Greener Journal of Medical Sciences

 

 

 

Husband Natal Care: Concept to Reduced Maternal and Perinatal Morbidity and Mortality, Nigeria’s View Point

 

 

Eli S¹, Kalio DGB², Briggs NCT³, Pepple DKO²

 

 

Mother, Baby and Adolescent Care Global Foundation.¹

Department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital.²

Department of Community Medicine, Rivers State University.³

 

 

 

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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).

 

 

REFERENCES

 

1.  Falade-Fatila O, Adebayo A. Male partners involvement in pregnancy related care among married men in Ibadan, Nigeria. Reproductive Health 2020; 17(1): 14.

2.  Ani F, Abiodun O, Sotunsa J, Imaralu J, Olaleye A. Demographic factors related to male involvement in reproductive health care services in Nigeria. Eur J Contracept Reprod Health Care 2015; 15: 1-11.

3.   Ditekemena J, Koole O, Engemann C, Matendo R, Tshefu A, Ryder R et al. Determinants of male involvement in maternal and child health services in Sub-Saharan Africa: a review. Reprod Health 2012; 9:32.

4.   Longworth MK, Furber G, Kirk S. A narrative review of fathers’ involvement during labour and birth and their influence in decision making. Midwifery 2015; (9): 844-57.

5.  Kakaire O, Kaye DK, Osinde MO. Male involvement in birth preparedness and complication readiness for emergency obstetric referrals in rural Uganda. Reprod Health 2011; 8:12.

6.   Harder KM, Cowan S, Enlesu MB, Krarup HB, Christensen PB. “Universal screening for hepatitis B among pregnant women led to 96% vaccination coverage among newborns of HBSAg pregnant mothers in Denmark”. Vaccination 2011; 50(29): 9303 – 9303.

7.   Moris SN, Johnson NR. Exercise during pregnancy: a critical appraisal of the literature. J Reprod Med 2005; 50: 181-188.

8.  Gibore NS, Bali TAL, Kibusi SM. Factors influencing men’s involvement in antenatal care services, a cross-sectional study in a low resource setting, central Tanzania. Reproductive Health 2019; 16:52.

9.   Singh D, Lanple M, Ehrnest  J. The involvement of men in maternal health care: cross-sectional, pilot case studies from Maligith and Kibibi, Uganda. Reprod Health 2014; 11: 68.

10. Matiang’l M, Mojoala A, Githar MN. Male involvement in antenatal care redefined: A cross-sectional survey of married men in Lang’ata district, Kenya. African Journal of Midwifery and Women’s Health 2013; (3): 117.

11.  Lewis S, Lee A, Simkhade P. The role of husbands in maternal health and safe childbirth in urban Nepal: a qualitative study. BMC Pregnancy Childbirth 2015; 15:162.

12. Mullany BC, Becker S, Hindin MJ. The impact of including husbands in ante natal health education services on maternal health practices in urban Nepal: results from a randomized controlled trial. Health Education Research 2007; 22(2): 166-176.