Antenatal 3

HOW TO DELIVER LIKE THE HEBREW WOMAN

HOW TO DELIVER LIKE THE 'HEBREW WOMEN'
Exodus 1 v 15-17
15 Then the king of Egypt spoke to the Hebrew midwives of whom the name of one was Shiphrah and the name of the other Puah.
16 And he said "when you do the duties of a midwife for the Hebrew women and see them on the BIRTH STOOLS, if it is a son then you shall kill him, but if it is a daughter then she shall live.
17 But the midwives feared God and did not do as the king of Egypt commanded them, but saved the male children alive."
Any woman who wants to deliver like the Hebrew women should behave like the Hebrew women. The Hebrew women in Egypt never delivered in the hands of unskilled childbirth attendants on mats or plantain leaves or in spiritual homes without trained attendants. They delivered on delivery beds which the Bible described as 'birth stools' in a maternity hospital where trained midwives took the deliveries. They delivered in a hospital where the king can, visit, not a place without name or formal registration with the Ministry of Health. When any pregnant woman claims, she will deliver like the Hebrew women and is being attended to by unskilled and unsafe child birth attendants in an unhygienic environment without facilities to help her if she needs it, such a woman should know that she is out of tune with the word of God, such a woman can never attract the faith that will save her in that pregnancy because faith is confidence in what the word of God said or implies. In this case of Hebrew women, the word implied that they were delivered by trained midwives in a maternity hospital with facilities like delivery beds. Any woman who wants to have safe delivery or deliver like the Hebrew women should register on time for antenatal care in a registered hospital, clinic or maternity where there are trained and God fearing child birth attendants, midwives and doctors. She should also deliver in such a facility long before the advent of Jesus Christ, ancient Egypt was known to have a highly developed medical practice with specialists in delivery matters and schools where midwives were trained.
Herodotus described the Egyptians as "the healthiest of all men, next to the Libyans" due to the dry climate and the notable public health system that they possessed. According to him "the practice of medicine is so specialized among them that each physician is a healer of one disease and no more.
Claiming to deliver like the Hebrew women and doing wrong things like being delivered by untrained personnel and in unsafe outfits make such belief not produce the desired faith for manifestation of safe delivery. What such in appropriate actions produce is unsafe delivery which is the reason for high maternal and new born mortality and morbidity in our surgeon. Belief must be coupled with appropriate actions for faith to come which produces our desired expectations which in this case is safe delivery.
The earliest known woman physician PESESHET practiced in ancient Egypt at the time of the 4th Dynasty. Her title was "Lady Overseer of the lady physicians." In addition to her supervisory role Peseshet trained midwives at an ancient Egyptian Medical School in SAIS.
It is unfortunate that in Nigeria many people depend entirely on supernatural cure neglecting scientific medicine even when it will benefit them while ancient Egyptians more than three thousand years ago, made use of specialists. The ancient Egyptians also recognized and made are of the supernatural which was a good combination.
Finally, “Medicine is of God and therefore it’s not evil”
check out our website smeei.com

THE UMBILICAL CORD CARE

THE UMBILICAL CORD CARE

·       Wear sterile hand gloves before attending to the cord to avoid infection

·       Remove the gloves you wear to clean the baby and wear a new pair of sterile hand gloves as you attend to the cord

·       Use sterile surgical blade or scissors or a clean unused razor blade to cut the cord

·       Cut the umbilical cord close to the body of the newborn baby. Only 2-3 centimeters should be left attached to the body

·       Keep the cord dry to prevent infection

·       Allow air to touch the cord

·       The baby’s nappy (diaper) should not cover the navel so that the cord does not get wet with urine. This is to avoid infection

·       If there are dust and flies the cord should be covered lightly with sterile gauze

·       Give mother tetanus toxoid immunization during pregnancy to prevent tetanus infection of the cord.

·       Do not apply concoctions which are likely to be infected to the cord.

