Danger Signs in Pregnancy

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DANGER SIGNS IN PREGNANCY

https://www.ncbi.nlm.nih.gov/books
/NBK304178/
What is in this session?
• It is important to share information with
women and their families about the early
detection and recognition of danger signs and
complications as part of birth and emergency
planning. You need to discuss with them what
the danger signs are and help them to think
about and decide where they will go if they
experience one or any of these.
What skills will I develop?

• To provide information about danger signs


and complications during pregnancy and
childbirth
• To support women in planning where to go
and how to get there quickly if an emergency
arises.
What am I going to learn?

• By the end of this session you should be able


to:
• Know the danger signs and complications.
• Be able to effectively communicate danger
signs to women and their families.
• Be able to effectively communicate how to
access emergency care when a danger sign is
recognized.
Danger signs and complications

• All pregnant women, their partners and


families should be aware of the signs of
complications and emergencies and know
when to seek care from the skilled attendant.
• DANGER SIGNS DURING PREGNANCY
• If any of the following signs occur, the woman
should be taken immediately to the hospital
or health centre.
• vaginal bleeding
• convulsions/fits
• severe headaches with blurred vision
• fever and too weak to get out of bed
• severe abdominal pain
• fast or difficult breathing.
• If she has any of these signs she should go to
the health centre as soon as possible:
• Fever
• Abdominal pain
• Feels ill
• Swelling of fingers, face and legs
Bleeding
• Bleeding means different things throughout
your pregnancy. “If you are bleeding heavily
and have severe abdominal pain and
menstrual-like cramps or feel like you are
going to faint during first trimester, it could be
a sign of an ectopic pregnancy,”
• Heavy bleeding with cramping could also be a
sign of miscarriagein first or early second
trimester. By contrast, bleeding
with abdominal pain in the third
trimester may indicate placental abruption,
which occurs when the placenta separates
from the uterine lining.
• A Persistent Severe Headache, Abdominal Pain,
Visual Disturbances, and Swelling During Your
Third Trimester
• These symptoms could be a sign of preeclampsia.
That’s a serious condition that develops during
pregnancy and is potentially fatal. The disorder is
marked by high blood pressure and excess
protein in your urine that typically occurs after
the 20th week of pregnancy.
Communicating danger signs without
fear
• When discussing danger signs with women
and their families, provide a realistic
description that would help them to identify
the signs in an emergency. Avoid frightening
the woman with the worst-case scenario of
what might happen.
• While complications such as bleeding,
obstructed labour or infection are relatively
rare, the focus should be on recognition of the
signs and awareness of what to do if they
occur. While as a health worker you are used
to seeing complications, remember for the
woman it can be very frightening.
• Reassure her that you will do everything you
can to help her, try to alleviate her fears, and
support her, but remember to answer her
questions and concerns truthfully. It will not
be helpful to make false promises or
reassurances about pregnancy outcomes.
• Activity 1

• To begin reflecting on how to inform pregnant women and their


families on the danger signs during pregnancy and build on
women's past experience where possible.
• Review the list of danger signs above.
– What problems do women and families have in identifying each of
these? Are there local terms that are used for any of them? Are there
any local beliefs, explanations, or ways of handling danger signs that
stop people from seeking care in a timely manner?
– How do women prioritize the main danger signs? Are there certain
signs that they feel need more urgent attention than others?
– Are all women told about danger signs or just those women who are
thought to be at high risk?
• Organize a discussion with a group of women.
Ask the group for their past experience with
danger signs and complications.
– Have any of the women experienced danger signs
before? If so, how did they recognize them?
– What did they do? Who did they see?
– Did they find transport urgently? If not, what could be
done next time?
– What information did they have or were there any
gaps?
– How could health workers have better prepared
them?
• Review the list of danger signs once again.
– Is the community aware and able to recognize
danger signs in pregnancy?
– Think of ways to help the broader community in
identifying danger signs and supporting women to
reach appropriate care in a timely fashion.
– Do you or other health agencies currently discuss
danger signs in pregnancy with the broader
community? What are the advantages of doing
so?
• What kind of support materials might improve
the communication of danger signs?
– Take into account the educational and cultural
background of your audience (e.g. the counselling
context) and the resources you have to develop,
or to obtain materials.
• Finally, think about whether there are any
other groups or providers in the community
that you could work with to help alert the
whole community to the danger signs in
pregnancy and labour.
• Write down some ideas in your notebook that
could help you discuss danger signs with
women and their families, both on a one-to-
one basis and in a group setting.

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