The document discusses reproductive health and the stages of labor and delivery. It defines reproductive health and its objectives. It then explains the three stages of labor as: 1) Early labor and active labor where contractions dilate the cervix, 2) Delivery of the baby, and 3) Delivery of the placenta within 30 minutes to an hour after birth. The document provides an overview of reproductive health topics.

2. REPRODUCTIVE
HEALTH
Presentation-2023
MEDICARE COLLEGE OF NURSING MULTAN
Presented to: Sir Mohsin Raza

3. OUR MEMBERS
ANAS RAZZAQ
M WAQAS
TALHA
MUDASSIR
ZOHAIB
SADIA SHOUKAT
INSHA ASHRAF
SABA KHAN
`MEMONA BATOOL
DUA FATIMA

4. Learning Objectives:
 Define Reproductive health, Objectives of Reproductive health,methods for good
reproductive health.
 integrate the role of a community health nurse and other health team
members in reproductive health care.
 An overview of women's health and its relationship to poverty, access and quality of
care.
 Define gestation and pregnancy.
 Define MCHC, objectives of MCHC, components of MCHC,
 Intranatal, antenatal and postnatal care.
 Domiciliary and institutional care.

5. Continue
Delivery process ( Stages of Labor)
Nursing care during delivery process.
Preparation of home for delivery.
Breastfeeding and contraindications of Breastfeeding
Health care team, members of health care team, roles and responsibilities of health
care team

6. REPRODUCTIVE HEALTH
Reproductive health is a state of complete
physical, mental and social well-being and not
merely the absence of disease or infirmity, in
all matters relating to the reproductive system
and to its functions and processes.
Reproductive health implies that people are able to
have a satisfying and safe sex life and that they have
the capability to reproduce and the freedom to
decide if, when and how often to do so.

7. Objectives of Reproductive health
The main objectives of the reproductive health
are:
It helps in educating every youth about sexual and
reproductive health.
It creates awareness among adolescents about
safe sexual practices.
It helps in preventing sexually transmitted
infections, including HIV/AIDS.

8. Components of Reproductive Health
 Reproductive health.
 Adolescent health.
 Maternal health.
 Contraception.
 Sexually transmitted infection.
 Abortion.
 Female genital mutilation.
 Child and forced marriage.

9. Methods for Good Reproductive Health
 Offer age-appropriate comprehensive sex
education.
 Use mass media.
 Provide adolescent-friendly contraceptive
services.
 Expand access to and promotion of the use of
 Condoms and other contraceptives.
 Implement programs for out-of-school and
 Married adolescents.

10. Problems of Reproductive Health
 Different life stages are associated with
 specific women's sexual and reproductive
health issues, including:
 Menstruation
 Infertility

11. High Risk Pregnancy
 If pregnancy is complicated with disease
or disorder that harm mothers life and
effect the life of baby in fetous is called
High risk pregnancy

13. Pregnancy induced hypertension
 Hypertension in pregnancy is a systolic blood pressure ≥ 140 mmHg or
diastolic blood pressure ≥ 90 mmHg or both. Both systolic and diastolic blood
pressure raises are important in the identification of Pregnancy induced
hypertension . Pregnancy induced hypertension (PIH) is hypertension that
occurs after 20 weeks of gestation in women with previously normal blood
pressure. The broad classification of pregnancy-induced hypertension during
pregnancy is gestational hypertension, pre-eclampsia and eclampsia

15. Pre calamsia and eclampsia
Preeclampsia and eclampsia are pregnancy-
related high blood pressure disorders.
Preeclampsia is a sudden spike in blood pressure.
Eclampsia is more severe and can include
seizures or coma.

16. Pre calamsia and eclampsia
 What causes preeclampsia and eclampsia?
 The causes of preeclampsia and eclampsia are not known. These disorders previously were
believed to be caused by a toxin, called “toxemia,” in the blood, but health care providers now
know that is not true. Nevertheless, preeclampsia is sometimes still referred to as “toxemia.”
 To learn more about preeclampsia and eclampsia, scientists are investigating many factors that
could contribute to the development and progression of these diseases, including:
 Placental abnormalities, such as insufficient blood flow
 Genetic factors
 Environmental exposures
 Nutritional factors
 Maternal immunology and autoimmune disorders
 Cardiovascular and inflammatory changes
 Hormonal imbalances

18. Continue
 cervical screening
 contraception
 sexually transmissible infections
 chronic health problems (such as
endometriosis and polycystic ovary
syndrome) and menopause.

