The third FANC visit

The third FANC visit should take place around 30–32 weeks of gestation. The objectives of the third visit are the same as those of the second visit. In addition you should:

• Direct special attention toward signs of multiple pregnancies and refer her if you suspect there is more than one fetus.
• Review the birth preparedness and the complication readiness plan (discussed later in this study session).
• Perform the dipstick test for protein in the urine for all pregnant women (since hypertensive disorders of pregnancy are unpredictable and late pregnancy phenomena).
• Decide on the need for referral based on your updated risk assessment.
• Give advice on family planning (Study Session 14).
• Encourage the woman to consider exclusive breastfeeding for her baby (Study Session 14).

Remember that some women will go into labour before the next scheduled visit. Advise all women to call you at once, or come to you, as soon as they go into labour. Don't wait!

You should also emphasise the importance of the first postnatal visit to ensure that the woman is seen by you either at her home or at the Health Post as soon as possible after the birth. The most critical postnatal period for the mother is the first 4 hours; this is when most cases of postpartum haemorrhage (PPH) occur. (You will learn about PPH in the Labour and Delivery Care Module.)