CHAPTER ONE

INTRODUCTION

1.1 Background

Pregnancy is a normal process that results in a series of both physiological and psychosocial changes in the women. Some of these are temporary changes that occur only during pregnancy (Lowdermilk and Perry, 2007). Most pregnant women suffer from minor disorders during their pregnancy period. These minor disorders are due to hormonal and metabolic changes (Amasha sand Heeba, 2013). Symptoms of disorders are different from women to women through the different months of pregnancy. The prevalence of minor disorders is varying according to its type. Nausea and vomiting (morning sickness) are of the most common disorders of the early pregnancy. Nausea and vomiting appear early in the first trimester (6 to 8 weeks) and subside by the end of 12 weeks of pregnancy’s. If nausea and vomiting increase, women should be taken a piece of dry toast before getting up, small meals of high quality (protein) food. According to Avosor and Keskin (2012), fainting occurring in the first and second trimesters due to vasodilatation occurring under the influence of progesterone increasing of blood volume. To improve fainting the ladies should be measuring the blood pressure, avoiding hard work, rest increasing fluids and taking balanced diet.

Fatigue occurs primary during the first and third trimester of pregnancy. In the first trimesters fatigue is usually related to physiological and hormonal changes. During the third trimester fatigue is usually related to physical disorders and inability to sleeping. To improve fatigue, the mother is advised to eat healthy food, taking naps during the day, increasing time exercise, and practicing relaxation techniques (Rice, 2006). According to Rosy, (2010), hormonal change may cause headache during pregnancy especially during the first trimester. To relieve from headache the ladies are advised to take rest, proper nutrition and adequate fluid intake which may help alleviate headache, symptoms. In severe headache the ladies go to the doctor to take medicine. Heart burn is common during pregnancy particularly during the last trimester, it is described painful retrosternal burning sensation.

In some studies the prevalence of heart burns has been found to increase from 22.0% in the first trimester to 39.0% in the second trimester and 60.0% to 70.0% in the third trimester women are advised to avoid spicy food, increase milk and milk productions and warm fluid (Archer, 2006). Backache more than two third of the pregnant women experience back pain and almost one fifth experience pelvic pain. The pain increases with advancing pregnancy and interferes with work daily activities and sleep. Pennick and Young (2007), reported that backache improves by exercise program and postural education given to the women as early in the pregnancy as possible which may prevent back pain or decrease pain. Many women experience leg cramps in the second trimester of pregnancy. Both calcium and sodium chloride appear to help reduce leg cramps in the pregnancy (Jewell and Young, 2000). Dyspnea or shortness of breath occurred in 60.0% of pregnant women. Dyspnea may occur during the first trimester because of the progesterone. During the latter half of pregnancy these symptoms result from the pressure of the uterus pushing upward on the diaphragm. It may be relieved by advising the women to sleep on additional pillows. Maintains good posture decreases anxiety as well as taking deep breathing (Klossner and Hatfied, 2010).

Pregnancy is presumed to be a major contributory factor to the increased incidence of varicose vein in the women which can in turn lead to venous insuffiency and leg edema. Most common symptoms of varicose vein and edema are substantial pain experienced as well as night cramps numbness, tingling and the legs may feel heavy, varicose may develop in up to 40.0% of pregnant women. Varicose vein often improves three to four months following birth and edema generally reduces soon after birth (Bamigboye and Hofmer, 2006).

Insomnia in later weeks of pregnancy may have a variety of causes including physical disorder and stress. To relieving from insomnia, the pregnant women should be taking warm baths before bed time and pillow in a way that promotes rest (Orsohan, 2008). Constipation is a common problem in late of pregnancy circulating progesterone may be causes of showering gastroinstinal movement in mild and later pregnancy. Constipation often improves by intake of dietary supplements in the form of bran, if the problem fails to resolve, stimulant laxative are likely to prove more effective (Iewel and Youn, 2000).

