Maternal health

 Standards for maternal health management services

1. Service object:

Pregnant and lying-in women who are resident in the jurisdiction.

2. Service content:

(1) Early pregnancy health management:

Establish a "Mother and Child Health Handbook" for pregnant women before 13 weeks of gestation, and conduct the first prenatal check-up.

1. Carry out early pregnancy health education and guidance.

2. Before 13 weeks of gestation, the "Mother and Child Health Handbook" shall be established by the township health center and community health service center where the pregnant woman lives.

3. Assessment of pregnant women’s health status: inquire about past history, family history, personal history, etc., observe posture, spirit, etc., and perform general physical examination, gynecological examination, blood routine, urine routine, blood type, liver function, kidney function, hepatitis B, In areas where conditions permit, laboratory tests such as blood sugar, vaginal secretions, syphilis serology test, and HIV antibody test are recommended.

4. Carry out early pregnancy lifestyle, psychological and nutritional health care guidance, with special emphasis on avoiding the adverse effects of teratogenic factors and diseases on embryos, and at the same time inform and supervise pregnant women to carry out prenatal screening and prenatal diagnosis.

5. Fill out the first prenatal check-up service record form based on the examination results. For pregnant women who have pregnancy risk factors and may have pregnancy contraindications or serious complications, promptly refer to the higher-level medical and health institutions, and follow-up transfer within 2 weeks Diagnosis results.

Maternal health

(2) Health management in the second trimester:

1. Conduct health education and guidance in the second trimester (16-20 weeks and 21-24 weeks each).

2. Assessment of pregnant women's health: through inquiry, observation, general physical examination, obstetric examination, and laboratory examination to assess the health of pregnant women and the growth and development of the fetus, and identify high-risk key pregnant women who need prenatal diagnosis and referral.

3. For pregnant women who have not been found to be abnormal, in addition to guidance on lifestyle, psychology, exercise and nutrition during pregnancy, pregnant women should also be informed and supervised to carry out prenatal screening and prenatal diagnosis for the prevention of birth defects.

4. For pregnant women who are found to have abnormalities, they should be transferred to the higher-level medical and health institutions in time. Pregnant women with critical signs should be immediately referred to a higher-level medical and health institution, and the results of the referral should be followed up within 2 weeks.

(3) Health management in the third trimester of pregnancy:

1. Carry out health education and guidance in the third trimester of pregnancy (28 to 36 weeks and 37 to 40 weeks each).

2. Develop self-monitoring methods for pregnant and lying-in women, promote natural childbirth, breastfeeding, and guidance on prevention and treatment of complications and comorbidities during pregnancy.

3. For high-risk pregnant women found in the follow-up, they should be urged to increase the number of follow-ups as appropriate according to the recommendations of the medical and health institutions. If a high-risk situation is found during the follow-up, it is recommended that the patient be referred in time.

(4) Postpartum visit:

Township health centers, village clinics, and community health service centers (stations), after receiving the delivery information from the delivery hospital, should go to the mother’s home for postpartum visits within one week after the mother is discharged from the hospital, conduct health management during the puerperium, and strengthen breast milk Feeding and newborn care instructions, and newborn visits at the same time.

1. Through observation, inquiry and examination, understand the general condition of the parturient, breast, uterus, lochia, perineum or abdominal wound recovery, etc.

2. Provide puerperium health care guidance to the parturient, and deal with problems such as breastfeeding difficulties, postpartum constipation, hemorrhoids, perineum or abdominal wounds.

3. Parturients who are found to have puerperal infection, postpartum hemorrhage, poor uterine involution, unrecovered pregnancy complications, and postpartum depression, should be promptly transferred to a higher-level medical and health institution for further examination, diagnosis and treatment.

4. Understand the basic situation of the newborn through observation, inquiry and inspection.

(5) Health check-up for 42 days postpartum:

1. Township health centers and community health service centers will perform postpartum health check-ups for normal parturients, while abnormal parturients go to the original delivery medical and health institutions for check-ups.

2. Through inquiry, observation, general physical examination and gynecological examination, if necessary, auxiliary examinations are performed to evaluate the recovery of the parturient.

3. Mental health care, sexual health care and contraception, prevention of reproductive tract infections, exclusive breastfeeding for 6 months, and maternal and infant nutrition should be given to mothers.

Four, service requirements:

(1) Township health centers and community health service centers that carry out health management of pregnant and lying-in women shall have the basic equipment and conditions required for services.

(2) In accordance with the relevant regulations and requirements of national maternal health care, the whole-process tracking and management of pregnant women shall be carried out. Personnel engaged in maternal health management services shall obtain corresponding practicing qualifications and receive professional technical training in maternal health care.

(3) Strengthen the contact with relevant departments of the village (neighborhood) committee and the Women's Federation, and grasp the information on the pregnant and lying-in women population in the jurisdiction.

(4) Strengthen publicity, publicize free service content in primary medical and health institutions, so that more women of childbearing age are willing to receive services, and increase the rate of early pregnancy establishment.

(5) Record relevant information in time after each service and include it in the maternal health file.

(6) Actively use traditional Chinese medicine methods (such as daily diet, emotional adjustment, diet, medicated diet, postpartum rehabilitation, etc.) to carry out health care services during pregnancy, puerperium, and lactation.

(7) Primary-level medical and health institutions qualified for midwifery technical services will conduct two follow-up visits to pregnant women in the second trimester and the third trimester. Primary medical and health institutions that do not have the qualifications for midwifery technical services urge pregnant women to go to qualified institutions for relevant follow-up.

Five, work indicators:

(1) The rate of early pregnancy registration = the number of mothers who established the registration book before 13 weeks of gestation and undergoes the first antenatal check-up in the jurisdiction/the number of live births in that place during this time period × 100%.

(2) Postpartum visit rate = the number of parturients who received postpartum visits within 28 days after the mothers were discharged from the hospital/the number of live births in the place within that time × 100%.