Health education first trimester
(1 – 3 month )
Nutrition
 Good nitration is essential all during pregnancy.
 The quality of food more important than quantity.
 The pregnant women should eat to provide all essential
nutrients while avoiding weight gain.
 Selecting foods of high nutritive value and avoiding empty
calories and junk food.
 Weight gain in pregnancy should not exceed 12 kg .
 Foods rich in protein, iron, and essential nutrients are
recommended to be eaten on a daily basis. During the first two
trimesters of pregnancy, iron is transferred to the fetus in
moderate amounts, but during the last trimester when the
fetus builds its reserve, the amount transferred is accelerated
ten times.
Travelling
 Travel can be especially trying in the first 14 weeks and during
the last 4 weeks of pregnancy , avoid it in the first trimester if
there is history of abortion.
 If travel by car , frequent stops should be provide with
opportunity and using the rest room.
 Using seatbelts, they should not too tight against the neck and
abdomen
Sexual intercourse
 Sexual intercourse in moderation usually dose no harm
 Stress that sexual intercourse is contraindicated once the
membranes are ruptured or if bleeding is present.
 Avoid intercourse if there is history of abortion or premature
labor.
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Environment factor
Drug
 The first trimester is particulars, susceptible time
 Ingestion of drug at any time during pregnancy holds
potential for fetal damage .
 Drug have tetrogenle effects on the fetus, causing
anomalies as bone and limb deformities, deafness,
cardiac defects, prematurity and metabolic
abnormalities.
 Avoid use of self-medication and prescription
medication.
 Drug with or suspected toxicity should be avoided.
 When doctors prescribe a drug for necessary to the
smallest dosage for short time.
Caffeine
 Pregnant women of common sources of caffeine
including coffee, tea, colas and chocolate use it in
moderate or limiting intake.
 Daily large caffeine intake will cause elevated the blood
pressure .
 Caffeine causes an increase production of adrenaline and
noradrenaline these hormone construct peripheral blood
vessels, including those of the uterus, ibis restriction can
result in temporary decrease of oxygen available to the
fetus.
Smoking
 Women who are smoke during pregnancy should stop
smoking , or if she can't must be reduces their smoking.
 Specific mechanism of smoking effect on the fetus is not
known.
 Smoking appears to decrease placental blood flow and
plasma volume.
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 Smoking may interfere with maternal absorption or
metabolism of calcium, vitamins A, B6, B12, and vitamin
C.
 Mother who smokes has an increased risk of
spontaneous abortion, placenta previa, low birth weight,
anemic baby, addict baby to cigarette.
Next visit
 Regular return visits during pregnancy to provide continuing
monitoring of maternal and fetal status.
 In 1st trimester returns every 4 weeks.
Warning sings and symptoms
Women should be immediately report of any of following sings and
symptoms to the doctor in the 1st trimester:
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Vaginal bleeding, no matter how slight it is.
Pain in the abdomen and back.
Persistent nausea or vomiting.
Persistent loss of appetite.
Painful. Burning sensation on urination.
Dizziness.
Health education second trimester
( 4 – 6 months)
Hygiene
 Daily hygiene routine is maintained.
 Skin glands are more active and frequent baths are necessary.
 If there is increased in vaginal discharge, which means local
cleansing are essential.
 Wipe from front to back to prevent contamination.
 Wear cotton underwear for good ventilated.
 Avoid douching except by advice of doctor.
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Dental care
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Dental examination should be done early in pregnancy.
Regular visit to the dentist as ordered.
An adequate diet and care of the gums.
Consult doctor before any dental work is done.
Breast care
 Cleanse daily with warm water, omitting soap, which causes
drying and cracking of the nipple and areola area.
 Rub nipples gently apply cream for dryness.
 If nipples are flat or inverted, grasp gently and pull out ward
for a few second several times a day.
Clothing
 Clothing in 2nd trimester should be practical, attractive and
nonconstricting.
 Avoid stocking with elastic tops.
 Low heeled shoes are more practical and safer.
 A well fitting bra is recommended .
Vaccination
 All women of childbearing age need to be fully aware of the risk
of receiving specific immunization if pregnancy is possible.
 Tetanus toxic 1st and 2nd dose in 2nd trimester , 1 month
between each.
Next visit
 Returns every 4 weeks.
