Health Promotion And Counseling

Important Topics for Health Promotion and Counseling

■ Screening for domestic violence

Counseling about nutrition and exercise is important to the health of the pregnant woman and baby. Evaluate the nutritional status of the woman at the first prenatal visit, including a diet history, measurement of height and weight, and screening for anemia by checking the hematocrit. Be sure to explore the woman's habits and attitudes about eating and weight gain, as well as her use of needed vitamin and mineral supplements. Develop a nutrition plan that is appropriate to the woman's cultural preferences. Be sure there is a balanced increase in calories and protein, since protein will be used for energy, rather than growth, unless sufficient calories are consumed. Women with low incomes should be helped to obtain additional food. At each visit, monitor weight gain and review nutritional goals for women at risk.

Ideal weight gain during pregnancy follows a pattern: very little gain the first trimester, rapid increase in the second, and a mild slowing of the increase in the third trimester. Women should be weighed at each visit, with the results plotted on a graph for the woman and health care provider to review and discuss.

Recommended Total Weight Gain Ranges for Pregnant Women

Prepregnancy

Weight-for-Height Category

Recommended Total Gain

lb kg

Low (BMI <19.8)

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