Nursing Care for Pre-marital Care

- Prepared by

Primary healthcare guide

- Premarital Care Program

General Objective:

To provide comprehensive care for couples about to marry that ensures protection of both spouses from the transmission of diseases that affect the life or health of either of them or the health of their offspring.

Specific Objectives:

·       Detecting chronic diseases and providing counseling and health, psychological, and social support to both parties.

·       Detecting hereditary diseases that may be passed on to their children and providing counseling about them to prevent the birth of children carrying these diseases.

·       Detecting and treating infectious genital diseases and providing counseling on ways to prevent and reduce them.

Expected Results of Implementing the National Program for the Care of Couples About to Marry:

First: At the Individual and Family Level

·       Increasing health awareness of sound principles and scientific foundations for building a healthy family.

·       Choosing a suitable marriage partner to avoid having children with hereditary diseases.

·       Reducing the social and psychological problems of families whose children suffer from hereditary diseases.

·       Reducing divorce cases that may result from problems related to chronic diseases and childbearing.

Second: At the National Level:

·       Increasing the utilization rate of health services and the resulting improvement in health standards.

·       Reducing the spread of infectious and hereditary diseases.

·       Building a generation free of hereditary diseases.

·       Reducing the financial burden resulting from treating people with hereditary or infectious diseases.

·       Providing allocations from the state budget for treating many diseases that could be prevented, and directing these budgets to other areas.

- Components of Premarital Care Services

The components of premarital care services include the following:­

Medical Examination:

    Includes the following:

·       Health, medical, and family history

·       External physical examination

Laboratory tests:

-  Mandatory tests: including a complete blood count, Rh factor determination, and a random blood sugar test.

-  Supplementary (optional) tests: determined through health, medical, and family history, external clinical examination, and informed counseling, such as semen analysis and hepatitis B and C testing.

Counseling

     Includes the following:

-  Counseling on the health condition according to the results of the medical examination

-  Counseling on marriage and reproductive health, which includes:-

·       Health education on a healthy marital relationship and correcting misconceptions and false beliefs.

·       Information about pregnancy, how it occurs, its signs, and the benefits of prenatal care.

·       Emphasizing the benefits of folic acid in preventing birth defects.

·       Information about childbirth and the importance of giving birth in health facilities.

·       Information about family planning methods and appropriate methods for delaying the first pregnancy.

·       Information about newborn care.

Health Awareness and Education

General information on healthy dietary patterns and disease prevention.

Genetic Counseling:

Genetic counseling services are provided for cases where the health, family, and medical history and family tree chart indicate a suspicion of hereditary diseases that may be passed on to offspring.

Vaccinations (optional):

 For those not previously vaccinated: rubella vaccination for girls and hepatitis B vaccination for both parties.

Health Education for Couples About to Marry

General Objective: To build the capacity of the medical team so that it can create the desire and intention in the beneficiary (male/female) to adopt healthy patterns and behaviors in various aspects of daily life and avoid behaviors that may affect their safety and the safety of their offspring.    

Proper Nutrition

Food is essential for the human body to perform its various functions actively, efficiently, and vitally. Food is a mixture of different substances, some of which supply the body with energy, some of which carry out growth, building, and repair of damaged tissue, and some of which also protect against disease and boost the body's immunity.

Characteristics of an Ideal Healthy Diet:

·       It should contain all the nutrients needed by the body, in addition to an adequate amount of dietary fiber.

·       It should be free of any chemical contaminants or substances harmful to health.

·       It should be appetizing and appealing in appearance.

·       It should suit the prevailing dietary habits in society.

·       It should be commensurate with the family's economic situation.

Important Food Groups for the Body:

The Energy Group:

·       This group supplies the body with the energy needed to perform work and carry out the body's basic vital processes, and is divided into:-

·       Carbohydrates, which include starchy foods: such as rice, pasta, and bread, grains and tubers such as potatoes, sweet potatoes, and taro.

·       Sugary foods: such as sweets, sugar, jams, and honey.

·       Fats: such as animal fats and various types of oils.

·       The body prefers to burn carbohydrates first to generate energy, even though fats contain more calories (9 kilocalories per gram compared to 4 kilocalories per gram for carbohydrates).

·       The body needs a certain amount of fat because it needs the essential fatty acids found in these foods.

The Building Group: (Proteins):

These are necessary for growth, renewal of body cells, and replacement of lost cells. This group includes various types of proteins, some of animal origin such as meat, eggs, fish, poultry, and dairy, and some of plant origin such as legumes of all kinds, like fava beans, lentils, black-eyed peas, chickpeas, and beans.

Protective Foods (Vitamins):

·       These are necessary for disease prevention and increasing the body's resistance, and are found in fresh vegetables and fruits.

·       A balanced diet must contain all the previously mentioned elements together, in addition to a dairy product to provide the calcium needed for bone building in the body.

·       A meal does not have to be expensive; many balanced meals can be made that give the body what it needs at the lowest possible cost.

-Female Genital Mutilation

Definition:

·       This is the removal of part or all of a girl's external genitalia, specifically the clitoris, in addition to the labia minora and labia majora.

·       FGM is one of the outdated traditions in some societies that has no connection to religion, and it has drawn attention due to the many health and social problems it causes, which threaten the wellbeing of many families.

Egyptian law criminalizes female genital mutilation.

·       FGM does not eliminate sexual desire, since desire depends on psychological and neurological factors linked to the brain, but it reduces a woman's natural sensation and may sometimes lead to complete sexual frigidity.