19. When health care is needed but is delayed or not obtained then
People Health Worsen
Which in turn Leads to

Higher Health care cost ( It contributes to poverty)
UHS: Women Health and it's Relationship
to Poverty and Quality of Care

20.  Geographic Accessibility
 Availability
 Financial Accessibility
 Acceptability
UHS: Conceptual framework for
assessing access to Health Services

22. 1. Eradicate extreme poverty and hunger
2. Achieve universal primary education
3. Promote gender quality and empower women.
4. Reduce child mortality.
5. Improve maternal health.
6. Combat HIV / AIDS , malaria and other disease.
7. Ensure environmental stability.
8. Global partnership for development.
Millennium Development Goals(MDG)

23.  Right to RH information and health care services for safe pregnancy and
childbirth
 Right to know different means of regulating fertility to preserve health and
where to obtain them.
 Freedom to decide the number and timing of birth of children
Basic RH Rights

24. 1. Socioeconomic conditions – education, employment, poverty, nutrition, living
condition/ environment, family environment
2. Status of women – equal right in education and in making decisions about her
own RH; right to be free from torture and ill treatment and to participate in
politics
Factors/ Determinants of Reproductive
Health

25.  Social and Gender Issues
 Biological (individual knowledge of reproductive organs and their
functions), cultural (country’s norms, RH practices) and
psychosocial factors
Continue....

26.  Preconception education
 Prenatal , delivery and post natal care
 Family planning services, counseling and
information.
 Educate about the Nutrition of the Pregnant
woman.
 Play a part in the health care for infant and
children.
 Management of abortion – related complications.
Role of Community Health Nurse and
other Health team in Reproductive Health

27.  Prevention and appropriate treatment for
infertility.
 Management of reproductive health.
 Management of reproductive cancers.
 Adolescent reproductive health.
Continue...

28.  Prevention of sexual violence as it is more serious threats to the health of the
woman.
 use of physical barrier methods for STD’s prevention .
 Prevention of infertility.
 Provision of contraceptive method for family planning methods.
 Proper diet
 Healthy body weight
 Exercise and sufficient sleep.
How to Improve Reproductive Health

29. GESTATION AND PREGNANCY

30. GESTATION AND PREGNANCY
Pregnancy is the term used to describe the period in which a fetus develops inside a
woman's womb or uterus. Pregnancy usually lasts about 40 weeks, or just over 9 months,
as measured from the last menstrual period to delivery.
Types of pregnancy include intrauterine pregnancy, ectopic pregnancy, tubal pregnancy,
intra-abdominal pregnancy, singlet pregnancy, multiple pregnancy (twins, triplets,
quadruplets, etc.), lupus pregnancy, high-risk pregnancy, and molar pregnancy. There are
many different types of pregnancies

31. Nursing Care during Pregnancy
 The nurse monitors the health status of the
mother and fetus, provides emotional
support, and teaches the pregnant woman
and her family about physiological and
psychological changes during pregnancy,
foetal development, labour and childbirth,
and care for the newborn.
 Nurse is responsible for MCH mother and
child health


32.  It is a branch of public health which is planned for health supervision of the mother and the
child not only physical but also mental and emotional.
AIMES:
 Making available the best possible care for women during pregnancy,labour and
puerperium.
 Best possible care to children while they are growing and are vulnerable.
MCHC

33.  To reduce the mortality and morbidity rate
 Reduce the birth rate
 To reduce the infant mortality rate
 Decrease the prenatal death
 To reduce the death rate
 To ensure the birth registration
 To study and obtain information regarding women education family income
psychological status maternal environment.
 To promote the reproductive health
Objectives of MCHC

34. Components of MCH
• Antenatal care
• Intranatal care
• Post natal care
• Infant care

35. Antenatal Care:
 The care provided to pregnant women
during pregnancy.
Aim:
 The aim of this type of care is to
achieve healthy mother and child life

36. Objectives of Antenatal care
 To promote protect and maintain mothers health
 Promote and maintain the physical, mental, and social health of mother and baby by
providing education on nutrition, personal hygiene, and birthing process
 Detect and manage complications during pregnancy, whether medical, surgical, or
obstetrical;
 Develop birth preparedness and complication readiness plan
 Help prepare mother to breastfeed successfully, experience normal puerperium, and
take good care of the child physically, psychologically, and socially.

