during labor increases the chance of infection because a little stool can easily get into the vagina. The contractions together with stomach cramps can make labor feel too fast or overwhelming for the woman.

Always warn women that castor oil tastes very bad and will make them feel very uncomfortable. Remind them to wipe from front to back after passing stool.

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How to give castor oil

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To use castor oil

Mix about 60 ml (2 oz) of castor oil in a cup (240 ml or 8 oz) of fruit juice. Lemon or orange juice work especially well to help with the bad flavor. Do not give more than 1 glass. The mother should drink the whole glass down.

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How to give
magnesium sulfate

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Magnesium sulfate is used to stop seizures. This medicine can save a woman's life, but only use it on the way to a hospital or medical center.

Only use magnesium sulfate if her blood pressure is over 160/110 or if she is having a seizure. Magnesium sulfate can cause the woman to have trouble breathing, especially if she is given too much. Get medical help immediately if her breathing slows to less than 12 breaths a minute or if she has not urinated for 4 hours.

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How to give
magnesium sulfate

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Give 10 g of magnesium sulfate 50% by injecting 5 g deeply in each buttock.

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How to give medicine
to stop bleeding

Give one of these medicines to stop bleeding:

Oxytocin
Inject 10 units of oxytocin in the side of the thigh muscle. You can give this dose again in 20 minutes if bleeding does not stop.

Misoprostol
Give 400 mcg misoprostol by mouth. If she feels nauseous, you can also insert tablets into the woman's rectum. Wear gloves.

Ergometrine (only give after the placenta has come out)
Inject 0.2 mg ergometrine in the side of the thigh muscle.
OR, give 0.2 mg of ergometrine pills by mouth. You can give ergometrine every 2 to 4 hours for severe bleeding, or every 6 to 12 hours for less severe bleeding. But continue to give the medicine until bleeding has stopped and the womb is hard, usually about 48 hours. Pills do not work as quickly as injections. Do not give ergometrine to a woman with high blood pressure.

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How to give rectal fluids

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You will need:

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How to give rectal fluids

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What to do:

  1. Tell the woman what you are doing and why.
  2. Wash your hands.
  3. Ask her to lie on her left side if she can. Put a pillow or cloth under her head.
  4. If you have them, put on clean gloves.
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How to give rectal fluids

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  1. Let the water come down to the end of the tube to get the air out. Then pinch the tubing to stop the flow.
  2. Wet the end of the tube with water, Vaseline, or vegetable oil, and slide it into the anus. Ask her to take slow, deep breaths to help her relax. Do not put the tube in more than 10 cm (4 inches).
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How to give rectal fluids

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  1. Hold the bag or can just high enough for the water to run in very slowly. About the level of the woman's hips is good. It should take about 20 minutes. If the water runs out of her body, the bag may be too high. Lower the bag so the water goes in more slowly.
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How to give rectal fluids

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  1. Gently remove the tube. Tell her to try and keep the water inside, and that the urge to pass stool will go away soon. If the woman is unconscious, you can hold her
    buttocks together.
  2. Clean and dry the woman. Then remove your gloves and wash your hands.
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How to help a woman while getting her to the hospital

If a woman is bleeding heavily, send 2 family members with her to the hospital to give blood if needed.

If she is in shock, treat her for shock while transporting her to the hospital. If you know how, start an intravenous drip (IV). Or give rectal fluids.

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How to inject medicines
into muscle

What form of medicine do you have?

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How to inject medicines
into muscle

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Choose where to inject

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How to inject medicines
into muscle

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How to inject medicines
into muscle

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How to inject medicines
into muscle

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How to inject medicines
into muscle

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  1. Wipe the ampule clean with a cloth or some alcohol.
  2. Then wrap a clean cloth around the top and break it off.
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How to inject medicines
into muscle

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  1. Put the needle into the ampule. Be careful the needle does not touch the outside of the ampule. Hold the barrel of the syringe steady and pull the plunger - this will draw the medicine into the syringe.
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How to inject medicines
into muscle

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  1. Hold the syringe with the needle pointing up. Gently tap the barrel of the syringe until all the air bubbles rise to the top. Then push the plunger in just a little to get the air out.
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How to inject medicines
into muscle

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How to inject medicines
into muscle

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How to lower a fever

Lowering a fever will help a woman feel better, but it will not treat the cause of the fever, such as infection or malaria.

