Special Needs of Women 161
Family planning and good care during pregnancy and birth
Fallen womb (prolapse). If a woman has been pregnant
often, had long labors, or pushed too early during labor, the
muscles and ligaments that hold up her womb may have
become weak. When this happens the womb can fall part
or all of the way into the vagina. This is called a prolapse.
• leaking urine
• in severe cases, the cervix can be
seen at the opening of the vagina
• Space children at least 2 years apart.
• During labor, push only when the cervix is fully open and
there is a strong need to push. Never let anyone push
down on your womb to get the baby out quickly.
Urine leaking from the vagina (fistula). If a baby’s head
presses too long against the wall of the vagina during labor,
the vaginal tissue may be damaged. Urine or stool may leak
out of the vagina. For more information, see page 370.
• Wait to get pregnant until your body is fully grown.
• Get medical help if labor goes on too long.
• Space babies at least 2 years apart so that your muscles
can get strong again in between pregnancies.
Vaccinations against tetanus
Tetanus is an infection that kills. A woman can get tetanus when a germ
that lives in the stools of people or animals enters her body through a wound.
Although anyone can get tetanus, women and babies are especially at risk during
childbirth. Tetanus can enter the body if an instrument that is not properly
disinfected is put into the womb or used to cut the baby’s cord.
All girls and pregnant women
should be vaccinated against
tetanus. If a woman is pregnant
and has not been vaccinated,
she should have an injection at
her first prenatal checkup, and a
second injection at least a month
later. Then, if possible, she should
follow the rest of the schedule.
Tetanus immunization schedule:
No. 1: at first visit
No. 2: at least 1 month after first injection
No. 3: at least 6 months after 2nd injection
No. 4: at least 1 year after 3rd injection
No. 5: at least 1 year after 4th injection
Then get an injection once every 10 years.
Where Women Have No Doctor 2012