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Safe motherhood, counseling of

mother & prolonged labor

Submitted by: Group E

1. Areesa
2. Bakhtawar
3. Dua paras
4. Maria khan
5. Rahat
6. Rahila
7. Sania

GBScN 3rd year 5th semester

Subject: Community health nursing II

Submitted to: Sir Aftab, Sir Perviaz ali, Ma’am Mudassra

Dated: November 18, 2023

College of nursing (female) MPK

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Objectives:

1. Define the concept of safe motherhood and its significance in maternal health.
2. Identify the key factors contributing to unsafe motherhood practices.
3. Discuss preventive measures and interventions for a safe and healthy
pregnancy.
4. Demonstrate knowledge of essential practices for safe delivery and
postpartum care.
5. Understanding the role of counseling in maternal health care.
6. Provide information on various aspects of pregnancy, childbirth, and
postpartum care.
7. Address common concerns and fears associated with motherhood through
counseling.
8. Define prolonged labor and its potential risks for both mother and baby.
9. Identify signs and symptoms of prolonged labor during different stages of
childbirth.
10. Identify signs and symptoms of prolonged labor during different stages of
childbirth.
11. Explore the causes and contributing factors of prolonged labor.
12. Discuss appropriate interventions and management strategies for addressing
prolonged labor.
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Safe motherhood:

Safe motherhood means making sure that pregnant women and new mothers get
the right care and support to keep them and their babies healthy during pregnancy,
childbirth, and after giving birth.

It's really important because it helps to prevent problems during pregnancy and
childbirth, making sure both the mother and the baby stay well.

Factors contributing to unsafe motherhood practices:

 Lack of accessibility to healthcare

 Insufficient prenatal care
 Poor nutrition
 Unsafe delivery condition
 Limited education and awareness
 Socioeconomic factors
 Culture practices
 Teenage pregnancy
 Complications from previous pregnancies
 Inadequate family support

Preventive measures and interventions for a safe and healthy

pregnancy:

 early and regular prenatal care

 nutritious diet and adequate hydration
 regular exercise
 adequate rest and sleep
 avoidance of harmful substances
 managing chronic conditions
 educational programs and counseling
 monitoring and managing weight
 Vaccination
 emotional support and mental health
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 skilled birth attendance

Essential practices for safe delivery and postpartum care:

Demonstrating knowledge of essential practices for safe delivery and postpartum

care is critical for ensuring the well-being of both the mother and the newborn. These
practices contribute to a positive childbirth experience, reduce the risk of
complications, and support the mother's recovery during the postpartum period.
Consistent implementation of these practices by healthcare professionals enhances
the overall safety and success of the childbirth process.

Essential practices for safe delivery:

 Clean environment: Ensure that the delivery area is clean and sanitized to
reduce the risk of infection during childbirth.
 Skilled birth attendance: Seek assistance from a skilled birth attendant,
such as an experienced nurse midwife or doctor, to ensure a safe and
supervised delivery.
 Monitor vital signs: regularly check and record vital signs, such as blood
pressure and heart rate, to identify any abnormalities.
 Pain management techniques: implement appropriate pain relief measures,
such as breathing exercises or pain medications, as needed.
 Positioning for delivery: Encourage and guide the laboring woman into
positions that facilitate a smooth delivery.

Essential practices for postpartum care:

 Monitoring and managing bleeding: monitor and manage postpartum

bleeding, seeking medical attention if excessive.
 Breastfeeding support: provide guidance and support to initiate
breastfeeding, addressing any challenges that may arise.
 Emotional support: offer emotional support to the new mother, addressing
concerns and providing reassurance.
 Monitoring and managing pain: administer prescribed pain relief measures
and educate on self-care techniques for pain management.
 Postpartum checkups: encourage and schedule postpartum check-ups to
monitor the mother's recovery and address any emerging health issues.
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Role of a Nurse in Counseling for Maternal Healthcare:

 Emotional Support: Actively listen to their concerns, validate emotions, and

offer encouragement during various stages of pregnancy, childbirth, and
postpartum.
 Information Sharing: Educate mothers about prenatal care, labor and
delivery processes, postpartum recovery, and newborn care. Ensure they are
well-informed to make decisions about their health.
 Addressing Concerns: Engage in open communication to understand
mothers' worries, provide information to alleviate concerns, and offer
emotional support to reduce anxiety.
 Assisting in Decision-Making: Provide information on available options,
clarify doubts, and encourage active participation in decision-making
processes related to pregnancy, childbirth, and postpartum care.
 Crisis Intervention: Recognize signs of distress, provide immediate support,
and facilitate appropriate referrals to mental health professionals if needed.
 Promoting Healthy Lifestyle Choices: Provide guidance on nutrition,
exercise, and stress management to promote overall well-being.
 Collaboration with Healthcare Team: Communicate and coordinate care
plans with doctors, midwives, and other team members to ensure a holistic
and coordinated approach to maternal healthcare.
 Educational Programs: Organize workshops or classes to enhance mothers'
knowledge on prenatal and postnatal care, breastfeeding, and newborn care.
 Follow-up Care: Conduct postpartum follow-up visits, assess the mother's
well-being, and address any emerging concerns or challenges.
 Advocacy: Ensure that mothers' voices are heard, and their choices are
respected within the healthcare system.