Lower a fever by giving 500 to 1,000 mg paracetamol by mouth every 4 to 6 hours (but do not give more than 4000 mg paracetamol in one day). Do not give ibuprofen to a pregnant woman in the last 3 months of pregnancy. It is not safe.

Give a sponge bath with cool (not cold) water, or use cool cloths to help bring the fever down.

Help the woman drink rehydration drink or
1 cup of water every hour. If she is too sick to drink, start an intravenous drip (IV) if you know how, or give rectal fluids.

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How to make bleach solution

If possible, use a 0.5% solution of bleach (chlorine) for disinfecting tools. If you do not have 0.5% bleach solution, you can make your own by mixing bleach and water:

If your bleach says:Use:
2% available chlorine...1 part bleach to
3 parts water
5% available chlorine...1 part bleach to
9 parts water
10% available chlorine...1 part bleach to
19 parts water
15% available chlorine...1 part bleach to
29 parts water

Soaking your tools in bleach solution for 20 minutes before you clean them will help protect you from infection.

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How to make
rehydration drink

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There are 2 ways of making rehydration drink. Both are good to give to any woman in labor, especially if she has a fever or has been in labor for a long time. If you can, add half a cup of fruit juice, coconut water, or mashed ripe banana to either drink. These contain potassium, a mineral which helps a sick person accept more food and drink.

Give the person sips of this drink every 5 minutes, day and night, until she begins to urinate normally. A large person needs 3 or more liters a day. Keep giving the drink often, and in small sips. Even if she vomits, not all of the drink will be vomited.

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How to make
rehydration drink

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Method 1:
Drink made with powdered cereal and salt

(Powdered rice is best. But you can use finely ground maize, wheat flour, sorghum, or cooked and mashed potatoes.)

In 1 liter of clean water

put half of 1 level teaspoon of salt,

and 8 heaping teaspoons of powdered cereal.

Boil for 5 to 7 minutes to form a liquid gruel or watery porridge. Cool the drink quickly and begin to give it to the sick person.

Caution: Taste the drink each time before you give it to make sure that it is less salty than tears and that it has not spoiled. Cereal drinks can spoil within a few hours in hot weather.

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How to make
rehydration drink

-

Method 2: Drink made with sugar and salt

In 1 liter of clean water

put half of 1 level teaspoon of salt,

and 8 level teaspoons of sugar.

(You can use raw, brown sugar or molasses instead of white sugar)

Mix well.

Caution: Before adding the sugar, taste the drink and be sure that it is less salty than tears.

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How to prevent malaria

Malaria is spread by mosquitoes. To prevent malaria, avoid mosquito bites.

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How to roll nipples

Rolling, squeezing, and massaging the nipples can help a woman have stronger contractions and start labor. Keep squeezing and massaging until her contractions get strong. If her contractions do not get stronger within half an hour, rolling the nipples probably will not help.

Rolling the nipples can also help the womb contract and stop bleeding.

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How to rub the womb

Put your hand on top of the womb and squeeze while you move the same hand in a circle. Rub the womb until it feels like a hard round ball. The womb should be in the center of the belly, not off to the left or right. If it is not in the center, have the woman urinate. Check the womb every 1 or 2 minutes for a while. If it gets soft again, rub it until it contracts again.

Rubbing the womb will be painful for the mother. You must keep rubbing to stop the bleeding, even if she is in pain.

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How to suction a baby's
mouth and nose

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First suction the mouth and throat until they are clear of mucus. Then suction the nose. (Practice using the syringe to suck up water before you use it at birth).

  1. Squeeze the syringe.
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How to suction a baby's
mouth and nose

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  1. Gently put the syringe in the baby's throat.
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How to suction a baby's
mouth and nose

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  1. Release the syringe as you wiggle it around. The bulb will suck up mucus.
    (Do not squeeze the syringe while it is in the mouth.)
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How to suction a baby's
mouth and nose

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  1. Squeeze out the mucus.
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How to take
blood pressure

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1. Fasten the cuff around the bare upper arm.