Degrees of FGM:

·       First degree: Removal of the clitoral hood or part or all of the clitoris.

·       Second degree: Removal of the clitoris and part or all of the labia minora.

·       Third degree: Removal of the clitoris and labia minora, then cutting and stitching together the labia majora, leaving a small opening for urine and menstrual blood.

Complications of FGM:

Short-term complications:

·       Bleeding.

·       Infections and microbial infection.

·       Severe pain, which may cause neurogenic shock.

·       Urinary retention due to severe pain.

·       Injury to the urethra or anus.

§  Death.

Long-term complications:

·       Deformity of the external genitalia and the formation of painful scars.

·       Pelvic congestion and pain during intercourse.

·       Infertility.

·       Chronic urinary tract infections.

·       Psychological harm: feelings of inadequacy, distorted self-image among girls, and fear of the marital relationship.

·       Sexual harm: sexual frigidity and diminished sensation.

·       Social harm: discord and tension in married life, and divorce.

-Early Marriage and Pregnancy

 - Early marriage is widespread in many developing countries, and many girls are married off as soon as they reach puberty.

Early Marriage

      Early marriage causes many health and social problems for the following reasons:-

·       Lack of physical and psychological readiness for family life.

·       Lack of information regarding reproduction and reproductive health.

·       Early pregnancy.

·       The husband's lack of attention to his wife's health.

·       Lack of communication between spouses.

Delaying marriage to a suitable age is important so that physical maturity is complete, especially for the girl, which makes pregnancy and childbirth go more safely and reduces the risks the woman is exposed to during them, and also reduces the negative effects on bone growth.

Also, the mental maturity of both parties to the marriage is very important to enable them to understand the meaning of marriage and the requirements of family life, and to make future decisions related to childbearing wisely and knowledgeably. In addition, raising children requires sound judgment and physical strength to help the couple fulfill their roles fully.

Early Pregnancy:

·       Pregnancy and miscarriage problems are among the leading causes of death among mothers under the age of 20.

·       Most women refuse to use family planning methods at the beginning of marriage and before having their first child, out of fear of infertility, which is a completely false belief.

Consequences and Problems Resulting from Early Pregnancy:

·       Decreased life expectancy for the girl.

·       Negative impact on general health, nutrition, and educational and employment opportunities.

·       Limits the woman's ability to support herself and her family in the future.

·       Negatively affects the upbringing and care of children.

Note: The optimal age for pregnancy and childbearing is between 20-35 years.

Health Problems of Early Pregnancy and Childbearing:

Young mothers are always at risk of:-

·       Preeclampsia and pregnancy-related hypertension: one of the most dangerous pregnancy problems, with many complications that can endanger the life of the mother and fetus.

·       Difficult labor due to incomplete development of the pelvic bones.

·       Iron-deficiency anemia: (increased need for this vital element among girls under the age of 20)

·       Miscarriage and unsafe abortion.

·       Increased likelihood of death during childbirth compared to mothers over the age of 20.

Note: Comprehensive medical care and prenatal follow-up reduce the occurrence of complications during pregnancy and allow early detection of any problems, especially for those under the age of 20.

Risks of Early Pregnancy to Newborns:

·       Increased rates of miscarriage, premature birth, and fetal death in the womb.

·       Delayed fetal growth in the womb and low birth weight: it was found that babies born to women under the age of 20 are 2-6 times more likely to have a low birth weight due to premature birth and delayed fetal growth in the womb.

·       The mother's young age reduces her ability to breastfeed due to lack of experience, which exposes the newborn to disrupted growth, weakened immunity, and greater susceptibility to disease and infection, which increases neonatal mortality rates and deaths during the first year.

Psychological and Social Effects of Early Pregnancy:

·       Psychological effects: depression, loss of self-confidence, and lack of ambition.

·       Negative effects on the husband: some young men experience psychological and social pressures due to early parenthood, especially if they are forced to take on additional work to increase income, which reduces their chances of completing their education and improving their living conditions.

·       Negative effects on the child itself: due to the parents' lack of experience in dealing with the newborn, which leads to an increase in neonatal mortality rates.

-Smoking

Smoking is a harmful behavior with negative health and economic effects that impact the smoker, their family, those around them, and society as well.

Reasons for the Spread of Smoking:

Social reasons:-

·       Family disruption and disintegration.

·       Imitating adults such as parents and relatives.

·       The widespread availability of cigarettes and their advertising through all media.

Psychological reasons:

·       Frustration and trying to escape reality and get rid of problems.

·       Trying to feel a sense of manhood.

·       Keeping bad company.

·       Nervous tension and stress resulting from social and economic pressures such as unemployment.

·       Idle time not put to good use.

Effects of Smoking on Pregnant Women:

Smoking causes health problems for pregnant women that affect both the mother and the fetus. Smoking leads to poor nutrition in the pregnant woman due to loss of appetite, and it also increases rates of miscarriage. Smoking also causes delayed fetal growth in the womb.

Other Negative Effects of Smoking:

·       Increased incidence of cardiovascular disease.

·       Increased incidence of lung cancer by 20%.

·       Increased incidence of lung infections and respiratory tract infections.

·       Decreased physical fitness and capacity for exertion.

·       Increased chance of death, 1.5 times greater than normal.

Note: Secondhand smoke has effects as serious as active smoking.

mlang en} - References {mlang}

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