·       Methylated spirit can be used to clean the cord if the cord came into contact with an infected material.

·       Double clamp every umbilical stump

·       Omphalitis (umbilical cord infection) is deadly. Avoid it by taking above named steps in handling the umbilical cord.

THE HIGHEST RISK TO SAFE DELIVERY IS DELIVERY BY UNSKILLED BIRTH ATTENDANTS

·       Traditional birth attendants (TBA) do not have the skills nor the medical materials to prevent women from dying.

·       One factor that delay women outside skilled setting is the wrong assumption or hope that a TBA is all they need, so they do not seek out any other pre-delivery assistance and then do not go to a properly resourced medical facility. When complications arise, such women can die as they are likely to be delayed in such unskilled facilities since the TBA may be unable to diagnose the complication let alone response to it appropriately.

·       Women can die from any of the following complications of pregnancy and delivery

Ø Excessive bleeding

Ø Infection

Ø  Severe pregnancy induced hypertension leading to eclampsia or fits

Ø Obstructed labour

Ø Severe anaemia (lack of blood)

Ø Complications of miscarriages

Ø Complications of unskilled termination of pregnancy

Unskilled birth attendants can hardly diagnose any of those complications that can kill women. Even if they recognize excessive bleeding, they have no capacity to help such women, they usually have no training or the medical resources to help such women.

·       TBA can delay a client with complications because of fear of forgoing income they would have made

·       TBAs are obstacles preventing women from getting proper care

·       Many TBAs and other untrained and unskilled birth attendants have a vaginal delivery-only mindset. They never talk about any other form of delivery in case vaginal delivery attempts fail. They discourage their clients from having a caesarean birth. When it becomes obvious the woman needs it, they send them away to a doctor without even telling them they will have a C/S. They engage in some dangerous practices to enforce vaginal birth. Some give high doses of uterine stimulant to facilitate vaginal birth. Some of such women end up with uterine rupture and/or the death of their babies. Most times, spouses or relations of such women rescue them by taking them to the hospital, most times against the will of the unskilled birth attendants. However, some arrive the hospital late and so die.

·       Some untrained birth attendants also run prayer ministries and give their clients the impression of providing spiritual care for them. Since such spiritual exercises are hardly seen in hospitals, they use it to draw pregnant women to themselves. Since they lack the training and medical resources to help these women, some of them and their babies die. When they have complications they quickly tell the rest of their clients the need for more prayers as those unfortunate women died from ‘spiritual’ attack.

·       They also deliver some negative prophesies to the pregnant women and their spouses to discourage them from going to the hospital. Such prophesies include but not limited to the following;

Ø “You will die if you go to the hospital”

Ø “If you do operation, you will die”

Ø “You shall deliver like the Hebrew women”

Ø “The Lord has told me that you will not do operation”

Ø “Somebody has tied your womb. So your delay in delivery is a spiritual problem which cannot be solved in the hospital”

Ø “Somebody is after your life, you must come for prayers. As we pray for you there will be no attack”

Ø “If you go to hospital, they will operate you”

Some negative words are also spoken to these women to discourage them from skilled care like the following;

Ø “Occultic doctors and Nurses abound in the hospital and can use you or your baby for sacrifice”

Ø “Doctors are only interested in doing operations so as to get big money. They have no skill for vaginal birth and so do not give women chance to labour and deliver vaginally”

Ø “You will spend a lot of money when you go to the hospital”

Ø “Nurses will not give you good attention when you go to the hospital”

These unskilled birth attendants instill fear in their clients about skilled care or hospital.

These negative prophesies and statements are not true and have contributed to maternal/new born mortality more than most cases recognized by medical personnel. They divert pregnant women from skilled care and prevent those with complications from accessing skilled care on time. Anybody who lacks the training and medical resources to deliver pregnant women should have no business doing that.