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How to take
blood pressure

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2. Close the valve on the rubber bulb by turning the screw to the right. The screw will get shorter.

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How to take
blood pressure

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3. Feel for a pulse just below the cuff, on the inside of the elbow. Put the stethoscope over the pulse and put the ear pieces in your ear.

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How to take
blood pressure

- -

4. Pump up the cuff by squeezing the bulb.

5. As you pump, the needle will move. When it reaches 200 stop pumping.

- -
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How to take
blood pressure

-

6. Then open the valve just a little so that the air leaks out slowly. As the air leaks out, you will start to hear the mother's pulse through your stethoscope.

Notice where the needle or mercury is:

-
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How to take a temperature
using a thermometer

-

(Using a thermometer marked in degrees Celsius - °C)

Clean the thermometer well with soap and cold water, or alcohol. Hold it at the end without the silver (or red) and shake it hard, with a snap of the wrist, until it reads less than 36 degrees.

-
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How to take a temperature
using a thermometer

- -

Put the thermometer:

under the tongue (keep the mouth closed around it)

OR in the armpit if there is danger that the person might bite the thermometer.

- -
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How to take a temperature
using a thermometer

-

Leave it there for 3 or 4 minutes.

Read the temperature on the thermometer. You may need to rotate the thermometer to see where the silver line stops.

Wash the thermometer well with soap and cold water. Then, if you can, soak it for 20 minutes in a bleach solution and rinse with clean water.

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How to treat infection during labor or after birth

For mild fever during labor, ampicillin plus gentamicin will usually work. For high fever in labor, or for signs of infection after birth, use metronidazole as well to fight all the possible bacteria that can cause the infection. It is best to inject at least the first dose of ampicillin, but if you have only pills give those instead.

Ampicillin: inject 2 grams. Wait 6 hours, then inject or give by mouth 1 gram every 6 hours. AND

Gentamicin: inject 5 mg per kg, once a day. If you cannot weigh the woman, inject 80 mg, 3 times a day. AND

Metronidazole: give 500 mg by mouth, 3 times a day.

Give all 3 medicines until 2 days after signs of infection have stopped.

In case of allergy to penicillins, give 500 mg erythromycin 4 times a day instead of ampicillin. Other combinations of antibiotics can be given if they are all you have. Choose a combination that fights a wide-range of bacteria.

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How to treat malaria

If a pregnant woman is sick with malaria, she should be treated right away.

Malaria should usually be treated with an Artemesinin-based Combination Therapy (ACT). Check with your local health authority to find out which ACT works best in your area.

If you do not know which works best, give artemether plus lumefantrine. This usually comes as a combined pill. Give 4 pills by mouth 2 times a day for 3 days. The woman should take the medicine right away after opening the package because it can lose strength once outside the package.

If the woman is in the first 3 months of pregnancy, she should take quinine plus clindamycin instead, if possible. Give 600 mg quinine 3 times a day for 7 days, AND 300 mg clindamycin 4 times a day for 7 days.

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How to treat yeast infections

Yeast infections are common during pregnancy. They are not dangerous, but should be treated before birth.

Signs: Treatment:
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How to treat bladder and
kidney infections

If the woman has a bladder infection, she should drink 1 glass of liquid every hour while she is awake to help wash the infection out of her body. Cranberry juice, cornsilk tea, or other home remedies often work.

If she does not start to improve quickly, or if she has any signs of a kidney infection, give antibiotics.

Antibiotics for bladder and kidney infection:
Give 500 mg amoxicillin by mouth 3 times a day for 7 days. If she is allergic to amoxicillin or penicillin give 960 mg cotrimoxazole by mouth 2 times a day for 7 days. But do not give cotrimoxazole in the last 3 months of pregnancy.

Prevention:
Wipe from front to back after urinating or passing stool to keep germs away from the pee hole. Remind women's partners to clean their hands and genitals before sex. Women should also urinate right after having sex.

