LETTER TO THE EDITOR
With the evolving challenges in reproductive
health there is the need to modify the concept of ante natal care to involve
men in the traditional or original plan of antenatal or prenatal care.1-4
This concept of “Husband natal Care”
will help address the rising Maternal Mortality Ratio (MMR) and Perinatal
Mortality Ratio (PMR) in the developing countries in the developing countries
of the world from Nigeria’s view point.3-10In addition, other
reproductive needs of women including family planning will be addressed. If this
concept of actively involving men in ante natal care is well structured, then
maternal and perinatal mortality ratio especially in the developing countries
of the world will be reduced drastically using Nigeria as a model.1,2
For a better
understanding of the concept of “husband natal care” five(5) basic areas will
be addressed with respect to ante natal visits of the pregnant woman at 8 to 12
weeks, 24 – 28 weeks and 36 – 38 weeks, labour and
puerperium.1,3-5
During the 8 – 12
weeks period, taking into consideration the recommended booking period by the
world health organization.5-10 At this visit the husband and her
spouse (pregnant women) are counseled on the journey of antenatal care which
entails what to expect , the challenges that may occur, importance of
compliance with routine antenatal medications for tropical countries like
Nigeria.1,2 In addition, emphasis are also made with respect to
preventive measures to tropical diseases such as malaria and tetanus by
ensuring that intermittent Preventive Treatment (IPT) pyremithamine-sulphadozine
is given to ante natal mothers in line with WHO recommendation as well as tetanus toxoid
injection.1-6
Furthermore, the
husband is advised to encourage his wife – the pregnant mother to carry out her
routine ante natal investigations such as packed cell volume – to check for anaemia, retroviral screening to rule out infections, hepatitis
B and C antigen and anti-body to screen for hepatitis B and C viral infections,
venereal disease research laboratory test to
screen for venereal diseases.2-5 At
this visit the importance of exercise for exercise pregnant woman is emphasized
of at least 20minutes a day for 5days a week, adequate rest and nutrition in
pregnancy by eating balanced diet.8 Also at this visit the pregnancy
is classified into high risk and low risk based on previous histories of
delivery – abdominal or vaginal, multiple gestations, underlying medical
conditions such as diabetes mellitus, hypertension or any other medical conditions.8-12
At 24 – 28weeks, the
husband and pregnant spouse are educated on the importance of birth
preparedness and complication readiness.5-8 The husband is counseled to bring her
pregnant spouse to the hospital in cases of emergences – ante partum haemorrhage (abruption placenta and placenta praevia). Compliance
with routine ante natal medications and visits are emphasized as well as
maintaining a healthy life style. 11 This visit also creates an
avenue to strengthen the relationship between the husband, her pregnant spouse
and the obstetrician.4-12
For the 36 – 38 visit:
the husband and her pregnant spouse – should be reminded of signs of labour, important instructions by the obstetrician such as
previous caesarean section(s), previous myomectomy, her “Rhesus factor” if she
is Rhesus negative, diabetic, hypertensive or any co-existing medical
condition.4-12 If need for
induction of labour or elective caesarean section, husbands
and pregnant spouses should be allowed to participate in the management of the
index pregnancy based on informed consent and counseling.
·
In labour men
should be involved in labour processes as research have shown that the presence of relatives helps to
alleviate pain in labour and offer psychological
support.
·
At the post-natal visit the presence of the
husband/father will create relaxed environment for the father, mother and baby
to addresses issues of reproductive health as it relates to
family planning which entails child spacing, when is the best time to get
pregnant and to be reminded on the number of children to have in other to
adequately take care of the family.13
The whole idea for
men to accompany their wives for antenatal care basically is to provide
psychological, emotional, financial support and to help her pregnant spouse
carry the baby to term and deliver a healthy baby to a contended mother and
father. In addition the husband should encourage his spouse to take informed
decisions on her reproductive health including family planning option of he/their choice.
Furthermore, “the
husband natal care” will also create enabling environment for husbands and
pregnant spouse to address the challenges of violence against women in
pregnancy and beyond.
The basic physiology
of pregnancy will be well understood by the husband, thus reducing undue
pressure on the woman which cuts across religious, social, culture, economic
and financial needs of the family.
CONCLUSION
By the adoption of this model of “husband
natal care” the challenges of maternal and perinatal morbidity and mortality
will be reduced especially in the developing countries of the world using
“Nigeria” as a case study. We the authors thus recommend that husbands should
attend antenatal visit atleast three times, labour and post-natal visit.
Acknowledgement
Mother, Baby and
Adolescent Care Global Foundation (Previously Mother and Baby Care Global
Foundation).
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