A major reason for death of women and/or their babies from the activities of TBAs is provoking complications that can kill.

o  Engaging in external cephalic version (Trying to turn a baby) not presenting by the head. Sometimes this can result in uterine rupture in a woman who delivered previously by caesarean section or had a scar in the uterus from a previous fibroid operation. This can result in injury to the uterus leading to bleeding into the abdominal cavity.

o  Provoking torrential bleeding by trying to remove a low-lying placenta blocking the decent of the baby’s head.

o  Introducing life-threatening infection by examining laboring women with bare hands or with unsterile hand gloves and without masks covering their nostrils and mouths. Such infections can kill the babies and/or their mothers if appropriate antibiotics are not given.

Safe motherhood Empowerment and Enlightenment Initiative (SMEEI) is engage in the following activities to encourage women to access skilled child birth care.

§  Public education of pregnant women, their spouses, relations, friends, social and spiritual mentors on the need for skilled Antenatal care. Antenatal care connects women to the idea of delivering in a skilled health facility. This is done through Television Enlightenment programs, Pregnant women’s health Seminars and Safe Men’s Forum (where husbands and other men are educated on the childbirth process and the need for skilled care)

We also train women to recognize danger signs so they will know at what point they should be sure to seek out emergency care in a hospital.

Our antenatal clinic team identify women likely to need emergency care

§  Previous C/S

§  Bad obstetric history (women with previous pregnancy wastages)

§  Fetal macrosomia (big baby)

§  Fetal mal-presentation (baby not staying well)

§  Short women

§  Pre-eclampsia (pregnancy-induced hypertension)

§  Several previous births

§  Diabetic women

§  Previous difficult birth

§  Low-lying placenta

We provide training for TBAs and other untrained birth attendants for them to recognize potential complications and how to respond appropriately to such complications. We encourage them to forge a working relationship with obstetricians (specialist in child delivery matters) who should handle any of their clients who will develop complications

We organize health worker’s seminars for them.

We provide spiritual cover for pregnant women through the intercessory prayer activities of the Power House of the Safe Motherhood Empowerment and Enlightenment initiative.

The Pregnant Women Health Seminar - Safe Motherhood Empowerment and Enli...

IATROGENIC INFECTIONS

DANGERS YOU MUST BE AWARE OF.

IATROGENIC INFECTIONS

These are infections introduced into the body of a client (patient) by a physician, therapist or an unskilled birth attendant in the course of medical or herbal treatment.

These infections can cause miscarriages in pregnancies, still birth or inability to reconceive after delivery.

A pregnant woman can get iatrogenic infections through the following ways:

1.   USING BARE HANDS FOR EXAMINATIONS: the using of bare hands to examine labouring women can introduce lots of germs into the body, so we urge our birth attendants to always use gloves for examination. And to our pregnant women, in order to be on the safe side we encourage you to go about with your gloves in your hand bags, especially when your delivery date is close. This is because labour might start where you cannot get to a safe birth place and you might need to be examined on the spot. In summary, never allow yourself to be examined with bare hands.

2.   USE OF UNSTERILE GLOVES: this involves using gloves that has already been used to examine laboring women, or using gloves that has been exposed to germs and infections to examine women in labour.

3.   INSERTION OF UNSTERILE MATERIALS: Any material that has been exposed to germs should not be inserted into the body of a pregnant woman to avoid iatrogenic infections.

4.   MULTIPLE VAGINAL CHECKS: Avoid multiple vaginal examinations to lessen the chances of iatrogenic infections. Because even when you use your sterile gloves, there are always germs around the perineum (The general region between the anus and the genital organs) and the more vaginal check, the more the chances of those germs getting into the body.

How to do a proper vaginal check

·       The first check is to know if she is actually in establish labour or not (i.e. if the cervix is open up to “4cm”). Then you can admit her.

·       The second check is an hour later, where you check the progress of labour, knowing that she was 4cm so in one hour time she should be 5cm or more. After that is done, there’s no point examining her again unless she is ready to push. Three to four vaginal checks should be enough for normal labour process.

