The World Health Organization (WHO) released new recommendations for the improvement of the quality of care that pregnant women all over the world should receive. The highlight was the increase in number of prenatal care visits, from four to a minimum of eight consulations with your doctor.
According to WHO recommendations, that’s getting your first visit to the doctor within your first 12 weeks of pregnancy, then getting consultations again for week 20, 26, 30, 34, 36, 38 and 40.
“More and better quality contacts between all women and their health providers throughout pregnancy will facilitate the uptake of preventive measures, timely detection of risks, reduces complications and addresses health inequalities,” says Dr Anthony Costello, director of Maternal, Newborn, Child and Adolescent Health for WHO, in a news release.
But that’s not all WHO discussed in the new guidelines. The comprehensive 152-page publication "for a positive pregnancy experience” contained 49 recommendations including ones on physical activity, healthy diet and optimal nutrition, disease prevention, vaccination, and the use of ultrasound. As these guidelines are meant to encompass all women around the world, a good number of them are context-specific and may not apply to pregnant women in the Philippines.
For the benefit of Filipina pregnant women, we’ve taken the recommendations pertaining to diet, assessment and prevention that may apply to Pinays and compiled them here. These may not apply to you specifically so, as always, consult your doctor. You can read through all the new WHO guidelines here.
Diet and nutrition 1. Eat right and keep physically active to stay healthy and prevent excessive weight gain. According to the guidelines, a healthy diet includes a variety of foods including colorful vegetables, meat, fish, beans, nuts, whole grains and fruit. Physical activity includes aerobics and strength-conditioning exercises
2. Nutrition education on increasing daily energy and protein intake is recommended for pregnant women in undernourished populations.
3. Daily iron and folic acid supplements are recommended for the prevention of anaemia, low birth weight, preterm birth and puerperal sepsis.
4. Daily calcium supplements is recommended to reduce pre-eclampsia in women in populations with low calcium intake. According to the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST), calcium is the least-consumed nutrient in the Filipino diet. In general, pregnant women do not meet the average recommended calcium-intake and, in fact, get very little of it in their diet, says the FNRI-DOST.
5. Supplements that are not recommended include: zinc, vitamin B6, vitamin E and C, and vitamin D as these are easy to get through a healthy, balanced diet. In addition, WHO says that sunlight is the most important source of vitamin D.
6. Caffeine intake should not be more that 300mg per day.
Assessment 7. Doctors should ask all pregnant women about their tobacco use (past and present) and exposure to second-hand smoke.
8. Doctors should ask all pregnant women about their use of alcohol and other substances (past and present) as early as possible in the pregnancy and at every antenatal care visit.
9. Testing and counselling for HIV should be considered for all pregnant women to eliminate mother-to-child transmission of HIV.
10. Screening for active tuberculosis (TB) should be considered for pregnant women in TB prevalent populations.
11. One ultrasound scan before 24 weeks of gestation is recommended for pregnant women to improve detection of fetal anomalies and multiple pregnancies and to estimate gestational age.
Prevention 12. For all pregnant women with asymptomatic bacteriuria (ASB), a seven-day antibiotic regimen is recommended.
13. Preventive anthelmic treatment is recommended after the first trimester for pregnant women in areas where soil-transmitted helminth (STH) infections is high. According to WHO, the whole Philippine archipelago is endemic of STH.
14. Tetanus toxoid vaccination is recommended for all pregnant women, depending on previous tetanus vaccination exposure.
15. Every pregnant woman should have her own "case notes" (your pregnancy journal)to improve continuity, quality of care and her pregnancy experience. WHO research found that women who have their own notes are more likely to feel in control of their pregnancy.