HEALTH EDUCATION

ANEMIA IN PREGNANCY

KELOMPOK

1. Sulastri
2. Sukmawati
3. Syarifah R. Annisa
4. Tri Wahyuti

KEMENTERIAN KESEHATAN REPUBLIK INDONESIA

POLITEKNIK KESEHATAN KALIMANTAN TIMUR
PROGRAM STUDI NERS
TAHUN 2020

 UNIT OUTREACH PROGRAM ABOUT ANEMIA IN PREGNANCY

Health problem/Nursing Dx : Lack of pregnant women knowledge about anemia in pregnancy

A. Goal and objectives

Goal : Pregnant mother are expected to understand about anemia in
pregnancy
Objective :1. The pegnant mother know the meaning of anemia in pregnancy

2. The pregnant mother know the causes of anemia in pregnancy

3. The pregnant mother know the sign and symptoms of anemia in

pregnanvy
4. The pregnant mother know the types of anemia in pregnant and
their causes risk
5.The pregnant mother know the risk factors for anemia
6. he pregnant mother know the predisposing factors for anemia
7. The pregnan know the impact of anemia on pregnancy
8. The pregnant mother know the prevent anemia in pregnancy

9. The pregnan mother know to increac Fe and Folic Acid intake.

B. Target : Dorothy and her family
C. Date : Oktober 17th 2020
D. Place : Gynecology policlinic
E. Presenter : Ns. Sulastri
F. Time (duration) : 15 minutes
G. Outline material : prevention of anemia in pregnancy
H. Media : Leaflet
I. Action Plan/Strategies :

Steps Lecture activities Client activities Duration

Introduction • Greeting • Answer the 2 minute
ques-
• Introduction : tions
introduce
identity, explain
objectives, • Agree with time
and content
 • Verify recent
condition

• Agreement
Presentation  Explain the • Actively ask 11 minute
meaning of questions and
anemia in discuss about
pregnant
the material
mother.
 Explain the • Answer
causes of questions
anemia in
pregnant
mother.
 Explain the
singn and
symptoms of
anemia in
pregnancy
 Explain the
types of
anemia in
pregnant and
their causes
risk
 Explain the
risk factors
for anemia
 Explain the
presdiposing
factors for
anemia
 Explain the
impact of
anemia on
pregnancy
 Explain the
prevent
anemia in
pregnancy
 Expalin the
increase Fe
and Folic
Acid intake
 Closing • Evaluate people Answer questions 2 minutes
knowledge
Approve the POA
• POA for people

• Greeting

J. Evaluation :
1. Participants are able to mention the meaning of anemia in pregnancy
2. Participants were able to state the causes of anemia in pregnancy
3. Participants are able to explain the sign and symptoms of anemia in pregnancy.
4. Participants are able to explain the types of anemia in pregnant their causec risk
5. Participant are able to mention the risk factors for anemia pregnancy
6. Participant are able to mention the predisposing factors for anemia
7. Participant are able to explain the impact of anemia on pregnancy
8. Participant are able to mention the prevent anemia in pregnantcy

K. Material (in detail) :

1. Definition of Anemia
Pregnancy anemia is a condition of the mother with hemoglobin levels below
11% trimester 1 and 3 levels <10.5% in trimester 2. Value limits and differences with
the condition of a nonpregnant woman occurs due to hemodilution, especially in the
2nd trimester.
Anemia is a decrease in the quantity of red blood cells in the circulation, an
abnormality hemoglobin content of red blood cells, or both (Corwin, EJ, 2009). Iron
deficiency anemia is anemia caused by a lack of iron in the body body, so the need
for iron for erythropoesis is not enough which is indicated by a picture
Hypochromic-micrositer red blood cells, serum iron levels (serum iron) and
transferrin saturation decreases, total iron capacity increases and reserves in bone
marrow and elsewhere very lacking or none at all.