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Common complaints

Increased vaginal discharge

Discharge is the wetness all women have from the vagina. Pregnant women often have a lot of discharge, especially near the end of pregnancy. It may be clear or yellowish. This is normal.

If the discharge is white and lumpy, and if the vagina itches, this might be a yeast infection.

Discharge with a very bad smell, or heavy discharge with pain in the belly, can be a sign of a sexually transmitted infection. She should see a health worker.

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Safe Pregnancy and Birth
Version 1.0.0, 2011

This app is a collaboration between Hesperian and UnaMesa.

Hesperian Health Guides is a non-profit publisher of books, newsletters and online resources for community-based health care.

Visit Hesperian's digital commons for more great resources.

The UnaMesa Association is a public charity dedicated to improving healthcare, education, and social services through innovations in technology and tools for sharing knowledge.

Learn more at www.unamesa.org

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Copyrights and Credits

Content: All rights reserved, copyright Hesperian Health Guides. Please contact permissions@hesperian.org for more information.

Design:

Application source code: available on
github under MIT license.

Contributors:
  • UnaMesa Association
  • Saq Imtiaz
  • Matthew Litwin
  • FND
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Things to avoid

Malaria

Malaria is an infection of the blood that causes chills and fever, and is spread by mosquito bites. Malaria is especially dangerous for pregnant women and their babies. A pregnant woman with malaria is more likely to have anemia, miscarriage, early birth, small baby, stillbirth (baby born dead), or to die.

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Common complaints

Nausea

Many women have nausea in the first months of pregnancy. No one knows for sure what causes this, but for many women, the way they eat affects it. If the nausea is mild, encourage the woman to try any of these remedies:

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Things to avoid

Sick people

A pregnant woman should avoid sick people to prevent getting sick herself. Some sicknesses are particularly dangerous to pregnant women or their babies. Rubella (German measles) is one sickness that can cause serious birth defects in the baby, including deafness and heart problems. It can even cause death.

There is a vaccine to prevent Rubella. A woman should not get this vaccine while she is pregnant, but her family and children should. A community-wide vaccination program is the best protection for all women.

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Pre-eclampsia
(danger of seizures)

Pre-eclampsia is when a woman has:

If a woman has both of these signs, she already has pre-eclampsia and needs medical help right away.

Pre-eclampsia can cause premature birth, bleeding, seizures, or even death for the mother.

If she only has high blood pressure, check it once a week to see if it goes up, and watch for signs of severe pre-eclampsia.

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Seizures or fits

When a woman has a seizure, she may have some or all of these signs:

A seizure may last anywhere from a few seconds to many minutes.

What to do if she has a seizure

  1. Stay calm.
  2. Do not put anything in the mother's mouth. She must be allowed to breathe freely.
  3. Put the mother on her side, so she does not breathe in her spit or vomit.
  4. Remove hairpins or other sharp objects that could harm the mother.
  5. Give her oxygen, if you have it.
  6. Give magnesium sulfate if you know how.

Get medical help as soon as possible when the seizure is over.

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Severe abdominal pain in pregnancy

Severe pain in the belly with or without bleeding may mean that the placenta has become separated from the wall of the womb.

Other signs that the placenta is separting from the womb are:

This is very dangerous. Get medical help to save the mother and the baby.

Watch the woman for signs of shock and start IV fluids if you know how.

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Severe pre-eclampsia

Signs of severe pre-eclampsia are:

If she has high blood pressure and any of these signs, get medical help immediately to save her life. Give magnesium sulfate on the way, and have the woman lie on her left side.
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Shock

Shock is a life-threatening condition that can result from heavy bleeding. Bleeding inside the body can also cause shock.

Signs:

Take the woman to a hospital right away. She needs medical help fast.

How to treat a woman in shock

If she is unconscious, do not give her anything by mouth - no medicines, drink, or food until she has been awake for one hour.

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Things to check

Signs of kidney or bladder infection

Bladder and kidney infections can be dangerous for the mother. They can also cause her to start labor too early if they are not treated right away.

