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Mother & Child Health

The days and weeks following childbirth – the postnatal period – is a critical phase in the lives of mothers and newborn babies. Major changes occur during this period, which determines the well-being of mothers and newborns. Yet, this is the most neglected time for the provision of quality services. Lack of appropriate care during this period could result in significant health issues and even death.

Some of the serious maternal health problems that can affect mothers include:
• Postnatal psychosis
• Postpartum haemorrhage
• Puerperal pyrexia
• Thromboembolism

Women who chose to breast-feed or bottle-feed often need a lot of advice and support, especially with their first baby (but experienced mothers shouldn't be assumed to know everything; support and advice should always be available). Breast-feeding should be strongly encouraged (first-time mothers may need a lot of support and encouragement initially). Breast-feeding has many advantages, including:
• Boosting the baby's immune system
• Reduction of autoimmunity disorders later in life
• Reducing risk of cot death
• Reducing gastrointestinal problems
• Promoting bonding between the mother and her baby

Breast engorgement may cause a lot of discomfort but is usually relieved by good bra support and analgesia.

Women who are unable to breast-feed or prefer to bottle-feed also need support and advice, including feeding routines and sterilizing.

Contraception and Family Planning
Contraception is not necessary in the 21 days after childbirth.

Methods that are suitable choices for breast-feeding women include the lactation-amenorrhoea method, barrier methods, intrauterine devices (including the levonorgestrel-releasing intrauterine system), the progestogen-only pill, injectable progesterone contraceptives, the etonogestrel implant and sterilisation. The combined oral contraceptive pill is not recommended, as it interferes with lactation.

The lactational amenorrhoea method is 98% if:
• there is complete amenorrhoea.
• the woman is fully or very nearly fully breast-feeding.
• the baby is no more than 6 months old.
Methods that are suitable choices for women who are not breast-feeding include all those for breast-feeding women but combined oral contraceptives can also be used.

• Health screening
Executive female profile screening blood test, pap smear, breast examination.

• Breastfeeding support
Breastfeeding advice.

• Family planning
Oral contraception, family planning advice and counselling.