In early pregnancy, women experience urinary frequency from the growing uterus compressing the bladder. Pregnant women often are fatigue because of nocturia and increased metabolic requirement. One cause of frequent urination in the first trimester is the increasing blood all diminishes during second trimester, only to reappear in their volume and increasing glomerular –filtration rates. According to lowdermilk et al. (2010), high level of estrogen in pregnancy results in marked shedding of superficial mucosal cell in vaginal discharge, (Leucorrhea) some relieving measures are the avoidance of tight clothing the mother should wear cotton underwear, washing with plain water twice a day and medicine as doctors order.

During pregnancy the ladies refuse taking any medicine to relieve minor disorders because any drugs may affect on the fetal development. Therefore, most women in developing countries return to their traditional or cultural practices. These women adhere to traditional practices aimed to restoring their health and preventing themselves and their babies from developing illness (Ngenda et al., 2003). The nurse can help pregnant with the appositive experience by providing information, suggestion, emotional support and ongoing reassurance to the mother and her partner. So, the nurse can focus on special needs of the pregnant adolescents to promote optimal maternal- child health. Few studies have addressed issues around minor disorders in pregnancy in Sub-Saharan Africa and in Cameroon in particular. Therefore this study aims at assessing the knowledge of pregnant women on minor disorders during pregnancy at the Mount Mary Hospital.

1.2 Problem Statement

Approximately 810 women die every day from preventable causes related to pregnancy and childbirth around the world. Global maternal deaths estimated that about 295,000 women died during and following pregnancy and childbirth. The vast majority of these deaths (94%) occurred in low-resource settings, and most could have been prevented. The maternal mortality ratio (467 per 100,000 live births) and infant mortality rates (48 per 1000 live births) in Cameroon remain extremely high despite numerous efforts put by government and NGOs (CDHS, 2018). Many women experience minor ailments during pregnancy. These ailments should be treated properly as they may escalate and become life threatening and contribute to maternal and infant mortality rates in LMICs. Minor ailments may occur due to hormonal changes & accommodation changes of every system of the body. The mother needs knowledge to cope with the experience of pregnancy. During pregnancy the ladies refuse taking any medicine to relieve minor disorders because any drugs may affect on the fetal development. Therefore, most women in developing countries return to their traditional or cultural practices. These women adhere to traditional practices aimed to restoring their health and preventing themselves and their babies from developing illness (Ngenda et al., 2003). I witnessed 5 cases at the MMH on minor disorders, among the 5 cases just 1 had knowledge about minor disorder in pregnancy and how to manage it, the remaining 4 cases had no knowledge about it and how to manage it. So I took it upon myself to carry out this reseach in order to assess their knowledge and teach them strategies to manage this minor disorders in pregnancy.

1.3 Rationale

Studies on minor acute illness during pregnancy suggest that despite being non-life threatening, the high prevalence of these conditions has a major effect on productivity and may have profound impact on the lives of pregnant women and their families. Yet, surveillance of so-called “minor ailments” during pregnancy is virtually non-existent in developing countries; this lack of reliable data impedes proper assessment of the disease burden and is a barrier to effective planning of control and preventive activities (Mudaliar, 2005). The investigator in her own experience in the hospital and community internship found that most pregnant women showed a poor knowledge about minor disorders and their remedial measures. Many mothers revealed misconceptions and misbeliefs about taking home remedies for the minor disorders of pregnancy. Most of them ignored their health owing to lack of health awareness. So, the investigator felt that there was a need to give sufficient health education regarding minor disorders and their home management.

1.4 Research Questions

1. What is the knowledge of pregnant women on minor disorders during pregnancy at the Mount Mary Hospital?
2. What are the various minor disorders experienced by pregnant women at the Mount Mary Hospital?
3. What are the management strategies by pregnant women regarding minor disorders during pregnancy at the Mount Mary Hospital

  1.5.1General objective:

The main objective of this study is to assess knowledge of pregnant women on minor disorders during pregnancy at the Mount Mary Hospital.

1.5.2 Specific objectives

1. To assess the knowledge of pregnant women on minor disorders during pregnancy at the Mount Mary Hospital.
2. To identify the various minor disorders experienced by pregnant women at the Mount Mary Hospital.
3. To evaluate the management strategies by pregnant women regarding minor disorders during pregnancy at the Mount Mary Hospital.