More of this information you can get during our monthly HEALTH WORKERS SEMINAR coming up every fourth Thursdays of every month at the safe motherhood center,  you can also get our books or call 08063389935. Email: info@smeei.com

·         

·        Or you can watch us on NTA every Tuesday 2pm and on RSTV Thursday 10:3pm.

·        Visit our website at;

·        www.smeei.com

Safe Motherhood

Safe motherhood Empowerment and Enlightenment Initiative (SMEEI) is engage in the following activities to encourage women to access skilled child birth care.

 Public education of pregnant women, their spouses, relations, friends, social and spiritual mentors on the need for skilled Antenatal care. Antenatal care connects women to the idea of delivering in a skilled health facility. This is done through Television Enlightenment programs, Pregnant women’s health Seminars and Safe Men’s Forum (where husbands and other men are educated on the childbirth process and the need for skilled care)

We also train women to recognize danger signs so they will know at what point they should be sure to seek out emergency care in a hospital.

Join us today and Safe a life.

THE VALUE OF PRE-CONCEPTIONAL CARE AND EARLY ANTENATAL CARE

THE VALUE OF PRE-CONCEPTIONAL CARE AND EARLY ANTENATAL CARE

Pre-conception as to do with “before pregnancy takes place” therefore PRE-CONCEPTIONAL CARE has to do with the necessary measures a woman has to take before she takes in, and most of those measures are;

B. P CHECK

It is important that you have your blood pressure checked before pregnancy; to be sure it is in good condition to take in, and to avoid complications during delivery. High blood pressure during pregnancy can kill the baby and/or the mother who can die from fits.

FASTING BLOOD SUGAR

This is the process of checking your sugar level before conception’’, because high sugar level in the pregnant woman can kill the baby in the womb two to three weeks before delivery.

PRE-CONCEPTIONAL ULTRA SOUND SCANNING

Some women have sub mucous fibroid, which is found under the lining of the womb, which can cause several miscarriages. So in order to avoid this from happening, it is advisable that you do a PRE-CONCEPTIONAL ULTRA SOUND SCANNING, so that the fibroid could be discovered on time and removed before the conception takes place.

PRE-CONCEPTIONAL HEMOGLOBIN ESTIMATION:

This has to do with checking your blood level before conception, especially women that deliver frequently; such women normally become very anemic because they are losing so much blood and if that is not properly handled, can lead to death.

FOLIC ACID.

When a woman is pregnant she is given folic acid, and the reason she is given folic acid is because it helps in the proper growth of the baby”, and folic acid is very important in mitosis {a type of cell division that result in two daughter cells } because without it the cells cannot divide, and this can lead to a pregnant woman giving birth to a mal-formed baby.

So we encourage you women to always take your folic acid, even before conception.

We also recommended;

Ø That you deworm yourself

Ø Treat typhoid

Ø Malaria parasite

Ø Do Urinalysis

Ø Stull analysis

Ø Urine microscopic culture and sensitivity etc.

Some of us may ask,

 WHY EARLY ANTENATAL CARE?

v To get basic information about you, like;

§  Your B.P

§  Your weight

§  Your sugar level

§  Your H.B

§  Your blood group

§  To discover infection

§  To discover infestation

§  To find out the age of the baby(gestational age)

