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Recommendations for Prenatal Care and Delivery Care in Emergencies

Author:
PAHO
Source:
PAHO
Contributor:
May 18, 2020
  • SDG 3 - Good Health and Well-Being

It is crucial to consider the prevention of pregnancy complications and avoid childbirth in unsafe conditions during emergencies. These guidelines were prepared by the technical divisions of the Pan American Health Organization.

During emergencies it is particularly important to consider the prevention of pregnancy complications and to avoid childbirth in unsafe conditions that could lead to disease or death in women of childbearing age. This holds true both during the immediate emergency phase, and the aftermath.

The activities mentioned below should be included among the chief points to consider in preparing emergency responses:

  • Promote a census or registry for the identification of women who are pregnant or have just given birth, in each geographical jurisdiction; classify pregnant women according to gestation and risk status.

  • Promote and confirm the detection of women involved in prenatal check-up and who have problems that imply High Obstetric Risk.

  • Identify whether conditions at primary and secondary health care units in each jurisdiction are appropriate for safe operations, and verify the status of equipment and supplies.

  • Confirm that prenatal care is being provided, particularly for women with high obstetric risk.

  • Estimate the volume of deliveries expected over the next 30 days in the emergency area, and the volume of resources needed to provide care under the best conditions possible.

  • Identify needs for supplies and equipment to attend deliveries and newborns, both by professional staffs and traditional midwives. Ensure that medical units attending deliveries and the shelters designated for this purpose have intravenous and plasma solutions to replenish blood volume in case of hemorrhage.

  • Confirm that it is possible to ensure delivery care in sanitary conditions, and to resuscitate newborns. The fact that a large number of deliveries can be attended in the home environment should be taken into account.

  • Identify sites where at-risk patients, obstetric emergencies, complicated deliveries, and general cases requiring surgical care may be referred. For each site, identify different potential access routes from the medical units with lesser complexity and response capacities.

  • Inform the population of the medical units closest to them, how to reach them, and when necessary of what is needed for pregnant women and newborns to receive care before, during, and after the emergency.

  • Disseminate knowledge among the population of warning signs to watch out for during pregnancy, childbirth, and post-childbirth (bleeding, pain, persistent fever, foul-smelling discharges, etc.) so that they may seek care in a timely fashion.

  • Insofar as possible establish obstetric/gynecological health care services, with trained staffs, in the shelters and temporary refuges.

  • Expand the application of tetanus toxoid to all pregnant women.

  • Encourage the preferential supply of food and food supplements, where indicated, to pregnant women and those who are nursing.

  • Promote the supply of containers for water and disinfection supplies to the shelters and temporary refuges, so they can be used for female personal hygiene.

  • Intensify activities to promote the early adoption of exclusive breast-feeding.

  • Identify and register births in the area, and locate newborns with any of the following problems: deficient thermoregulation, neonatal respiratory insufficiency, and low birthweight. Assign daily special surveillance to these cases.

  • Take all necessary precautions to ensure the safe supply of blood for obstetric emergencies and traumas

  • Confirm the preparation and dissemination of messages directed to the general population, geared at the protection of women during pregnancy, childbirth, and post-childbirth, and the proper care of newborns.

  • Ensure the availability, at all times, of educational supplies on reproductive health activities that the population should conduct in emergencies, so they can be drawn on for health promotion activities when necessary.

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