Antenatal care is an important part of your pregnancy journey because your hospital will provide you information on all you need to know about pregnancy, labor as well as taking care of your newborn.
It’s also extremely important because it can detect abnormalities and preventable illnesses in both mother and baby, thereby reducing the maternal mortality rate and risk of stillbirths
Regular antenatal check-ups help to:
- Maintain the health of the Mum-to-be
- Carry out proper screening tests and ultrasound scans
- Identify high risk cases of pregnancy related complications and prevent them where possible
- Decrease maternal and infant mortality.
- Provide some assurance to the mother regarding the delivery process
- Educate the pregnant mum about childcare, nutrition, sanitation and hygiene
The advice is to register for your antenatal care as soon as you know you are pregnant. Generally, all mums to be should be offered a combination of ultrasound scans, antenatal screening tests including that of sickle cell and thalassaemia., blood tests to check for STDs.
In Africa, the overall maternal mortality rate is higher than those of developed countries. According to 2017 statistics reported in the World bank , South Sudan had the highest mortality rate of 1150 per 100,000 live births, with Chad reporting 1140, Sierra Leone reporting 1120 and Nigeria being the 4th highest at 917.
On the other hand, other African counterparts like Ghana, Kenya and South Africa had a lower number of mortality rates at 308, 342 and 119 respectively.
The mortality rate was much worse in previous years and got better when in 2002, the WHO recommended a approach to Ante-Natal Care to improve quality of care of pregnant women and increase ANC coverage.
This model included four antenatal visits occurring between 8 and 12 weeks of gestation, between 24 and 26 weeks, at 32 weeks, and between 36 and 38 weeks. They are broken down into:
First visit (8-12 weeks) :
- Confirm pregnancy and EDD.
- Screen, treat and give preventive measures
- Develop a birth and emergency plan.
- Advise and counsel.
Second visit 24-26 weeks:
- Assess maternal and fetal well-being.
- Exclude PIH and anaemia. Give preventive measures.
- Review and modify birth and emergency plan.
- Advise and counsel.
Third visit 32 weeks;
- Assess maternal and fetal well-being.
- Exclude PIH, anaemia, multiple pregnancies. Give preventive measures. Review and modify birth and emergency plan. Advise and counsel.
Fourth visit 36-38 weeks ;
- Assess maternal and fetal well-being.
- Exclude PIH, anaemia, multiple pregnancy, malpresentation.
- Give preventive measures.
- Review and modify birth and emergency plan.
- Advise and counsel
However, there were shortcomings with this approach as it did not offer women adequate contact with health-care practitioners. The WHO said that recent evidence had shown that a higher frequency of antenatal contacts by women and adolescent girls with the health system is associated with a reduced likelihood of stillbirths.
As a result, in 2016, WHO then updated recommendations for pregnant women to improve the quality of antenatal care and reduce the risk of stillbirths and pregnancy complications. It introduced a more focused approach so that pregnant women had a minimum of eight contacts with health care professionals to reduce perinatal mortality and improve women’s experience of care.
WHO’s focused antenatal care is practiced alongside the traditional antenatal care in African countries. In Nigeria for example, the traditional care requires visits every four weeks up to when the pregnancy is 28 weeks old. From 28 – 36 weeks, the woman is required to visit the hospital every 2 weeks. From the 36th week until delivery, the woman has to go to the hospital every week. Likewise, the Ghanaian version had women paying monthly visits up to 28 weeks, fortnightly visits from 28 to 36 weeks followed by weekly visits until delivery.
Possible questions during antenatal care
• Past medical history
• Height, weight, blood pressure
• Menstrual history
• Family history
• Social history
• Pregnancy history
• Surgical history
• Biodata
Tests and scans
The following tests will be carried out every time you visit the hospital:
1. Urine test to ascertain glucose, acetone and proteins
2. Blood test for Genotype, Blood group, Haemoglobin, blood count, syphilis, Rhesus group, HIV, Hepatitis B, Rubella
3. Ultrasound will also be carried out to screen for: Fetal size and abnormalities, multiple pregnancies, Premature membrane rupture, Intrauterine growth
In most African countries, the cost of antenatal care is usually supported by the government to make sure it is affordable for al pregnant women.
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