The first FANC visit

The first FANC visit should ideally occur before 16 weeks of pregnancy. You are expected to achieve the following objectives:

• Determine the woman's medical and obstetric history in order to collect evidence of her eligibility to follow the basic component of FANC, or determine if she needs special care and/or referral to a higher health facility.
• Perform basic examinations (pulse rate, blood pressure, respiration rate, temperature, pallor, etc.).
• If you think the pregnancy is beyond the first trimester, try to determine the gestational age of the fetus by measuring fundal height
• Provide nutritional advice and routine iron and folate supplementation. Advising against misconceptions about diet is also important. For example, in some areas it is thought that eating eggs and meat during pregnancy will cause vernix (the sticky white substance on the baby's skin at birth), and that vernix is dirty. In fact, eggs and meat are important sources of protein for the mother and the developing fetus, and vernix is good for the baby because it protects the baby's skin.
• Provide HIV counselling and PMTCT services.
• Give advice on malaria prevention and if necessary provide insecticide-treated bed nets (ITNs).
• Check her urine for sugar using the dipstick test , or refer her to the health facility if you suspect she may be developing diabetes.
• Advise her and her partner to save money in case you need to refer her, especially if there is an emergency requiring transport to a health facility. She may also need money for additional drugs and treatments. Financial help may be available from local community organisations like women's groups.
• Provide specific answers to the woman's questions or concerns, or those of her partner.