37. Component of antenatal care
 Care clinic
 Home visit
 Laboratory and diagnostic facilities
 Mental preparation
 Making referrals and follow up

38. Antenatal Care Clinic:
 Careful and complete obstetric history
 Medical examination
 Consultation
 Health education classes

39. Routine Visits
 1st visit as soon as possible
 After 4 weeks till 28 weeks
 After every 2 weeks till 36 weeks
 Once a week till she deliver
 Minimum Visits
 1st visit - before 12w to confirm pregnancy
 2nd visit at 24w for baseline health profile
 3rd visit at 32-34w to find out position and
presenting part
 Last visit at 36w to decide where to deliver
the baby.

40. Intranatal care
 Intra natal care means care of mother
during childbirth and also of child .
 Childbirth is a normal physiological process
but complications may arise. Therefore,
need for intranatal care is necessary.

41. Aims of Intranatal Care
 Clean delivery through aseptic measures . It is achieved by:
 Clean delivery surface
 Clean hands
 Clean cutting and care of cord
 Delivery with minimum injury to infant and mother
 Ready to deal with complications such as prolonged labor, antipartim hemorrhage, convulsions
, mal-presentations, etc.
 Care of baby at time of delivery.

42. Intranatal Services
 The aims of Intranatal Care are achieved by following services:
 Domiciliary care
 Institutional care
 Home helps
 Maternity homes
 Transport facilities for midwives
 Ambulance services
 Blood transfusion services
 Diagnostic and laboratory facilities
 Arrangements for consultations and referrals

43. Domiciliary Care
 The care provided at home is called domiciliary care.
 Mothers with normal obstetric history may be advised to have
domiciliary care. In such cases, delivery is conducted by trained
dai/ midwife.

45. Advantages / Disadvantages
 Advantages
 Domiciliary care is less
expensive
 No tension of going to
hospital
 It is convenient and
psychologically satisfactory
 Mother can keep an eye
upon her children and
home affairs.
 Chances of cross infection
are rear
 No chance of mixing of
children.
 Disadvantage
s
 Less medical care at home
 Less rest for women , she
may resume her duties
earlier
 Her diet may be neglected
 Not fully safe

46. Institutional Care
 The care provided in an institution ( hospitals, maternity homes etc.) is called
institutional care.
 Institutional care is recommended for all high risk cases and where home
conditions are not suitable.
 Mother is allowed to rest in bed on first day after delivery. From next day she is
allowed to sit.
 After 3 to 4 days, she is discharged.

48.  Advantages
 Aseptic measures
 Better medical services
 Safe for high risk cases
 Diet and health is properly
looked after
 Emergency conditions and
complications are
managed.
 Disadvantage
s
 More expensive
 Psychological tension of
going to hospital
 Chances of Cross
infection
 Chances of mixing of
children
Advantages / Disadvantages

49. Postnatal Care
• The care of mother after delivery is known as postnatal care.
Services:
• Home visiting program by health visitors:
• Day 1 to 3 , twice a day
• Daily for 7 days
• Last visit at the end of 6 weeks
• Providing consultations and health education
• postnatal clinic for mothers
• Family planning services
• Referral and follow up

50. Objectives
 To prevent postpartum complications
 To provide family planning services
 To check adequacy of Breastfeeding
 To provide basic health education to mother e.g. postnatal exercises

51. Postnatal Complications
 Peurperal sepsis
 Thrombophlebitis
 Secondary hemorrhage
 Mastitis
 Urinary tract infections
 Air embolism

52. Care of Newborn
 Care of an infant us also very important. The
immediate care of Newborn comprises the
following:
 Resuscitation
 Care of cord
 Care of the eyes
 Care of the skin
 Examination of the abnormalities
 Birth weight
 Others include home visiting, breast feeding,
immunization, monitoring of growth and
development, baby friendly hospitals

54.  Stage 1: Early labor and active labor
 Stage 2: The birth of your baby
 Stage 3: Delivery of the placenta
Stages of Delivery

56.  The first stage of labor and birth occurs when you begin to feel persistent contractions.
These contractions become stronger, more regular and more frequent over time. They
cause the cervix to open (dilate) and soften as well as shorten and thin (efface) to allow
your baby to move into the birth canal.
 The first stage is the longest of the three stages. It's actually divided into two phases —
early labor and active labor.

