Planning and preparing for a baby on its way is a fantastic experience for any couple but, like anything new, it can also be quite daunting especially for first time pregnant mothers.
As such, antenatal, also called prenatal classes,or childbirth education, come in handy to prepare for the moms’ upcoming labour, birth and first few weeks with their newborn baby.
A team of health experts in Rwanda, launched the first public prenatal class on Saturday, not just to provide information but also demystify myths surrounding pregnancy as well demystify hospital procedures, and provide a forum for questions mothers forget or have no time to ask their gynecologist.
The classes that were launched on Saturday not only target pregnant mothers but also their spouses and caretakers.
“When a woman finds out she’s pregnant, she’s given a lot of advice from friends and relatives, and sometimes health experts. This is why it’s important to get prenatal classes, to find out the truth,” Mohammed Okasha, a gynecologist from Legacy Clinics, suggests.
Birthing the idea
The idea was first introduced last year, during the sixth Rwanda Society of Obstetricians and Gynecologists conference. One of the proposed policies, was classes organised in a casual setting, to provide expectant mothers correct information from obstetricians, midwives, pediatricians, physiotherapists and nutritionists, who otherwise, do not have ample time to talk to them and answer their milliard of questions, during clinical visits.
The prenatal classes aim at creating interactive discussion between health experts and the public to answer prenatal and postnatal questions. Photos by Sharon Kantengwa.
Christine Ashimwe, founder of Rwanda Clot Awareness Network (RCAN), who is part of the steering committee, spearheaded the initiative. As a survivor of thrombosis that resulted from pregnancy, she realised the need for expectant mothers to access information surrounding pregnancy and its health risks.
“The reason we came up with this program, is because pregnancy is a risk factor of blood clots and we realised that many pregnant women don’t know that blood clots are related to pregnancy, hormonal imbalance or even preeclampsia.
I derived it from a research I conducted in the antenatal units of three referral hospitals in Kigali city in 2017, which showed that out of the 150 pregnant women interviewed, only 14 had some knowledge about blood clots. We realised that regardless of the social class and the woman’s educational background, the knowledge of blood clots is always the same,” she says.
A panel of health experts that shared information regarding pregnancy.
For Ashimwe, thrombosis is however, just one drop in an ocean. There are so many other issues that pregnant women deal with, mostly first time mothers, and find solutions without some knowledge.
“Back in the days, mothers were for example told that after delivery, they had to tie a cloth around their waist to put it back in shape but that’s dangerous as it causes other health issues.
As someone who experienced a fatal blood clot because of pregnancy, I woke up and was joined by policy makers and the steering committee we launched the antenatal classes. These classes will therefore be having well prepared material because doctors will take their time in preparing these questions, and the discussions with doctors have to be as casual as they can be, she says.
Involving men in the classes
The classes however, also involve men which organisers feel is important, especially spouses of expectant mothers. This is because most of the aspects of these classes are not only pregnancy related issues, but also about the care rendered to the expectant mothers.
“Men, for example, need to learn that they should not be involved in quarrels and harsh talk because it has a psychological effect on the foetus. Also, he has a role to play in ensuring that the mother has to be well taken care of,” she says.
Childbirth education should cover all aspects of pregnancy and birth as well as how to care for mom and her new born baby. We are therefore going to emphasise that during the classes, we register couples and that they attend the classes because we know the importance of having the support of a spouse especially this critical topic like pregnancy, Ashimwe says.
She adds that even though the classes are targeted for expectant couples it’s also important that all people attend, to equip people with the right information to use when taking care of mothers.
“Even though we have a target group, we would like to build a system in our society whereby whoever knows someone pregnant should be able to help because someone can signal out something that you had not seen. For example in 2016, my auntie is the one who realised that I had a swelling in my knee and that was then that I was diagnosed with preeclampsia.”
With thrombosis, the symptoms come within a blink of an eye and if nothing is done and the person doesn’t get timely medical attention, they can die. So we need to have information shared across different categories of people whereby at least we are going to have some people who have some information and will help others, she says.
The next prenatal classes will resume in May and will come with different topics to be discussed such as labour, hygiene, breastfeeding.
Besides the prenatal classes, RCAN every year organises public awareness campaigns, ahead of the world thrombosis awareness day. According to Ashimwe, this year’s event will be high key as Rwanda was selected among the few countries to get support from the International Society on Thrombosis and Haemostasis, in terms of public relations and communications globally. The focus of the awareness campaign will be on young people between the ages of 16 to 21 and the initiative will be taken to schools to create more awareness.
RCAN also takes the campaign to corporate offices, to spread the awareness around thrombosis.
Health experts demystify myths around pregnancy
At the launch several health experts answered questions and gave information on issues related to pregnancy. Here are some of the beliefs and myths that the doctors, addressed.
It’s a false belief that pregnant mothers need to eat for two. There are no extra calories needed during pregnancy save for the last 12 weeks. Only 200 calories per day are needed and that is like two slices of bread.
Regarding weight that bothers most pregnant mothers, so many factors are determined such body mass index (BMI) and weight before pregnancy doctors however recommend avoiding dieting and losing weight during pregnancy.
Fish is allowed during pregnancy but only two portions per week, because they contain mercury, toxic for the baby’s brain. Liver is rich in iron but also contain high levels of vitamin A which is toxic for the baby for the nervous system of the baby. It’s not recommended to eat liver throughout pregnancy. Consuming peanut during pregnancy is believed to bring allergy to the baby but they are not related. There are some infections related to food which can bring infection that can affect both mother and baby. Raw cheese, raw eggs, raw and half cooked meat should be avoided. Cravings are mostly psychological but in some cases, even outside pregnancy, it is caused by anaemia, although there isn’t a clear explanation for the cause of cravings.
Mohammed Okasha, Gynecologist
Breastfeeding doesn’t cause breasts to sag.
Infant formula is not the same as breast milk, as it has no antibodies, living cells, enzymes or hormones that protect the baby from infections and diseases later in life. Working mothers can preserve breastmilk in the freezer for six months for the baby, but should not substitute it with infant formula.
Occasionally, there are clinical reasons for not breastfeeding and only then can infant formula be recommended.
Majority of people do not mind breastfeeding in public and the more it is done, the more normal it will be.
Almost all women are physically able to breastfeed and can produce the amount of milk their babies need.
Stephenson Musiime, Pediatrician