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Antepartal Care
Antepartal Care
UNIVERSITY
San Vicente West, Urdaneta City, Pangasinan 2428
urdanetacityuniversity@yahoo.com
(075) 568-7612 / (075) 568-2475 loc. 110
SCHOOL OF MIDWIFERY
M101 NORMAL OB
THE ANTEPARTAL PERIOD
Assessment
Classification of Pregnancy
A. Gravida: number of times pregnant,
regardless of duration, including the present
pregnancy.
1. Primagravida: pregnant for the first time
2. Multigravida: pregnant for second or
subsequent time
B. Para: number of pregnancies that lasted more
than 20 weeks, regardless of outcome.
1. Nullipara: a woman who has not given
birth to a baby beyond 20 weeks gestation.
2. Primipara: a woman who has given birth
to one baby more than 20 weeks gestation.
3. Multipara: Woman who has had two or more
births at more than 20 weeks gestation. . . twins
or triplets count as 1 para.
4. TPAL: Para subdivided to reflect births that
went to Term, Premature births, Abortions, and
Living children.
Use of GTPAL: Pregnancy outcomes can be
described with the acronym
GTPAL.
1. G is gravidity, the number of pregnancies,
including the present one.
2. T is term births, the number born at term
(longer than 37 weeks' gestation).
3. P is preterm births, the number born before
37 weeks' gestation.
4. A is abortions and/or miscarriages, the
number of abortions and/or miscarriages
(included in gravida if before 20 weeks'
gestation; included in parity if past 20 weeks'
gestation). Note that a termination of the
pregnancy after 20 weeks is referred to as a
therapeutic termination.
5. L is the number of current living children.
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COMPLICATIONS OF PREGNANCY
Pregnancy can be complicated by
situations unique to childbearing (e.g., placental
bleeding), or by longstanding conditions
predating pregnancy and continuing into the
childbearing process (e.g., age, socioeconomic
status, cardiac problems); for common
discomforts of pregnancy
General Midwifery Responsibilities
B. Syncope
1. Usually occurs in the first trimester; supine
hypotension occurs particularly in the second
and third trimesters
2. May be triggered hormonally or caused by the
increased blood volume, anemia, fatigue, sudden
position changes, or lying supine
3. Midwifery Interventions
a. Sitting with the feet elevated
b. Changing positions slowly
c. Changing the position to the lateral recumbent
to relieve the pressure of the uterus on the
inferior vena cava
C. Urinary urgency and frequency
1. Usually occurs in the first and third trimesters
2. Caused by pressure of the uterus on the
bladder
3. Midwifery Interventions
a. Drinking adequate amounts of fluid during the
day
b. Limiting fluid intake in the evening
c. Voiding at regular intervals
d. Sleeping side lying at night
e. Wearing perineal pads, if necessary
f. Performing Kegel exercises
D. Breast tenderness
1. Can occur from the first through the third
trimesters.
2. Caused by increased levels of estrogen and
progesterone.
3. Midwifery Interventions
a. Encouragement for wearing a supportive bra
b. Avoiding the use of soap on the nipples and
areola area to prevent drying
E. Increased vaginal discharge
1. Can occur from the first through the third
trimesters.
2. Caused by hyperplasia of vaginal mucosa and
increased mucus production.
3. Midwifery Interventions
a. Proper cleansing and hygiene
b. Wearing cotton underwear
c. Avoiding douching
d. Advising the client to consult the physician or
nurse-midwife if infection is suspected
F. Nasal stuffiness
1. Occurs during the first through third
trimesters
Prepared by: Dr. Christopher R. Baez
ANTEPARTAL MIDWIFERY CARE 7 | P a g e
3. Midwifery Interventions
a. Wearing support hose
b. Elevating the feet when sitting
c. Lying with the feet and hips elevated
d. Avoiding long periods of standing or sitting
e. Moving about while standing to improve
circulation
f. Avoiding leg crossing
g. Avoiding constricting articles of clothing
K. Headaches
1. Usually occur in the second and third
trimesters.
2. Result from changes in blood volume and
vascular tone.
3. Midwifery Interventions
a. Changing position slowly
b. Applying a cool cloth to the forehead
c. Eating a small snack
d. Using acetaminophen (Tylenol) only if
prescribed by the physician or nurse-midwife
L. Hemorrhoids
1. Usually occur in the second and third
trimesters
2. Result from increased venous pressure and
constipation
3. Midwifery Interventions
a. Soaking in a warm sitz bath
b. Sitting on a soft pillow
c. Eating high-fiber foods and avoiding
constipation
d. Drinking sufficient fluids
e. Increasing exercise, such as walking
f. Applying ointments, suppositories, or
compresses as prescribed by the physician or
nurse-midwife
M. Constipation
1. Usually occurs in the second and third
trimesters
2. Results from decreased intestinal motility,
displacement of the intestines, and taking iron
supplements
3. Midwifery Interventions
a. Eating high-fiber foods
b. Drinking sufficient fluids
c. Exercising regularly
d. Avoiding laxatives or enemas and consulting
with the physician or nurse-midwife about their
use
N. Backache