Prenatal patronage of pregnant women: what is it and what is it for?
When a woman is preparing to become a mother, she needs the help of medical professionals. It does not matter what kind of childbirth is first or third, the doctor must always be near. He should monitor the course of pregnancy, the condition of the future mother and her unborn baby. The purpose of antenatal patronage is to continuously monitor the life of the pregnant woman, her social position. Special attention is paid to living conditions and family relations. During such visits, the woman receives both advice and answers to all questions of interest about the future care of the baby. From this article you will learn the timing of prenatal patronage, the goals of each, the main points.
What is patronage?
This is a form of work of medical institutions. It is aimed at carrying out preventive and recreational procedures on the patient’s territory, teaching hygiene rules, improving sanitary and hygienic factors in everyday life.People with mental disorders, seriously ill patients, pregnant women and newborns are especially in need of patronage.
Who conducts patronage?
Particularly widespread are the visits of doctors to homes for pregnant women. After registration, a paramedic or obstetrician from the antenatal clinic, a doctor and a nurse from the children's clinic will visit the woman.
Prenatal patronage of pregnant women is aimed not only at controlling the life and condition of the future mother, but also at meeting the doctors and establishing contact with them, because after the baby arrives, the family and the medical staff will communicate closely for at least a year.
A doctor or nurse during the visit assesses the living and social conditions of the woman and the future baby. If necessary, makes recommendations on sanitary standards and personal hygiene. On the very first visit, the health care provider determines whether the family belongs to any risk group. We'll talk about everything in order later in the article.
The need for control
A woman who is going to become a mother comes to the medical institution herself to monitor her health and development of the fetus.In the interval up to 21 weeks, visits occur only once a month. This does not take into account mandatory procedures, analyzes. After this period and up to 33 weeks, visits increase to two times a month, and before delivery they occur every week. If the patient does not come to the doctor on the appointed day, then after two days the medical worker himself visits the specified place of residence to establish the reason for the non-appearance and explain the need for a stable examination. However, this is not considered a patronage.
During communication with the obstetrician-gynecologist, the expectant mother reports in detail about her life, living conditions, financial situation and family relations. Of course, you can tell anything, but this is not enough for the doctor. He should know the real and complete picture of the living conditions of the woman and the future baby. The health worker is obliged to know in detail everything about the life of a woman, because it affects the carrying of the child, so there is a need for "espionage."
Conducting prenatal patronage allows you to get all the necessary information, possibly hidden to a pregnant woman: bad habits, living conditions, material well-being, sanitary and hygienic factors of life, family relationships, psychological conditions.The doctor also gives the pregnant woman the necessary information. She is in the advice on the arrangement of the child's room, creating a comfortable environment for the most pregnant, caring for the baby after birth.
The multiplicity of prenatal patronage
Throughout pregnancy, a woman is expected to have at least two visits to her doctor at home. Most often there are three visits of the health worker to the patient's housing. The quantity may increase under the following circumstances:
- unstable visits by the woman to the obstetrician-gynecologist;
- suspected fetal abnormality;
- severe pregnancy;
- the age of the pregnant woman is less than 18 years or more than 30 years during the first birth;
- unfavorable financial environment;
- identified sanitation and hygiene;
- after discharge of the pregnant woman from the medical institution;
- after the change of residence.
One way or another, the doctor will find out everything about his patient. Therefore, it is better to honestly tell all about your addictions, if there are any, the psychological situation in the family, the material condition. This will avoid many problems, including an uncomfortable position in front of the health care provider during antenatal care.
Each observation of a doctor or nurse when visiting a patient is recorded in a personal patronage sheet. Recommendations given to a woman are also written there. The physician carefully monitors the fulfillment of the prescriptions, taking the necessary measures for the elimination of non-conformities.
First prenatal patronage
Conducted by a pediatrician and a nurse from the local clinic or obstetrician-gynecologist. Medical workers come to a pregnant woman about two weeks after she was registered in the antenatal clinic. The sooner a woman visits an obstetrician-gynecologist and tells about her situation, desire to give birth, the sooner the pediatrician will receive information about the need for a visit. Most often, the first antenatal patronages pass between 7 and 14 weeks.
The initial visit is very important. It is necessary to warmly welcome the employee, to treat him to visit and inspect the housing calmly, to understand that this is part of his work. From what kind of contact will be established, will depend on all relationships during pregnancy. Prenatal patronage allows you to bear a baby with great comfort. A woman receives useful information and moral support.
