Chapter 7: Learning a pregnant woman’s health history
Did she have a very long labor or a long pushing stage?
Was her labor longer than 24 hours for a first baby, or longer than 12 hours for
other babies (see page 186)? Did she push for more than 2 hours? Ask if her long
labor caused problems for her or her baby. If that birth was healthy and the baby
was OK, then she will probably not have a problem with this birth. If that birth
was not normal, ask her if she knows why the labor was long. Did she have
anemia? Was the baby in a difficult position or very big? Was she very afraid? You
may need to get medical advice.
D id she hav e a fi stula?
If she had a long labor leading to a fistula (an opening in the tissue of the vagina)
she should have this birth in a hospital. (See page 273.)
Did she have a very short labor (less than 3 hours)?
If the mother had a very short labor in the past, make sure she and her family
know what to do if you do not get there in time. You can teach the family how to
deliver a baby in an emergency.
Did she have an early birth?
If she had a baby born more than a month
early, ask her if she has signs of bacterial
vaginosis (BV, see page 328). Bacterial vaginosis
can lead to early births. Be ready in case this baby is
early too, and watch for signs of labor. (See page 149.)
Did she have a small baby
(less than 2.5 kilograms or 5 pounds)?
Find out if the baby was born early (it is normal for early
babies to be small). If the baby came on time, ask the
mother if she had anemia, high blood pressure, or
pre-eclampsia. Also ask if she had enough to eat, or if she
smoked cigarettes or used drugs. Any of these things could
have made the baby small.
Check to see if this baby is growing normally. If you think this baby may be
very small for her age, the mother should probably give birth in or near a medical
center, because small babies can have more health
problems. (See pages 221 and 256.)
Did she have a big baby
(over 4 kilograms or 9 pounds)?
Ask if the birth was difficult. If it was not, this birth
will probably be OK too. Look for signs of diabetes
(see page 115). Check carefully to see if this baby seems
big too. If possible, have the mother tested for diabetes.
A Book for Midwives (2010)