section 1
Waiting is good!
pre-natal
meeting
1
Let’s review:
Once the meeting starts, welcome everyone and ask the participants: • Who can help us remember what we talked about in our last meeting? • Who was able to do the activity at home that we asked you to do at the end of the meeting? How did it go? • Does anyone have questions or concerns after doing the activity?
What are we going to learn?
The importance of picking the best time to get pregnant and how long to wait before you get pregnant again (Not having your children spaced too close together), for the health of the mother and her children. Let’s talk about it! We are going to look at some pictures, so we can talk about what we all know about this topic. How many children should a family have? Why?
How often should parents have children? Why do you think so? Based on what we’ve been talking about: How many children do you plan on having and how will you space out their births? Why?
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Activity:
“A little bag of dreams” We are going to make a little bag of dreams for every child we have and hope to have.
What we’ll need: • Small bags
WHAT WE’LL DO: • Markers • Ask the parents at the meeting to remember when they were children. What dreams did they have for • Small pieces of colored paper or their future? Did they want something different from index cards what their parents had? Did they want to be teachers, • Pens or pencils athletes, doctors? What happened to those dreams? • Tell them that one of the advantages of spacing out pregnancies is the possibility of offering them a better life, a life that is different from the one we had. Ask what dreams they have for their children. • Now ask them to take one bag for each child they have and one bag for each child they hope to have down the road. Now tell them to put the name of each child on the bag, even the ones who have not been born yet. • In each bag they will put pieces of paper with the dreams they have for their children, for their health, their education, their work, their families, etc. For example, on one paper they could write: ‘I hope he always gets good grades;” another could say: “I hope he has a uniform and shoes to go to school”... It can be anything, any dream. Note: those who can’t read can draw a picture of their hopes for their children. • When they finish filling the bags of every child, tell them that these dreams represent their responsibility to every child, and so we have to do the best we can, with the help of God to make the dreams in those bags come true. • Tell them to keep the little bags of dreams to give them to their children when they are old enough to understand and talk about their own dreams. Some day your children can even make a little bag of their dreams! Other suggestions: • The subject of spacing between pregnancies has to do with family planning, a subject that is taboo in some cultural contexts. It might be a good idea to talk about the myths surrounding family planning. For example: • What can we tell a woman whose husband won’t let her use contraceptives or another type of family planning because he thinks it’s will allow her to be unfaithful to him? • What can we tell parents who believe that family planning is sinful? • What do the community and the husbands think of women who want to wait a while before having another child? • What do we tell a woman who thinks she won’t get pregnant because she is nursing? • Another reason we can give for why mothers should space out pregnancies is because they value themselves. It is a well known fact that women’s bodies get worn out or tired with every pregnancy, especially when they are spaced too close together. • Ask the women if they have noticed the change in the health and bodies of women who have had many children.
Facilitator’s Manual
3 • Every woman should ask herself: “How much do I love myself?... If I really love myself I will take good care of my body.) • You can have a discussion about traditional and modern types of family planning with their pros and cons. There are posters and brochures on family planning in health clinics. You can plan a visit with the whole group to look for information and clarify any doubts the participants may have and to explain how each method works.
Summing up:
What did we learn today? Now, we’ll review what we discussed today. • How do you feel after this meeting? Why? • What are the two most important things you’ve learned today? • What will you do differently based on what you learned during the meeting? • What did you like the most? Are there things you didn’t like? • Do you have any remaining concerns or questions about what we talked about? To finish, what would you recommend to improve today’s meeting when we do it again with another group. (Explain that answering this question will help the meeting be even better in the future for parents with small children.)
To do at home:
• Discuss with your spouse how many children you would like to have and how you want to space out the pregnancies. • Decide with your spouse what method of family planning you would like to use.
Basic information for the facilitator: Learning more about waiting: 1- Timing births
• P regnancy and birth before the age of 18 increases the risk of dying among mothers and newborns. Young mothers experience more health complications such as early births, small size newborns and low birth weight. The safest time to have babies is between the age of 18 and 35 years old. The social consequences of teenage pregnancy are: dropping out of school, leaving home, and the loss of opportunities for recreation and peer socialization. After the age of 35, the health risks of pregnancy and childbirth begin to increase again. If a woman is over the age of 35 and has had four or more pregnancies, another pregnancy is a serious risk to her own health and that of the baby. She should not deliver at home!
2- Spacing births
• For the health of both mothers and children, couples should make sure there is a space of at least two years between the last birth and the new pregnancy.
section 1 / pre-natal • meeting 1
4 • After a miscarriage or abortion, women should wait at least six months before getting pregnant again. • A woman’s body needs two years to recover fully from pregnancy and childbirth. So, the risk to the mother’s health is greater if births come too close together. The mother needs time to get her health and energy back before she becomes pregnant again. Women who get pregnant too often do not have time for themselves or for their husbands; they have too much work to do; they are always tired, they don’t have energy to properly care for their children; they don’t have time to help children with their school work; they have to spend their money on feeding and clothing their children, and there is little left to spend on themselves. There is no time for resting. • Men need to be aware of the importance of a two-year space between birth and pregnancy and the need to limit the number of pregnancies to help protect their family’s health. Spacing pregnancies is also good for fathers because it is easier to find the money to educate fewer children who are about three years apart. Too many children born too close together means greater financial burdens for the father and the mother. • One of the greatest threats to the health and growth of a child under the age of two is the birth of a new baby to his or her mother. Breastfeeding for the older child stops too soon and the mother has less time to prepare the special foods a young child needs. She may not be able to give the older child the care and attention he or she needs, especially when the child is ill. As a result, children born less than two years apart usually do not develop as well, physically or mentally, as children born two years apart or more.
3- Appropriate number of children
• Husbands and wives should decide together how many children they can love and take care of properly. They should know that the health risks of pregnancy and childbirth increase after four pregnancies. • If the husband is not willing to time or space pregnancies, his wife has the right to get family planning services from a health professional.
4- Family planning services
• Couples should know about modern and traditional family planning methods that are safe, accessible, convenient and acceptable. This will help them plan when to begin having children, how many to have, how far apart to have them and when to stop. • Of the various contraceptive methods, only condoms protect against both pregnancy and sexually transmitted infections, including HIV. • Exclusive breastfeeding for the first six months of a baby’s life can delay the return of the mother’s fertility for approximately six months after childbirth. Exclusive breastfeeding provides a woman with 98 per cent protection from pregnancy, but only if her baby is under the age of six months, her menstrual periods have not returned, and the baby is breastfed on demand and exclusively — receiving no other foods or drinks.
5- Consequences of too many pregnancies on women’s health and general well being
• A woman’s body can easily become exhausted by repeated pregnancies, childbirth, breastfeeding and caring for small children. After four pregnancies, especially if there has been less than two years between births, she faces an increased risk of serious health problems such as anemia (‘thin blood’), decalcification and hemorrhage (heavy loss of blood). A baby is at greater risk of dying if the mother has had four or more pregnancies. • Women can also have other health issues such as the uterus falling down and pressing on the bladder and causing urinary problems. This is very frequent in women with many deliveries.
Facilitator’s Manual