Telling pregnant women about the danger symptoms
You should realise that pregnant women have many responsibilities at home and usually also in the fields, and they may already be overwhelmed by too much information about the current pregnancy. Table 15.2 presents what the mother primarily needs to know, but you shouldn't tell her everything all at the same time. Counselling the pregnant woman in relation to the stages of pregnancy is a good strategy from the perspective of the pregnant woman's understanding and using your time as efficiently as possible. In other words, you need to discuss the common danger symptoms with her, taking into account the stage of pregnancy. For instance, a pregnant woman coming for antenatal care before 20 weeks of gestation should be counselled about the danger symptoms of miscarriage, which are usually manifested by vaginal bleeding. She should also be aware of danger symptoms of common medical disorders that can occur any time during pregnancy - in the same way that they could occur to anyone in the rest of the population.
Most pregnancy-related serious problems occur in the third trimester. Therefore, it is a good opportunity to counsel the mother about them during the second trimester, to let her prepare ahead of time. If you have them, using printed instructions, diagrams, photos or pictures, which improve the pregnant woman's understanding and her ability to remember the key points. It is also a good approach to remind her about what was discussed at earlier antenatal visits (see Box 15.3).
Box 15.3 Following up on previous counselling messages
In subsequent antenatal visits, helping the woman to go over what was discussed before will help you to:
- Discover how much she understood the issue already
- Discover how much she can recall correctly
- Identify her acceptance and readiness to act on the knowledge
- Identify areas she has wrongly understood.
It will also help her to express her concerns and doubts, so that you can:
- Discuss any issues that were not clear or not accepted
- Plan together what to do next, involving her husband/partner.