Warning sings and symptoms
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Vaginal bleeding.
Sever continuous headache.
Swelling of the face and hand.
Chills and fever over (37.8 ).
Dizziness.
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 Increase weight gain
 Increase in B.P
Health education third trimester
( 7 – 9 months)
Travelling
 Avoid it if there is history of bleeding , premature labor ,
pregnancy induce hypertension, or if multiple births are
anticipated.
 Don't travel without consult your doctors.
 Mother must be surd there is a hospitals or emergency center
in a place, which went to it
Sexual inter course
 Women in third trimester should be avoid sexual intercourse
during the last 6 – 8 week of premature ruptnre of membranes
& pre mature labor
S & S of labor
 The onset of labor is signald by one or more of following
symptoms
1. The irregular contractions of pregnancy give way to regular
uterine contractions every 15 – 20 min
2. The show –a small amount of blood mixed with mucus is
passed
3. The membranes may ruptunc
 Omther 2 hold be go to the hospital any time she fell one or
more of these symptoms
Place of delivery
 When the mother to be in labor is admit to the hospital
 Avoid stay at home if mother feel symptoms of labor to prevent
complication
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Vaccination
 The important topic that is interrelated with travel is that of
immunization & vaccination protection for pregnant woman
 Virus vaccinations are contrincticated (measles, mumps, and
rubella)
Warning S & S
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Vaginal bleeding
Edema
Sever headache
Visual disturbance
Absence of fetal movement
V. discharge & changing in normality ( colour, amount, odors,
itching)
Nutrition
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In 3rd trimester iron or folic acid intake in food
Increase Ca intake (milk & milk products).
Adequate intake of fluid to prevent dehydration.
Increase fiber intake to prevent constipation
Avoid fluid contain sodium bicarbonate.
Next visit
 From 7th to 8th month the visit every two weeks.
 The 9th month will be every one week.
Differentiate between true and false labor
Site
False labor pain
abdomen
Walking
Enema
Discharge
Cervical diltation
Pattern of pain
It will gone
It will gone
No discharge
No dilatation
Irregular
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True labor pain
Abdomen and back
may be upper thigh
It will increase
It will increase
Show
There is dilatation
Start irregular then
become regular
Exercising During Pregnancy
Exercise is safe and encouraged during a normal healthy pregnancy.
If you exercised before you became pregnant, you can continue
exercising at the same level. If you are just starting an exercise
program, talk to your doctor and start slowly. Do not push yourself
too hard. Talk to your doctor about what kind of exercises to
do.There are some health conditions that may limit your exercise.
General Guidelines
• Drink plenty of water and eat a healthy snack before exercising.
• Wear clothing that is comfortable.
• It is best to exercise for 30 to 45 minutes 3 to 5 times each week.
• You should be able to carry on a conversation during exercise.
• Avoid getting overheated. Do not exercise on very hot or very cold
days.
• Avoid any type of exercise that can cause even mild trauma to your
stomach.
• You may need to change the type of exercise you do as your
stomach gets bigger and your balance changes.
• It is common to feel some mild cramping during exercise. Drink
plenty of water and the cramping should stop after you are done
exercising.
Exercise Safely
 Warm up and cool down with each exercise session.
 Start slowly.
 Listen to your body. Do not try to push yourself too hard. Stop
exercising when you get tired. Do not exercise to the point of
exhaustion.
 If you have pain or any unusual signs, stop exercising right
away. Rest and call your doctor if these signs do not go away
 Keep one foot on the floor during all standing exercises, do not
over reach and do not do quick, jerky movements. This may
throw off your balance.
 Never hold your breath.
 Your joints are softer so do not over extend or bend the joints
such as deep knee bends or deep squats. Do not do bouncing
stretches. Use a longer slow stretch.
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Types of Exercise to Do
 Walking is a great exercise. If you were not active before
pregnancy, walking may be a good way to start.
 You may use light weights.
 Swimming is a great exercise but do not dive.
 Jog or play tennis only if you did these before your pregnancy.
Exercises to Avoid
 Do not do any exercise where you lie flat on your back after the
first 3 months of pregnancy.
 Do not use ankle weights, do double leg lifts or do full sit ups.
This strains your back.
 Do not do any activity that may cause jerking, bouncing or high
impact movements.
 Do not water ski, snow ski or scuba dive.
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