2. Etiologi
Most anemia in pregnancy is caused by iron deficiency and bleeding acute, even the
two often interact with each other. Common causes of anemia are as follows:
a. Undernutrition (malnutrition)
b. Lack of iron in the diet
c. Malabsorption
d. Losing a lot of blood, such as past labor, menstruation and others
e. Chronic diseases such as pulmonary tuberculosis, intestinal worms, malaria, and
others.

3. Signs and Symptom

Signs and symptoms of anemia can include:
 a. Feelings of being easily tired, weak, fatigued, lethargic, limp (5L)
b. Headache, lost concentration
c. Nausea vomiting, anorexia
d. Often sleepy
e. Shortness of breath (in severe anemia)
f. Pale skin, mucosa, gums, fingernails and palms
g. Tachycardia or slow murmur (in severe anemia)
h. Slippery tongue, brittle hair and nails (in severe anime)

4. Types of anemia in pregnantcy and their causes

a. Iron deficiency anemia / due to iron deficiency
b. Anemia due to bleeding
c. Anemia due to inflammation / malignancy
d. Aplastic anemia due to bone marrow damage
e. Hemolytic anemia due to a short age of red blood cells
f. Megaloblastic anemia due to indigestion
g. Anemia due to hereditary diseases such as sickle cell anemia

5. Risk factors for anemia in pregnant women

a. Age <20 years or> 35 years
b. Low education
c. Acute bleeding
d. Heavy workers
e. Take blood booster tablets <90 points
f. Eat <3 times and the food consumed is less iron

6. Predisposing factors for anemia

Predisposing factors for anemia include:
a. Non-compliance in consumption of Fe
Compliance is a behavior of a person in an appropriate and periodic manner
activity. Treatment obedience behavior related to illness and with disease, service
systems, health and treatment (Notoatmodjo, 1993, in Warni,2006). The side
effects of consuming Fe in the form of stomach upsets on oral administration
reduce mass compliance, it turns out that on average only 15 tablets are used by
pregnant women.
b. Needs that increase during pregnancy
The mother's need during pregnancy is 8000mg of iron, of which 300mg is for the
placental fetus and 500 mg for increased maternal erythocytes. Thus the mother
needs additional about 2-3mg of iron / day.
c. Chronic infections, liver disease and thalassemia.

7. Impact of anemia on pregnancy

Anemia in pregnant women is not without risk, according to studies of high mortality
rates maternal anemia is closely related. Anemia also causes low physical abilities
because the cells don't get enough oxygen. In pregnant women, anemia increases
frequency of complications in pregnancy and childbirth. The risk of perinatal death
 increases. Partum and post partum bleeding are more common in women who are
anemic and more often it is fatal, because anemic women cannot tolerate the loss
Blood.
The effects of anemia in pregnancy vary, including:
a. Abortion
b. Preterm / untimely delivery
c. The labor process is long
d. Bleeding after childbirth
e. Shock
f. Infection during and after delivery
g. Sick heart
h. Babies are born prematurely
i. Maternal death
j. Babies with congenital defects
k. Lack of iron reserves
l. Fetal deat

8. How to Prevent Anemia in Pregnantcy.

a. By taking 1 tablet of blood booster every day once it is known that the woman is
pregnant and advised to consume green vegetables. Eat foods that contain
balanced nutrition (4 healthy 5 perfect) and increase the consumption of food
contains iron such as vegetables and fruits.
b. Eat foods rich in iron sources regularly.
c. Eat foods rich in vitamin C sources to facilitate iron absorption.
d. Avoid drinking tea, coffee, chocolate milk after meals because they can inhibit
absorption iron.
e. By controlling birth spacing and limiting pregnancy by being a family planning
participant.