Stage 1: Early labor and Active labor

57. it's time! You'll deliver your baby during the second stage of labor.
How long it lasts
It can take from a few minutes to a few hours or more to push your baby into the world. It
might take longer for first-time moms and women who've had an epidural.
What you can do
Push! Your health care provider will ask you to bear down during each contraction or tell
you when to push. Or you might be asked to push when you feel the urge to do so.
Stage 2: The birth of your baby

58. After your baby is born, you'll likely feel a great sense of relief. You might hold the baby in
your arms or on your abdomen. Cherish the moment. But a lot is still happening. During the
third stage of labor, you will deliver the placenta.
How long it lasts
The placenta is typically delivered in 30 minutes, but the process can last as long as an hour.
What you can do
Relax! By now your focus has likely shifted to your baby. You might be oblivious to what's
going on around you. If you'd like, try breastfeeding your baby.
Stage 3: Delivery of the placenta

59. Preparation of Home for Delivery
 7 Highly Recommended Items To Prepare For a Home Birth
 Do your research
 Child birth education
 Assemble your birth team
 Assemble your home birth supplies
 Prepare your home
 Gather newborn necessities
 Stay hydrated and well nourished

60. Do your Research
Home births are just that ,vaginally delivered in comfort of your home.
They are an option for expectant mothers with healthy ,low risk pregnancies.
As the parents , you should always play an active role in decision making regarding
your pregnancy ,labor ,birth ,and postpartum.
So you must learn what the best option is for you and your baby.

61. You learn about procedures
Possible complications that may arise
Role of you and your team
Child Birth Education

62.  Care provider- Midwife
 Birth Doula (from Greek word meaning “a women who serves”) is a trained ,non
clinical professional who provides continuous emotional ,physical ,and informational
support, helps in sense of calm to the labor ,particularly for first time ,nervous parents
 Partener
 Family Friend
 Nurse
Assemble your Birth team

63.  A birth pool
 Essentials oils & diffuser
 Birthing ball
 Tape measure
 Large trash bags
 Alcohol / cotton balls
 Receiving blankets
 Towels
Assemble your Birth Supplies

64.  Your home must be a safe and peaceful environment for your birthing
experiences
 Be sure to clean the bathroom thoroughly if you plan to labor there
 Germ free area
 Any linens ,towels ,blankets ,or clothes that you plan to use should be freshly
washed and dried
Prepare your Home

65.  A comfortable sleeper and hat
 Newborn diapers
 Swaddling blankets
 Wipes
 Car seat
 Bottles
Gather Newborn necessities

66.  Eat easy to fix foods and
liquids to hydrate and nourish
throughout
 To prepare for home birth
,stock up on electrolyte –rich
drinks like pedialyte as well as
nutritious snacks like yogurt
,cheese , fresh fruits ,crackers ,
soups , broths , and even a
sandwitch
Stay Hydrated and well Nourished

67.  Breastfeeding is good for both infants and mothers.
 Breast milk is the best source of nutrition for most infants.
 As an infant grows, breast milk changes to meet the infant’s nutritional needs.
 Less chances of malnutrition in infants.
 It helps in development of jaws and teeth
 It is easily digestible.
 Breast milk is safe,clean, hygienic and cheap.
 Breastfeeding can also help protect the infant and mother against certain
illnesses and diseases such as breast cancer.
 It gives psychological satisfaction to mothers.
 It forms close relationship between mother and child.
Breast feeding

68. Contraindications of Breastfeeding
 In following maternal problems breast feeding is
contraindicated:
 High fever
 Septicemia
 Breast cancer
 Kidney disease
 Active untreated tuberculosis
 Leprosy

69. Health Care Team
 A health care team is all of
the people who provide
care and services to
patients. Every employee
at a healthcare facility is a
member of health care
team.

70.  Characteristics of Health Care team
 Team have an objective.
 Team follows rules.
 Team organize themselves to achieve
their goals/ objectives.
 Teams members should be co-
operative.

71. Health Team Members in Community
 Health team consists of:
 Physician
 Nurses
 National Social workers
 Health assistant
 Trained Dais
 Village Health guides
 Auxillary personnel

72. Roles and Responsibilities of Health Care team
members in Community
 Assessment
 Management
 Treatment
 Education
 Advocacy
 Referrals
 Collaboration

73. A mother is your first friend,
your best friend, your
forever friend