§  To know the number of babies

THE SAFE BIRTH PLACE

IN RESPONSE TO THOSE THAT HAVE BEEN ASKING FOR THE BEST PLACE TO DELIVER THEIR BABY
• The best place for women to deliver is a centre with comprehensive emergency obstetric care facilities/personnel. This is a health facility where emergency surgery like caesarean section can be done when needed. This is a facility with drugs, consumables, equipment and personnel to take care of complications that can arise during pregnancy and labour. Women should be helped to access such facilities by ensuring they get to such centres when necessary providing money for antenatal care and procedures that may need to be done;
Untrained or unskilled child birth attendants are dangerous. They can convert a normal labour to an abnormal labour. Some women being delivered by them can mean death or secondary infertility. Some of them do not engage infection prevention methods of delivery and so can transfer germs from themselves and their environment into the laboring women. They do not wear sterile gloves and masks that protect women from germs;
• Awareness of pregnancy risks by men is important to ensure the safe delivery of their wives. Men will act decisively and quickly to take their women to the care of skilled personnel working in a centre with comprehensive emergency obstetric care facilities when such women have pregnancy risks which can take the lives of such women and/or their babies or can cause serious harm to them:
The following are such pregnancy risk factors
• Bleeding before labour
• Premature labour
• Hypertension
• Diabetes mellitus (abnormally high blood sugar level)
• Anaemia (lack of blood)
• Women under 15 or over 35 at their first pregnancies
• Short stature
• Multiple pregnancy
• Abnormal presentation and positioning of baby
• Fibroid in pregnancy
• Breaking of the bag of waters before labour
• Greenish staining of liquor (water surrounding the baby)
• Fever
• Severe bleeding following previous birth.

This is why we at safe motherhood do our best to ensure that all that is needed for safe delivery of all women is available in all of our facilities and we are always open to accept you.
At No. 1 Obudu Str. Mile 2 Port Harcourt, or No. 3 Trinity Close Mini Woji, Woji Port-Harcourt.

PREGNANCY IS RISKY BUT IT CAN BE SAFE

Decision to get pregnant is a decision to take a risk. It can take lives. You can lose your life or that of your baby or both if you are not well informed about the birth process and issues that can arise from it. Pregnancy is not a state of health. All pregnant women should be aware of this fact.

A pregnant woman can be healthy at this moment and become very sick the next moment.

The spouses need to know this fact (safe men’s forum).

Mentors of pregnant women need also to know this fact. The risks can be mitigated by appropriate actions by all involved including the birth care giver.   

All pregnant women can have safe delivery if all concerned respond appropriately to forestall or handle risky challenges that crop up.

Pregnancy is a state of health – is a wrong thought.

I can deliver anywhere I want or like – is a wrong thought.

Unskilled birth attendants can facilitate death. They have no training to prempt, detect or handle complications that can arise during pregnancy, labour and delivery.

Ill health can be induced by handlers of pregnancy and child birth. Ill health can arise spontaneously as pregnancy advances or during labour and delivery.

v High blood pressure

v Anaemia

v Bleeding during pregnancy, before labour and delivery or after delivery.

Wrong thoughts, wrong ideas - are reasons for unsafe child birth. Prompt and appropriate response saves lives.

A pregnant woman or her baby can die because of issues that can arise out of the pregnancy.

The baby is usually the first victim of unsafe and unskilled childbirth. Actions and responses are part of the big picture.

Responses to pregnancy by the woman, spouse, mentors, and care givers determine its outcome. Poor response, poor outcome. Appropriate response, good outcome. Inappropriate response, poor outcome. No response is inappropriate response.

Pregnancy is an event or occurrence and people must respond to it.

Complications is an event. The response to it determines also the outcome.

Books on pregnancy-related topics if read can influence response to pregnancy positively. It can influence the reader to respond appropriately  to pregnancy.

Infections from the hands, mouths and nostrils  of unsafe care givers to laboring women can cause their demise.

People don’t know that pregnancy is an event that can take lives. If they do, they can decide not to be pregnant (Contraceptive practice). They can also decide to save in order to respond appropriately to issues that may arise.

“ I shall deliver like the Hebrew women,” make people think there will be no risk to pregnancy. When complications arise they are ill-prepared to handle it. That you went through pregnancy and have no problems does not mean that pregnancy is not risky. It does not mean that the next pregnancy will also be risk-free.

