Talk with the mother
If the mother has diarrhea (loose watery stool) or other signs of illness along
with vomiting, get medical advice. She should be checked for infection, malaria,
ulcers (sores in the stomach), and parasites (harmful worms or other tiny animals
living in people’s intestines).
If the mother has parasites but they are not causing too many problems, she
should probably wait until after the birth to take medicine. Some medicines for
parasites harm the baby, especially during the first 3 months of pregnancy. If
illness from parasites is severe and the woman is not gaining weight
normally or has other signs of illness, get medical advice.
If the mother is unable to keep fluids down and stops
urinating, get medical help immediately. She may already have
severe dehydration, which is very dangerous. She will need
intravenous fluids (fluids given in the veins, which are also called
IV fluids, see page 350) and medicine. If you are trained in starting
IV fluids, start them while you are traveling to get medical help.
If other people in the area also have trouble with nausea,
vomiting, or diarrhea, there may be a problem with the local water. It will not help
to give the mother medicines for parasites if she will get parasites again from bad
water. If the water is bad, she should only drink it after boiling it or cooking with
it. See the book Where Women Have No Doctor for simple ways to purify water.
Ask if she feels weak
Healthy signs Mother has plenty of energy.
Wa r nin g sig ns Mother feels weak or tired all of the time, especially
after the 4th month.
It is normal for a pregnant woman to feel sleepy in the first 3 months
and in the last 4 to 5 weeks of pregnancy. But during the rest of
pregnancy she should have plenty of energy.
If a woman is weak or tired for a long time, she may be
suffering from one or more of the following problems:
• poor nutrition (see pages 33 to 42)
• anemia (see page 116)
• depression (see page 274)
• too much work
• illness
Help her find out what is causing her weakness. A mother who feels very weak is
more likely to have problems in labor and birth. She may have a long, difficult
labor, bleed heavily, or get an infection after the birth. Her baby is also more likely
to get sick.
A Book for Midwives (2010)
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