Contents
Learning is lifelong . . . . . . . . . . . . . . . . .1
Share what you know . . . . . . . . . . . . . . .3
Respectful and compassionate care . . . .6
Work to improve women’s health . . . . .8
Work for the joy of it . . . . . . . . . . . . . . .11
Introduction
Chapter 2: Treating health problems………………………………………………………………..12
Finding the causes of health
problems . . . . . . . . . . . . . . . . . . . . . . .13
Finding the best treatment . . . . . . . . . .16
Finding root causes of
health problems . . . . . . . . . . . . . . . . .21
Midwives can make change . . . . . . . . .25
Chapter 3: A woman’s body in pregnancy ……………………………………………………….26
A woman’s sexual and
reproductive parts . . . . . . . . . . . . . . . .27
How women become pregnant . . . . . .29
Chapter 4: Helping women stay healthy…………………………………………………………..32
Eating well . . . . . . . . . . . . . . . . . . . . . . .33
Caring for the body for good health . .42
Things to avoid during
pregnancy and breastfeeding . . . . . .45
Chapter 5: Preventing infection………………………………………………………………………..48
Preventing infection saves lives . . . . . .49
Prevent infection by keeping
germs away . . . . . . . . . . . . . . . . . . . . .52
Clean your hands and wear
protective clothing . . . . . . . . . . . . . . .53
Clean the space and bedding . . . . . . . .57
Clean and sterilize tools . . . . . . . . . . . .59
Get rid of wastes safely . . . . . . . . . . . . .67
PREGNANCY
Introduction……………………………………………………………………………………………………….70
Chapter 6: Common changes in pregnancy ……………………………………………………..72
Changes in eating and sleeping . . . . . .73
Body changes and discomforts . . . . . . .76
Changing feelings and emotions . . . . .82
Chapter 7: Learning a pregnant woman’s health history………………………………….84
Questions in a pregnancy
health history . . . . . . . . . . . . . . . . . . .86
Does she have signs of pregnancy? . . .86
How pregnant is she now?
When is the baby due? . . . . . . . . . . . .88
Has she had any problems with past
pregnancies or births? . . . . . . . . . . . .93
Malaria . . . . . . . . . . . . . . . . . . . . . . . . . .98
HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . .99
What else in her life might affect
her pregnancy and birth? . . . . . . . . .104
Making a transport plan . . . . . . . . . . .106
Chapter 8: Prenatal checkups …………………………………………………………………………108
Talk with the mother . . . . . . . . . . . . .109
Check the mother’s body . . . . . . . . . .116
Check for signs of anemia . . . . . . . . .116
Weigh the mother . . . . . . . . . . . . . . . .118
Check the mother’s temperature . . . .119
Check the mother’s pulse . . . . . . . . . .120
Check the mother’s blood pressure . .122
Check for signs of pre-eclampsia . . . .125
Signs of bladder or kidney infection . .128
Check the baby . . . . . . . . . . . . . . . . . .130
Measure the mother’s womb . . . . . . .130
Find the position of the baby . . . . . . 135
Listening to the baby’s heartbeat . . . .139
What to do if you find
warning signs . . . . . . . . . . . . . . . . .142
After the checkup . . . . . . . . . . . . . . . .144
Record of prenatal care . . . . . . . . . . . .145
LABOR AND BIRTH
Introduction …………………………………………………………………………………………………….146
Chapter 9: Getting ready for labor and birth ………………………………………………….148
Signs that labor will start soon . . . . .149
When to go to the birth . . . . . . . . . . .151
What to bring to a birth . . . . . . . . . . .151
Sterilize your tools and wash up . . . .153
Chapter 10: Giving good care during labor and birth…………………………………….154
What happens during labor
and birth . . . . . . . . . . . . . . . . . . . . . .155
Care for the mother during labor . . .157
Be ready for emergencies . . . . . . . . . .163
Keep a record of what happens
during labor . . . . . . . . . . . . . . . . . . .164
Chapter 11: Opening: stage 1 of labor ……………………………………………………………166
What happens during stage 1 . . . . . .167
When you first arrive . . . . . . . . . . . . . .168
Helping the mother relax in stage 1 .169
Signs for the midwife to check
in stage 1 . . . . . . . . . . . . . . . . . . . . . .170
The baby’s position . . . . . . . . . . . . . . .170
The baby’s heartbeat . . . . . . . . . . . . . .172
The bag of waters . . . . . . . . . . . . . . . .174
The mother’s pulse . . . . . . . . . . . . . . .178
The mother’s temperature . . . . . . . . . .178
The mother’s blood pressure . . . . . . .180
Bleeding during labor . . . . . . . . . . . .183
Pain in the womb . . . . . . . . . . . . . . . .183
Watch for signs of progress . . . . . . . .185
Safe ways to encourage labor . . . . . . .191
Chapter 12: Pushing: stage 2 of labor …………………………………………………………….194
Watch for signs that stage 2 is near
or starting . . . . . . . . . . . . . . . . . . . . .195
What happens during stage 2 . . . . . .197
Help the mother have a safe birth . . .199
Watch for warning signs . . . . . . . . . . .202
Help the mother give birth . . . . . . . . .206
Baby is breech . . . . . . . . . . . . . . . . . . .215
Delivering twins . . . . . . . . . . . . . . . . .219
Baby is very small or more than
5 weeks early . . . . . . . . . . . . . . . . . . .221
Chapter 13: The birth of the placenta: stage 3 of labor ………………………………….222
Check the mother’s physical signs . . .223
Bleeding after birth . . . . . . . . . . . . . . .224
Watch for signs the placenta
has separated . . . . . . . . . . . . . . . . . .226
