Self-Assessment Questions (SAQs) for Study Session 5

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions below. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 5.1 (tests Learning Outcomes 5.1 and 5.2)

You arrived too late to deliver a baby which was born two hours before you got there. What do you do?

Answer

  • Check that the mother’s temperature, pulse rate and blood pressure (her vital signs) are normal.
  • Palpate her abdomen to check that the uterus is contracting. Do this again 30 minutes later and then every hour for the next three hours.
  • Monitor very carefully how much she is bleeding – if she is soaking more than one pad an hour and you can’t stop it, take her to the nearest health facility. Make sure you check for any signs of shock and start pre-referral IV fluid therapy if her blood pressure is low and falling and her pulse rate is fast and rising.
  • Gently help her to clean herself – belly, legs and genitals (using soap and very clean water). Check the genitals for any tears, injuries or bleeding under the skin (haematoma), or a prolapsed cervix (the cervix has dropped to the vaginal opening)
  • Help her to urinate.
  • Make sure she starts drinking to rehydrate her, and if possible encourage her to eat some food.

SAQ 5.2 (tests Learning Outcomes 5.1, 5.3 and 5.4)

Good nutrition and support for the postnatal mother are key aspects of good postnatal care. Complete Table 5.1 to show, for each problem in the first column:

  • What you hope the mother or her family would do.
  • What you would do to ensure the mother has all she needs.

Table 5.1 Care and support for new mothers.

Problem or potential for a problem if not addressedActions the mother or her family can do to help herTreatments or other actions that you can provide

Goitre (caused by iodine deficiency)

Not eating or drinking in the first few hours

Lack of energy (maintaining energy when breastfeeding)

Vitamin A deficiency

Anaemia

Seclusion of mother and baby

Lack of interest in the baby

Support for the mother

Answer

Table 5.1  Care and support for new mothers (completed).

Problem or potential problemActions the mother or her family can do to help herTreatments or other actions that you can provide
Goitre (caused by iodine deficiency)Use iodised salt in cooking.A dose of iodised oil after delivery, if goitre is common locally.
Not eating or drinking in the first few hoursThe woman should try and remember that she must drink and eat for her own health and the health of her baby.Check for bleeding, fever or other signs of illness which may be an underlying problem; encourage the woman to talk about how she is feeling.
Lack of energy (maintaining energy when breastfeeding)Eat one to two more meals a day of high protein foods (meat, milk, oils, nuts, etc) if possible.Check if there are taboos about foods, talk to family members about ensuring the woman eats enough and avoids hard work.
Vitamin A deficiencyIncrease intake of high vitamin A, vegetables and fruits, e.g. carrots, mangoes, cabbage and spinach; also eat liver, fish liver oil, milk, eggs and butter.One 200,000 IU vitamin A capsule taken after delivery or within six weeks of delivery; explain the importance of foods rich in vitamin A.
AnaemiaIncrease intake of vegetables and fruits rich in iron and folate.Give her enough tablets (60 mg iron and 400 micrograms folate) to take one every day for three months.
Seclusion of mother and baby.Family members stay with the mother and newborn to offer support, despite the cultural norms.Explain why the woman needs someone near her, especially in the first seven days, when there is the highest risk; a quick response is needed if something goes wrong.
Lack of interest in the babyFamily to give extra attention and support, and have someone care for the new baby if necessary.Check for illness, blood loss or infection. Talk to her. Check if she is hearing voices, or ‘seeing things’. If the latter, refer her for psychiatric help.
Support for the motherPartner, grandmother and/or mother-in-law to take over some routine domestic jobs.Make sure partner and family know the danger signs and the importance of avoiding delay in getting the mother to a health facility.

Summary of Study Session 5