Objectives of the first visit
Doctors are required to visit the pregnant woman at home, in order to provide necessary assistance, if necessary. The health workers constantly reiterate that the baby will be healthy if his mother is healthy. Prenatal patronage of pregnant women can reveal all the unfavorable factors of a woman’s residence, give advice for their elimination. The main objectives of the first visit:
- Assessment of the state of development and health of the fetus, prevention of the possibility of premature birth.
- Identify the presence of risk factors.
- Issuance of recommendations to eliminate the detected nonconformities (nutrition and daily regimen of pregnant, hygienic and sanitary conditions).
- Informing parents about the identified possible pathology of the fetus.
- Talk (preferably) with both parents. It deals with the positive aspects of a healthy lifestyle, the dangers of smoking and excessive alcohol consumption, the rules of personal hygiene, the need to maintain normal sanitary conditions in the house. During the conversation, the health worker sets up the parents for a positive attitude towards the birth of the baby, provides psychological support, and answers questions of concern.At the same time, the doctor is advised to breastfeed the baby as much as possible in the future, to attend a school for women preparing to become mothers during pregnancy.
Prenatal patronage is also aimed at meeting a woman, establishing contact with her. At the first visit, the doctor reveals that the future mother or family is at risk, if there is one. In this case, the pregnant woman is taken under special control, all measures are taken to preserve the life of the baby.
Major risk groups
Most often, future mothers do not belong to this category of persons, but the risk is still there. Therefore, the health worker must take these women under special care. There are the following risk groups:
- minor woman;
- expected birth late or first after the age of thirty;
- women in labor weighing less than 45 kg or more than 91 kg;
- the woman had more than five pregnancies;
- the probability of termination of pregnancy (if in history there are post-term, premature babies or miscarriages);
- if several babies are expected;
- women with an adverse history (stillbirths, abortions, miscarriages, uterus defects, narrow pelvis, etc.);
- women with chronic diseases (heart disease, asthma, diabetes, pyelonephritis);
- women belonging to socially disadvantaged groups (alcohol addiction, drug addiction, a dysfunctional family in financial terms, a large single mother).
Additional meetings are held with women who have fallen into one of the groups, and elimination (if possible) of identified adverse circumstances is monitored. If there are problems with the health of the future mother, as described above, the doctor provides help at home, gives advice on how to save the life of the baby.
Algorithm of the first patronage
Below is an example of prenatal patronage, so that every woman knows what to expect when meeting with the health worker at home, how to behave, what questions you will have to answer.
First of all, the doctor meets a woman. The whole of the expected conversation depends on the pregnant woman, so it is important to tune in to her positively, to treat the hospitable hospitably. The doctor can examine the housing, but not in detail, as an employee of the sanitary epidemiological station, but take a look at it in order to have an idea about hygiene, financial situation.After that, the questionnaire is filled out with the words of a pregnant woman. If at this time there was, for example, a drunk spouse discovered, the doctor will mark the fact on the sheet, even if the woman claims that this happens rarely. What is filled in the questionnaire?
- Names and surnames of parents, dates of birth, information about work.
- Education, place of residence and registration.
- Data on other family members living with a pregnant woman, those that will often communicate with the baby (grandmothers, grandfathers, aunts, uncles, and others).
- Information about the chronic diseases of parents, close relatives.
- Financial position, personal hygiene, sanitation at home.
- Readiness for the birth of a child and the psychological mood of the couple.
At the end of the meeting, an approximate term is appointed when there will be a second antenatal patronage. It is worth remembering that a doctor can get a real picture only with a spontaneous visit. That is why the exact dates of the next visits pregnant can not get.
Repeated meeting with the medical staff at home takes place from 32 to 34 weeks, if no risk factors have been identified. It is carried out to control. During the visit, the doctor monitors the fulfillment of his instructions, and the conversation is usually devoted to future childbirth and the baby. A rough plan might look like this:
- the doctor is interested in general well-being, learns about past diseases during pregnancy;
- what is the psychological attitude of the family;
- Are parents ready for birth (concerns material things);
- whether other family members support morally and financially.
In general, the conversation is easy and pleasant, a pregnant woman can get recommendations for visiting a full-time psychologist at the antenatal clinic.
The need for another visit is regulated individually. It occurs closer to childbirth if there are problems with the health of the woman in labor, the pathology of pregnancy or the fetus. Also, special attention is paid to families classified as disadvantaged. The third patronage is carried out on the basis of information obtained during the first two visits.
The medical staff does not need the prenatal patronage to simply inquire and verify orally received information from a pregnant woman. Visits are necessary to preserve the life of the child, to maintain the health of the mother, and to issue valuable advice. Patronage need the most pregnant. That is why it is worthwhile to treat spontaneous visits to the doctor at home with a friendly and understanding way, to adequately respond to the words of the health worker and his recommendations, whatever areas they may concern.