Help her push out the placenta . . . . .227
Watch for bleeding after the
placenta is born . . . . . . . . . . . . . . . .236
What to do for the baby . . . . . . . . . . .240
Chapter 14: The first few hours after the birth ……………………………………………….246
What to do for the mother . . . . . . . . .247
What to do for the baby . . . . . . . . . . .252
General appearance . . . . . . . . . . . . . . .253
Breathing, heartbeat, temperature . . .254
The baby’s body . . . . . . . . . . . . . . . . .256
Clean up and answer questions . . . . .267
Chapter 15: The first weeks after the birth……………………………………………………..268
What to do for the mother . . . . . . . . .269
Watch her womb and bleeding . . . . .270
Watch for signs of womb infection . .271
Watch for signs of vaginal infection . .272
What to do for the baby . . . . . . . . . . .274
Encourage the baby to breastfeed
and watch how she grows . . . . . . . .274
Care for the cord . . . . . . . . . . . . . . . . .277
Look for signs of infection . . . . . . . . .277
Watch the color of the baby’s skin
and eyes . . . . . . . . . . . . . . . . . . . . . . .279
Chapter 16: Breastfeeding………………………………………………………………………………280
Breast is best . . . . . . . . . . . . . . . . . . . .281
How to breastfeed . . . . . . . . . . . . . . . .282
When the mother works
outside the home . . . . . . . . . . . . . . .284
Common difficulties while
breastfeeding . . . . . . . . . . . . . . . . . .286
Situations that affect breastfeeding . .291
Alternatives to breastfeeding . . . . . . .294
HEALTH SKILLS
Introduction …………………………………………………………………………………………………….296
Chapter 17: Family planning …………………………………………………………………………..298
Choosing a family planning method .300
Chart: family planning methods . . . .301
Making family planning work for
the community . . . . . . . . . . . . . . . . .318
Chapter 18: Sexually transmitted infections (STIs) …………………………………………320
What are STIs? . . . . . . . . . . . . . . . . . . .321
Discharge from the vagina . . . . . . . . .323
Sores on the genitals . . . . . . . . . . . . . .329
STIs that affect the whole body . . . . .334
Teaching women how to
prevent STIs . . . . . . . . . . . . . . . . . . . .336
How to help stop STIs in your
community . . . . . . . . . . . . . . . . . . . .337
Chapter 19: Advanced skills for pregnancy and birth…………………………………….338
Vaginal exams during labor . . . . . . . .339
Home methods for starting labor . . .341
Injections . . . . . . . . . . . . . . . . . . . . . . .345
How to give fluid through a vein . . .350
Catheters . . . . . . . . . . . . . . . . . . . . . . .352
Episiotomy . . . . . . . . . . . . . . . . . . . . . .354
Sewing a tear or an episiotomy . . . . .356
Caring for a woman after female
genital cutting (circumcision) . . . . .367
Turning a breech or sideways baby . .369
To learn more …………………………………………………………………………………………………..499
Technical and medical words…………………………………………………………………………..503
Index (yellow pages)………………………………………………………………………………………..505
Due date calculator………………………………………………………………………………………….527
Chapter 20: The pelvic exam: How to examine a woman’s vagina and womb …372
When to do a pelvic exam . . . . . . . . .374
Before the exam . . . . . . . . . . . . . . . . . .375
The visual exam . . . . . . . . . . . . . . . . . .376
The speculum exam . . . . . . . . . . . . . .377
Tests for infections and cancer . . . . . .379
The bimanual exam (2-hand exam) . .385
Chapter 21: How to insert an IUD……………………………………………………………………388
Help a woman decide if the IUD
is right for her . . . . . . . . . . . . . . . . .390
Before you insert the IUD . . . . . . . . . .391
Inserting the IUD . . . . . . . . . . . . . . . .392
After you insert the IUD . . . . . . . . . . .398
Removing the IUD . . . . . . . . . . . . . . .399
Chapter 22: Helping a woman after a pregnancy ends early………………………….400
Problems from a pregnancy
that ends early . . . . . . . . . . . . . . . . .401
Emergency care for problems after
miscarriage or abortion . . . . . . . . . .406
Infection . . . . . . . . . . . . . . . . . . . . . . . .409
Bleeding . . . . . . . . . . . . . . . . . . . . . . . .412
Shock . . . . . . . . . . . . . . . . . . . . . . . . . .414
Work with the community to
prevent unsafe abortions . . . . . . . . .415
Chapter 23: Manual vacuum aspiration ………………………………………………………….416
Deciding when to do MVA . . . . . . . . .418
Getting ready for the MVA . . . . . . . . .419
Doing the MVA . . . . . . . . . . . . . . . . . .422
Problems with the MVA . . . . . . . . . . .428
After the MVA . . . . . . . . . . . . . . . . . . .430
Chapter 24: Getting medical help …………………………………………………………………..432
What medical centers and hospitals
can provide . . . . . . . . . . . . . . . . . . . .433
Getting to a medical center . . . . . . . .438
Working with medical centers
and doctors . . . . . . . . . . . . . . . . . . . .438
Chapter 25: Homemade tools and teaching materials …………………………………..442
Low-cost equipment . . . . . . . . . . . . . .443 Teaching materials . . . . . . . . . . . . . . .447
Medicines (green pages): uses, dosage and precautions ……………………………….463
When to use medicines . . . . . . . . . . . .463
How to take medicines safely . . . . . . .464
How to take medicines . . . . . . . . . . . .467
Kinds of medicine . . . . . . . . . . . . . . . .470
Problem index . . . . . . . . . . . . . . . . . . .472
Alphabetical list of medicines . . . . . .

 

DOWNLOAD