To be on the safe side every pregnant woman should be handled by skilled birth attendants.

A risky journey does not mean that some people cannot still go through it without problems. It means that everybody has to go through that journey fully alert and prepared to avoid or handle challenges that can arise.

Pregnancy is risky because it has potentials for causing death or severe illness. Some factors can trigger such complications. That one person died solely because she was pregnant is enough to regard pregnancy as risky. No child is born to die.

Pregnancy is risky, but many people don’t know. Help spread the information. Denying this fact is not faith but delusion – believing a lie. Something can be done to make it safe. Pregnancy is the major reason for death of young women across the world.

The Hebrew women mentioned in the bible;

v Married as virgins

v  Had a righteous covenant relationship with God

v Had antenatal child birth care in a government -recognized health facility.

v Were attended to by qualified midwives and doctors who had relevant trainings and certificates to show

v Did not deliver on mats, pumpkin leaves or bare floors

v Were not delivered  by  uneducated birth attendants who do not know risks associated with pregnancy

v Were not delivered by people who have no capacity to respond to life-threatening complications.

Pregnancy is risky but the risk can be preempted, avoided or handled by trained personnel working in a place with comprehensive emergency obstetric care facilities and personnel. Risk – taking – is the practice of doing something that involves risks in order to achieve something.

Any risky venture requires preparations to avoid or mitigate risk that can arise.

God has provided a way to make pregnancy safe – skilled child birth care. Believing it is faith – it is believing the truth.

There is but one BEST way to solve every situation that confronts you. That BEST way is the truth. To know it is to make you free from all worry or trouble in connection with that situation. For if it is met in the right way only good can come out of it. If you know that even though pregnancy is risky but that you can be safe if you subscribe to skilled care, anxiety, doubt, fear will be gone as you actually subscribe to skilled care.   

Faith will arise in your heart for safety since you know you are going about that pregnancy the best way.

The pregnant woman needs to know pregnancy is risky but the risks can be handled through skilled care.

Pregnant women can take appropriate steps to ensure their safety.

How? By listening to and watching pregnancy-related public enlightenment programmes on:

v TV

v Radio

v Internet

v Churches, Mosques

v Bill boards

v Books and Booklets

v Pamphlets

v Tracts

Pregnancy is risky. Do not leave it to chance. Subscribe to skilled care. Complications that take lives can arise at any stage. Get to know more about pregnancy and how to be safe.

Visit the Safe Motherhood Emp. and Enlight Initative (SMEEI). Getting pregnant may mean the end of your life. Get to know how to be safe. Know how to avoid/handle pregnancy – related life – threatening complications.

Having sex may mean the end of your life.

Get to know how to have safe sex. Denial of the risk of pregnancy is not faith but delusion – believing a lie.

The truth is that almost all pregnant women can be safe inspite of the risks if they subscribe to skilled care.

I shall deliver like the Hebrew women is delusion if skilled care is avoided.

Pregnancy is risky but you can be safe if you follow instructions of professional child birth care givers.

To think there is no risk to pregnancy is a wrong thought. That kind of thought can lead to complacency and death.

Complacency means

v No antenatal care

v Poor antenatal care

v Avoiding needed caesarean section

v No tetanus immunization

v No Rhogam for women with Rhesus negative blood group

v No savings towards delivery

v Ignoring signs of complications like

·       Antepartum hemorrhage (bleeding before delivery)

·       Premature rupture of membranes

·       Prolonged labour

v Avoiding skilled antenatal care

v Ignoring treatments needed during pregnancy – malaria treatment, Typhoid treatment, cerclage for women with cervical incompetence.

v Doing nothing about prolonged pregnancy

The risk of pregnancy is the reason people are trained to handle pregnancy. It is wisdom to make use of such trained medical personnel. Giving to people who have no training when pregnant can mean the end of your life and that of your baby. It can also mean frustrations for the rest of your life if you survive the pregnancy.