Pregnancy is an important and responsible period in the life of every woman. At this time, the expectant mother and her child need increased attention from medical professionals. Prenatal patronage allows you to monitor the course of pregnancy and the state of he alth of a woman, as well as monitor the implementation of the necessary recommendations, the conditions for the safe bearing of a new little man. This article provides answers to the most significant questions: why such visits are needed in our time, their approximate plan, as well as the timing and goals of antenatal care.
Definition
Patronage is one of the forms of work of medical institutions aimed at carrying out he alth and preventive measures at the patient's home. Held for citizens who especially need the attention of doctors: seriously ill people, people with mental disorders, babies, pregnant women.
Antenatal care is the most important preventive measure for pregnant women. They allow not only to control the future parent, but also establish friendly relations between the mother and the medical staff, since in the first year after the birth of the baby theycontact will be regular.
Carrying out prenatal care consists in a personal visit of a responsible medical worker. When meeting, the nurse evaluates the social and living conditions in which the woman lives and the newborn has to grow up. During the same visit, the family's affiliation to risk factors is established, which will be discussed later.
Meaning of Patronage
Expectant mother visits the obstetrician-gynecologist on her own to monitor the he alth of her and her baby. The longer the period, the more often she is forced to go to the antenatal clinic. However, this approach does not allow to identify the real living conditions of a pregnant woman, which are of great importance for the successful bearing of a child. All data is recorded by the doctor only from the words of the woman and may not be true.
Antenatal care for a pregnant woman allows you to get a true picture of a woman's life: bad habits, the psychological situation in the family, material we alth. In addition to "espionage" activities, the medical worker performs other duties. During the visit, the nurse gives the expectant mother a lot of interesting and useful information, as well as advice on the bearing of the child, the upcoming birth, and how to care for the baby.
Highlights
For the entire period of pregnancy, a woman expects three visits from the hospital. This is the standard number of nurse visits and may be increased in the following cases:
- problem pregnancy;
- suspected congenital pathology in an infant;
- if the expectant mother is at risk;
- irregular visits to antenatal clinics;
- after hospitalization of a pregnant woman.
As a rule, antenatal care is provided by a nurse at a children's polyclinic or a midwife from a antenatal clinic. Sometimes they take turns visiting the expectant mother. All visits are supervised by the doctor of the medical institution, who sometimes conducts patronage together with the he alth worker. All observations of the nurse, as well as recommendations and appointments are recorded in the patronage list. This data is regularly reviewed by the doctor, who, if necessary, takes appropriate measures.
First patronage: goals and deadlines
The first visit to the expectant mother is carried out by a midwife from the antenatal clinic when registering for pregnancy. Usually it is 7-13 weeks. As already mentioned, during the first prenatal patronage, the woman's lifestyle, domestic and sanitary conditions in the house, and the psychological atmosphere in the family are clarified. Unfavorable living conditions negatively affect the he alth of both the mother and the unborn baby, so the data obtained by the midwife on the first visit are very important for further work with the expectant mother.
The purpose of the visit is also to continue the discussion of preventive measures that a pregnant woman gets acquainted with when registering. The following topics are mandatory for discussion:
- baby protection, preterm birth prevention;
- he althy lifestyle rules;
- rational nutrition;
- personal hygiene (prevention of constipation, wearing a bandage and others);
- need for regular medical check-ups.
A nurse from a children's clinic usually comes to the expectant mother a little later, from 20 to 28 weeks of pregnancy. The purpose of prenatal patronage is pursued by a similar one - getting to know the woman and the living conditions of the unborn baby.
Algorithm for the first patronage
At the visit, the he alth worker introduces himself to the pregnant woman. During this period, it is important to create a friendly attitude that will help maintain contact in the future. After the conversation, the nurse fills out a patronage sheet, which contains basic information about the expectant mother:
- Last name, first name and patronymic of the woman.
- Address of residence.
- Full age.
- Profession, education, speci alty.
- Place of main job.
- Full name husband.
- Spouse's age.
- Data about his speci alty, education.
- Husband's place of work.
- Data on other family members who live with the pregnant woman.
- Housing hygiene, living conditions, material we alth.
- Bad habits of father and mother.
- Chronic illness in the family.
- Preparing for the birth of a child (for a pediatrician).
Sometimes a nurse fills in the data not from the words of a woman. For example, if a woman claims that her drinking husband has nobad habits, the he alth worker still records the actual data.
Second patronage
The next visit is to monitor the fulfillment of the appointments received on the first visit. The district nurse comes at 32-34 weeks of pregnancy, and the midwife is closer to childbirth, that is, at 37-38 weeks. Preventive conversation is dedicated to the future baby. Below is a sample antenatal care plan:
- Collecting data on pregnancy, past illnesses and general he alth.
- Compliance with recommendations received last time.
- Psychological climate in the family.
- Preparing for the birth of a child (buying a dowry).
- Preparing breasts for lactation.
- Conversation with relatives about the upcoming event, the importance of supporting a pregnant woman.
Sometimes at this stage, the expectant mother receives an invitation to the school of young parents. Usually classes are held in the antenatal clinic and help prepare the future parent and her spouse for the birth of a child.
Second patronage pattern
At the end of the conversation with the expectant mother and, if possible, with her close people, the nurse records the information received. Below is a sample of prenatal care.
All data received is subject to comparison with the information provided during the first visit of the he alth worker. Is there an improvement in sanitary conditions, was there any relief of labor dutiespregnant woman? The level of preparedness for the appearance of a child is also revealed (buying personal items and furniture for the baby, arranging the children's room, and so on).
Pipiparous women have the opportunity to get a free consultation about the upcoming birth and ask the most burning questions. Midwives are always in touch and are happy to share knowledge with young parents.
Third patronage
Another visit can be made by a local pediatrician to a pregnant woman. This visit is optional and is scheduled on a strictly individual basis. As a rule, the doctor comes if the pregnancy is complicated and there is a risk of having a child with developmental pathologies or congenital diseases. Increased attention is also being paid to disadvantaged families.
The need for a third patronage is determined by analyzing the information received after the previous two visits. Based on the results of visiting the future parent, the doctor raises the question of the need to register the family. At the same time, after the birth, the baby and his mother will be under the close attention of the pediatrician and other specialists.
Risk factors
It has already been said above that in patronage there is such a thing as risk factors. Women who fall under this category need increased attention from local specialists:
- young mothers under 18;
- primiparous after 30;
- single mothers;
- women with many children.
In addition, close attention from the obstetrician and pediatrician can be causedthe following reasons:
- risk of miscarriage;
- abortion attempts;
- severe toxicosis;
- high blood pressure, heart problems;
- maternal illnesses;
- bad habits of parents;
- unfavorable environment for the life of the unborn baby.
According to these indicators, a probable risk to the life and he alth of the child is revealed, and the local pediatrician takes measures to minimize adverse factors. A set of preventive measures is designed to prevent possible problems.
Problems of doctors
Despite the fact that prenatal visits are well-intentioned, doctors still have to face certain difficulties. Firstly, it is far from always that a pregnant woman is at home during a visit by a nurse. It is only possible to get an idea of the real situation in the family, as well as of living and hygienic conditions, if the visit is spontaneous. Therefore, medical workers do not warn about the upcoming visit, and the timing of prenatal care is not discussed with patients. As a result, specialists often knock on the doors of an empty apartment.
Secondly, not every woman has a positive attitude towards such control by the antenatal clinic and children's clinic. For this reason, not all pregnant women make contact and agree to provide detailed information about their lives.
