Pregnancy is a natural event that occurs in a woman. But in pregnancy it needs special attention so that the pregnancy remains normal and there are no complications or others. At first the pregnancy develops normally and everything is as expected. However ante natal care (ANC) is important to monitor and support the health of pregnant women and detect high risk, doubtful risk, and low risk of pregnancy, with antenatal care as early detection to reduce maternal and fetal morbidity and mortality
** A. Understanding ante natal care (ANC) **
Ante natal care is care given to pregnant women from the beginning of pregnancy to the birth of the baby safely. As well as optimizing the physical and mental health of pregnant women, so they are able to face childbirth, childbirth, until the process of breastfeeding, and the return of reproductive health naturally
** B. The goal of antenatal care (ANC) **
According to Sondakh (2009) there are a number of objectives for examining pregnant women as a whole, namely:
- Monitor the progress of pregnancy to ascertain the pregnancy of the mother and the growth of the fetus.
- Increasing and maintaining maternal physical, mental and social health.
- Recognize and reduce early complications or complications that may occur during pregnancy, the history of the disease in general, and surgery.
- Prepare for months of labor and safe delivery with minimal trauma.
- Prepare the mother so that the puerperium period runs normally and prepares the mother to be able to provide breast milk (ASI) exclusively.
- Preparing the role of mother and family in accepting the birth of a fetus in order to grow and develop normally.
- Reducing premature birth, stillbirth and neonatal death.
- Prepare optimal health for the fetus.
** C. Benefits of Ante Christmas Care **
The benefits of early prenatal care are to obtain a basic description of the physiological changes that occur during pregnancy and various abnormalities that accompany pregnancy early, so that steps can be taken into account and prepared in the delivery of assistance (Manuaba, 2009).
Antenatal care checks also benefit the fetus, including:
- For mothers
a. Reducing and enforcing pregnancy complications early and treating complications that affect pregnancy.
b. Maintaining and improving mental and physical health of pregnant women in the face of childbirth.
c. Improve maternal health after delivery and to give breast milk.
d. Provide counseling in choosing contraceptive methods (Manuaba, 1999). - For the fetus
The benefit for the fetus is maintaining maternal health so that reducing premature labor, LBW, also improves infant health as a starting point for the quality of human resources (Manuaba, 1999).
** D. Implementation of Ante Christmas Care **
According to Kusmiyati, Wahyuningsi, & Sujiyatini (2008) that checks are often carried out in hospitals or pukesmas namely:
Inspection
a. Face: is cloasma gravidarum, a state of pale or red eye membranes, edema, tongue and teeth.
b. Neck: is there a vein dam in the neck, an enlarged thyroid gland or swollen lymph glands.
c. Chest: the shape of breasts, nipple pigmentation and milk rinks, the state of the nipple, colustrum.
d. Stomach: the abdomen enlarges forward or to the side, the central state, linea alba pigmentation, shows the child's movements or uterine contractions, is there striae gravidarum or scars.
e. Vulva: state of the perineum, varicose veins, chadwick, kondylomata, fluorine.
f. Lower members: are varicose veins, edema, sores and brush on the groin.Palpation
a. To determine the size of the uterus, its consistency
b. Fetal parts, location, presentation
c. Fetal movement
The method of palpation according to Leopold (Prawiroharjo & Wiknjosastro, 2005) is:
a. Leopold 1 aims to determine the height of the uterine fundus and to find presentations by identifying what parts of the fetal body are in the fundus.
b. Leopold 2 aims to determine the left and right side of the uterus and to determine the location of the fetus and the smallest parts.
c. Leopold 3 goal to determine the bottom of the hard or not yet held up on the upper part of the pelvis.
d. Leopold 4 aims to determine what part of the fetus is lower and how far it is difficult for the fetus to enter the pelvis.Auscultation
Uliyah and Hidayat (2008) indicated that auscultation was performed using a monoaural stethoscope to listen:
- Fetal heart rate.
- Umbilical cord noise, uterine noise, bowel sounds.
- Fetal kick movement.
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