Information on various aspects pregnancy, childbirth and

postpartum care:

Prenatal Care, During Pregnancy:

 Regular check-ups with healthcare providers are essential.

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 Monitoring fetal development through ultrasounds and other tests.

 Nutritional guidance for a healthy pregnancy diet.
 Information on managing common discomforts and potential complications.

Nutrition during Pregnancy:

 Importance of a balanced diet for the health of both the mother and baby.
 Necessary nutrients, including folic acid, iron, and calcium.
 Guidelines on weight gain during pregnancy.

Physical Changes during Pregnancy:

 Explanation of physical changes, including weight gain, breast changes, and

skin alterations.
 Understanding hormonal shifts and their effects on the body.
 Addressing common discomforts like nausea, back pain, and swelling.

Preparing for Childbirth, Before Labor:

 Overview of different childbirth options (vaginal, cesarean section).

 Childbirth education classes to familiarize with the labor process.
 Birth plan considerations and communication with healthcare providers.

Labor and Delivery, During Labor:

 Explanation of the stages of labor.

 Pain management options, including medications and natural techniques.
 Supportive role of healthcare providers, such as nurses and midwives.

Postpartum Care for the Mother, after Childbirth:

 Guidance on perineal care and recovery after vaginal delivery.

 Monitoring and managing postpartum bleeding.
 Emotional well-being and recognizing signs of postpartum depression.

Newborn Care, after Childbirth:

 Overview of newborn health assessments and screenings.

 Breastfeeding guidance, including positioning and latching.
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 Diapering, bathing, and dressing the newborn.

Postpartum Physical Changes:

 Understanding changes in the mother's body postpartum.

 Resuming physical activities and exercises after childbirth.
 Managing common postpartum issues, such as perineal discomfort and
breastfeeding challenges.

Family Planning and Contraception, Postpartum Period:

 Discussion on family planning options.

 Choosing a suitable contraception method.
 Understanding fertility and the menstrual cycle after childbirth.

Postpartum Follow-up Visits:

 Importance of postpartum check-ups with healthcare providers.

 Assessment of the mother's physical and emotional well-being.
 Addressing any concerns or questions about postpartum recovery.

Common concerns are fears associated with motherhood through

counseling:

 Fear of labor pain

 Worries about childbirth complications
 Concerns about postpartum recovery
 Anxiety about parenting skills
 Worry about balancing work and motherhood
 Fear of postpartum depression and anxiety
 Body image concern
 Financial worries
 Concerns about breastfeeding
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Prolonged labor:

Prolonged labor, also known as prolonged or slow progress in labor, occurs when
the active phase of labor is longer than usual. This phase is characterized by regular
uterine contractions and cervical dilation. Prolonged labor is typically defined based
on the duration of the active phase, which varies depending on various factors,
including maternal age, parity (number of previous pregnancies), and whether it is a
first-time delivery.

Potential risk for mother:

 Exhaustion
 Increased stress and anxiety
 Increased risk for infection
 Need for medical intervention
 Postpartum hemorrhage
 Perineal tears
 Uterine rupture

Potential risk for baby:

 Fetal distress
 Increased risk of infection
 Birth injuries
 Low APGAR score
 Neonatal intensive care unit (NICU) admission
 Long term neurological issues

Signs and symptoms of prolonged labor during different stages:

1. Early labor:
 Slow, weak or irregular contraction
 Slow cervical dilation
2. Active Labor:
 Lack of progress in dilation
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 Failure of descent
 Stalled contractions
 Maternal exhaustion
3. Transition phase:
 No progress in dilation
 Intense contractions
 Increase maternal distress
4. Second stage (Pushing):
 Ineffective pushing
 Maternal exhaustion
 Fetal distress
5. After birth (third stage):
 Delayed placenta delivery
 Excessive bleeding

Causes & contributing factors of prolonged delivery:

 First time pregnancy

 Maternal factors (pelvic structure, uterine dysfunction)
 Obesity
 Age
 Fetal factors (fetal positioning, large fetal size, multiple pregnancies)
 Maternal position and movement (immobility, ineffective push)
 Emotional factors
 Inadequate support
 Medical condition ( gestational diabetes, hypertension)
 Cervical factors (cervical stenosis, trauma)
 Malposition of the baby (occiput posterior position, brow or face presentation)

Appropriate interventions and management strategies for

addressing prolonged labor:

 Moving around  Trying different positions

 Staying hydrated and eating  Pain management options
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 Oxytocin use  Ceserean section