Integrated Maternal and Newborn Care Basic Skills Course ...

It is important to discuss issues of safer sex because infidelity by the male partner can be
highest during the third trimester of pregnancy. The risk of getting HIV through sex can be
reduced if: 1) people don't have sex, 2) if they reduce the number of sex partners, 3) if
uninfected partners have sex only with each other, or 4) if people have safer sex, i.e., sex
without penetration or while using a condom. Correct and consistent use of condoms can save
lives by preventing the spread of HIV.
Hygiene
Due to hormonal changes brought about by the pregnancy, pregnant women sweat more and
have more vaginal discharge than women who are not pregnant. The pregnant woman needs,
therefore, to be vigilant about her personal hygiene to prevent infections and disease. Gentle
reminders about needs for bathing and wearing clean clothes are never misplaced.
When the woman comes in for antenatal care, the provider can remind her about other simple
hygiene rules that can help her prevent diseases: hand washing, treatment and care of drinking
water, avoiding raw meats, reheating leftovers well, and being careful about coming into contact
with people who are ill.
Dental care is also important during pregnancy because estrogen can make gum tissues
edematous. Using a dental stick or using a toothbrush and toothpaste are equally appropriate.
Breastfeeding
Provide advice on breastfeeding, especially on early initiation without pre-lacteal feeds and on
continuing exclusive breastfeeding on demand. Further details on normal breastfeeding are
noted in chapter 5 under care of the baby at birth.
Prevention of mother-to-child transmission (PMTCT) of HIV
Offer HIV testing and counseling to all pregnant women and their sexual partners. The following
are the standard HIV pre-test session messages in all PMTCT settings:
• Help the client understand basic information on HIV transmission and prevention.
• Explain in simple terms how HIV infection can be transmitted from mother to child.
• Explain how transmission of the infection from mother to child can be prevented.
• Explain the importance of HIV testing.
• Explain HIV testing processes and procedures, including issues of confidentiality.
• Discuss implications of positive and negative test results.
• Explain the importance of partner testing:
o discordance
o disclosure and partner referral
• Explain risk-reduction and available services:
o prevention of sexual transmission of HIV
o PMTCT interventions, including ARV prophylaxis and safer infant feeding
o referral for prevention, care, treatment, and support
• Discuss with HIV-positive clients the mode of delivery and feeding options. Assist them in
identifying HIV support services.
• Provide information on health timing and spacing of pregnancy and family planning.
• Encourage continuous healthcare attendance and delivery care.
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Integrated maternal and newborn care
Basic skills course