By Dr Billy Magagula
Obstetrician & Gynaecologist
MBChB (UL, Medunsa), DIP Obst (SA), DIP HIV Man (SA), MMED O&G (UP), FCOG (SA)
Pregnancy is a journey of many joyful and sometimes challenging times. Pregnancy awareness week is commemorated to raise awareness about pregnancy with the aim to ensure good outcomes for both expecting mother and baby.
A study in low-middle income countries including African countries found that 25% of pregnancies are unintended. The South African Medical Research Council found that 70% of pregnancies among teenagers and women less than 25 years old were unintended.
It is important to access contraception services as this prevents unintended pregnancies, which are associated with poor outcomes.
Pre-pregnancy care is important as it is an opportunity to modify some risk factors before the planned pregnancy. These include lowering body mass index in obese women, optimising control of medical conditions, adjustment of chronic medications, optimise nutritional status etc. The use of folic acid before pregnancy is important to prevent abnormal development of the baby’s brain and spinal cord.
Early initiation of antenatal care is important. This allows early assessment, dating of the pregnancy, identifying risk factors and plan the antenatal, delivery and post-delivery journey.
Key elements as recommended by WHO for a positive pregnancy experience include:
- Healthy eating and keeping physically active
- Pregnancy supplements: Iron and folic acid
- Cessation of smoking (tobacco and other substances) and alcohol use
- Having an ultrasound scan before 24 weeks
- Vaccinations: Tetanus
- Carrying own antenatal record for continuity of care
- Having a minimum of 8 antenatal visits with a health care professional
Furthermore its essential to ensure psychological well-being as mental health conditions have a negative impact on pregnancy.
Gender Based Violence (GBV) is another major threat to the health and wellbeing of women in South Africa. Health care workers are able to offer help and guidance to women affected by GBV. Women should have confidence in the health system to seek help with issues of GBV.
It is important for women of reproductive age to plan pregnancy, use reliable contraception until they are ready for conception.
Early initiation of antenatal care and continued contact with health care professionals during and after a pregnancy optimizes outcome for both mother and baby.
Dr Billy Magagula
T: +27 (13) 752 3196
E: INFO@DRBILLYMAGAGULA.CO.ZA
OFFICE 2 LC, 39B BROWN STREET NELBRO BUILDING, NELSPRUIT, 1200
References
1. Bellizzi S, Mannava P, Nagai M, Sobel HL. Reasons for discontinuation of contraception among women with a current unintended pregnancy in 36 low and middle-income countries. Contraception. 2020 Jan;101(1):26-33. doi: 10.1016/j.contraception.2019.09.006. Epub 2019 Oct 23. PMID: 31655068.
2. MATHEWS, C et al. HIV care coverage among HIV-positive adolescent girls and young women in South Africa: Results from the HERStory Study. South African Medical Journal, [S.l.], v. 111, n. 5, p. 460-468, apr. 2021. ISSN 2078-5135. Available at: <http://www.samj.org.za/index.php/samj/article/view/13283>. Date accessed: 27 Jan. 2022. doi:10.7196/SAMJ.2021.v111i5.15351.
3. ACOG Committee Opinion No. 762: Prepregnancy Counseling. Obstet Gynecol. 2019 Jan;133(1):e78-e89. doi: 10.1097/AOG.0000000000003013. PMID: 30575679. 4. WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience. Geneva: World Health Organization; 2016. PMID: 280799