Signs of bladder infection:

  • Constant feeling of needing to urinate, even after having urinated
  • Pain or burning while, or just after, urinating
  • Pain in the lower belly, behind the front of the pelvis

Signs of kidney infection:

  • Pain in the lower back, sometimes on the sides
  • Fever
  • Cloudy or bloody urine
  • Feeling very sick or weak
  • The woman may have signs of bladder infections as well
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Signs of malaria

High fever, especially along with shivering, body aches, and severe headache, can be caused by malaria. Malaria is especially dangerous for pregnant women and their babies. The typical malaria attack has 3 stages:

  1. It begins with chills and often headache. She shivers or shakes for 15 minutes to an hour.
  2. Chills are followed by fever, often 40°C (104°F) or more. She is weak, flushed (red skin), and at times delirious (not in her right mind). The fever lasts several hours or days.
  3. Finally she begins to sweat, and her temperature goes down. After an attack, she feels weak, but may feel more or less OK.

Malaria attacks usually happen every 2 or 3 days, but they can also happen every day or only once in a while.

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Things to avoid

Smoking, alcohol, and
other drugs

Cigarette smoke, alcohol, and other drugs are all harmful to the mother. When a woman smokes, drinks, or takes drugs, they also pass through her blood to her baby. This causes babies to be born small or dead, or can cause permanent damage to the baby's brain and body.

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Staying Healthy
During Pregnancy

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Things to check

The baby's position

Healthy sign: The baby is head down at the time of birth.

Warning sign: The baby is breech (feet or bottom down) at the time of birth. A breech birth can have serious problems. If possible, a breech baby should be born at a well-equipped medical center, especially for a mother's first baby.

If the baby is sideways, it cannot be born through the vagina. If the baby is sideways when labor starts, get to a hospital. Cesarean surgery is needed.

During pregnancy, it is common for a baby to change position several times in the womb. By the end of the pregnancy, the baby should be head down in the womb. This is the safest position for birth. To make sure the baby is head down, check the baby's position.

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Things to avoid
during pregnancy

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Things to check
during pregnancy

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Common complaints

Tiredness

Some pregnant women feel tired much of the day. This is most common during the first 3 months.

It is normal for pregnant women to feel tired. Their bodies are telling them to slow down and rest. A woman should rest when she can. But if she also feels weak, she may have other problems, like a sickness, depression, or anemia.

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Too long labor

A very long labor can lead to lasting health problems for the mother, or may be a sign that the baby cannot come out without medical help. Labor is too long when:

If her contractions are not coming every 2 to 3 minutes, or if she can still talk through them, she is not in active labor yet. Encourage her to sleep. If she cannot sleep, have her walk, dance, climb stairs or hills. Help her to drink and eat light foods.

Once contractions are coming regularly and are strong, be mindful of the time. Also think about how far from help you are, in case it is needed. You may need to try to strengthen her labor at home or get medical help.

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Things to avoid

Unnecessary medicines

Medicines a pregnant woman takes also pass to her baby. And some medicines that are safe for an adult, can cause birth defects or other harm to the baby. So pregnant women should avoid most medicines. For minor problems like headaches, stomach aches, and colds, rest and fluids are better treatment than medicines.

But some illnesses are too harmful to leave untreated throughout pregnancy. Always treat for malaria, bladder or kidney infections, HIV or AIDS, and sexually transmitted infections.

Ask an experienced health worker if you are not sure if a particular medicine is safe in pregnancy and during breastfeeding.

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The water breaks, but labor does not start

Most women will give birth within 24 hours after their waters break. If labor has not started within 12 hours, the woman and her baby could get a serious infection.

What to do if the water breaks but labor does not start

The mother must not put anything in her vagina. This could cause an infection.

Try to strenghten labor. If labor does not start after a few more hours, she should go to a health center or hospital.

Do not use injections to start labor. They can cause contractions that are so strong that they can kill the woman or the baby.

If she has a fever or there is a bad smell in the vagina, an infection is starting. Give antibiotics on the way to the hospital.

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How to strengthen labor

Do not use injections to start labor. They can cause contractions that are so strong that they can kill the woman or the baby.

First, check the baby's position to make sure he is not sideways.

If the baby is still not coming, get medical help. Medication or surgery may be needed.