Antenatal care
Introduction
• The antenatal care (ANC) is a health service
provided to pregnant women in the continuum
• of maternity care.
• The WHO defines ANC as the care
provided by skilled health-care professionals
to pregnant women and adolescent girls in
order to ensure the best health conditions for
both mother and baby during pregnancy.
components of ANC include
• risk identification
• prevention and management of pregnancy-related
or concurrent diseases
• Health education
• health promotion.
KEY PRINCIPLES OF ANTENATAL CARE
• Implementing the new ANC model of 8 contacts
schedule
• ANC care should be woman-centered:
• De-medicalized ANC:
• Providing efficient and timely care to all pregnant women.
• ANC should be evidence based: meaning supported by
best available evidence.
• VI. ANC should be multidisciplinary: involving
contribution from health professionals
.
Con…
• ANC should be holistic and concerned with intellectual
emotional, social, and cultural
• needs of women, their babies, and families, and not only
with their biological care
• ANC should respect privacy, dignity and confidentiality of
women
• ANC providers should be motivated, competent, and
compassionate (MCC)
• Women with special needs require care in addition to
the core components of basic
care.
ANC contact schedule
• As per the WHO recommendation, Ethiopia is
replacing the previous four-visit FANC model
was the new ANC 8-contact model in 2016.
In order to reduce perinatal mortality and
improve the pregnancy experience of women, a
minimum of eight contacts is required
Con…
• Accordingly, the first contact is recommended
to be single contact in the first trimester, two
contacts in the second trimester (at 20 and 26
weeks of gestation) and five contacts in the
third trimester (at 30, 34, 36, 38, and 40 weeks).
Summary of ANC history and physical examination
during first contact:
• Identification: Name, age, address, phone number, occupation, and
marital status
• Menstrual history: Date of first LNMP and the regularity; current or
previous breast feeding,
• use of contraception; determining the gestational age and expected date of
delivery (EDD)
• History of present pregnancy: Including pregnancy symptoms, fetal
kicks, and any complication to date
• Intention of the present pregnancy: planned/unplanned; if unplanned,
wanted/unwanted
Con..
• Past obstetric history: Number of pregnancies and
outcome of each; cesarean sections; problems and
complications, including bleeding, preterm births,
stillbirths, and high blood pressure during pregnancy
• Medical history: Including cardiovascular disease, renal
disease, diabetes mellitus, convulsion, Tuberculosis, and
other past and current medical problems;
• Current medication: Including therape
Con…
• Gynecologic history: Including screening for cervical cancer,
gynecologic surgery, STI
• Nutritional history: Number of food groups and frequency
of meals consumed per day, craving for unusual food type,
apatite, emesis
• Social and personal history: Including use of alcohol,
tobacco, exposure to secondhand smoke, khat, caffeine in
large quantity (>300 mg/day or >3 small cups of
• Ethiopian coffee), or other harmful substances, assessing for
intimate-partner violence,
• female genital mutilation (FGM