9. How to Increase the Intake of Fe and Folic Acid

a. Consumption of animal protein (meat, poultry, seafoods, eggs, milk, and their
processed products)
b. Consume food sources of folic acid (asparagus, spinach, beans, beef liver, peas,
nuts ground, orange juice, almonds, brown / mashed rice, cauliflower, eggs,
lettuce, instant cereal)
c. Increase your intake of fresh orange and red fruits (oranges, bananas, kiwi,
watermelon, pineapple)
d. Consume fortified foods (milk, cheese, ice cream, flour-based foods)
e. Consumption of vitamin C, to increase iron abortion in the intestine
f. Consume food sources of vitamin B12 (meat, liver, fish, fermented foods, yogurt,
shrimp, milk)
g. If you need to add supplements of vitamin B12, Fe and vitamin C.
h. Consume green vegetables at least 3 servings / day
i. Consumption of fruit juices rich in vitamin C at least 1 gls / day
THERAPEUTIC COMMUNICATION SCENARIO

Orientation  Good morning Mrs. Dorothy…

How are you to day? Do you have
time to talk about anemia in pregnant
women? Because from the results of
the examination, you are diagnosed
with anemia.
 My name is Ns. Sulastri. I came here
according with our agreement that
we have agreed on.
 Ok. Before I start…let me give
leaflets about anemia in pregnancy.
 Then let’s just start our discussion
today about anemia in pregnancy..

Stage of work  Ok…Do you know about anemia in

pregnancy? What caused it? How are
the sign and symptoms? Then how is
the treatment? Good….It seems that
Mrs. Dorothy knows a little about
anemia in pregnancy.
 Now..we will understand what is
hanemia in pregnancy? Pregnancy
anemia is a condition of the mother
with hemoglobin levels below 11%
trimester 1 and 3 levels <10.5% in
trimester 2. Value limits and
differences with the condition of a
nonpregnant woman occurs due
to hemodilution, especially in the 2nd
trimester
 Do you know what causes it? Most
anemia in pregnancy is caused by
iron deficiency and bleeding acute,
even the two often interact with each
other. Common causes of anemia are
as follows: Undernutrition
(malnutrition), Lack of iron in the
 diet, Malabsorption, Losing a lot of
blood, such as past labor,
menstruation and others, Chronic
diseases such as pulmonary
tuberculosis, intestinal worms,
malaria, and others.
 Do you know the signs and
symptoms of anemia in pregnancy?
Ok…I will explain what the sign and
symptoms are anemia in pregnancy.
Signs and symptoms of anemia can
include are Feelings of being easily
tired, weak, fatigued, lethargic, limp
(5L), headache, lost concentration,
nausea vomiting, anorexia, often
sleepy, Shortness of breath (in severe
anemia), Pale skin, mucosa, gums,
fingernails and palms, Tachycardia
or slow murmur (in severe anemia),
Slippery tongue, brittle hair and nails
(in severe anime)
 Now… I will explain about types of
anemia in pregnancy. Types of
anemia in pregnantcy and their
causes are iron deficiency anemia /
due to iron deficiency, anemia due to
bleeding, anemia due to
inflammation / malignancy, aplastic
anemia due to bone marrow damage,
hemolytic anemia due to a short age
of red blood cells, megaloblastic
anemia due to indigestion, anemia
due to hereditary diseases such as
sickle cell anemia. Are you
understand Mrs. Dorothy? Ok…I
will continue the explanation of
presdiposing factor of anemia.
 Predisposing factors for anemia
include:
a. Non-compliance in consumption
of Fe . Compliance is a behavior
of a person in an appropriate and
periodic manner
activity. Treatment obedience
behavior related to illness and
with disease, service systems,
 health and treatment
(Notoatmodjo, 1993, in
Warni,2006). The side effects of
consuming Fe in the form of
stomach upsets on oral
administration reduce mass
compliance, it turns out that on
average only 15 tablets are used
by pregnant women.
b. Needs that increase during
pregnancy. The mother's need
during pregnancy is 8000mg of
iron, of which 300mg is for the
placental fetus and 500 mg for
increased maternal
erythocytes. Thus the mother
needs additional about 2-3mg of
iron / day.
c. Chronic infections, liver disease
and thalassemia.
 The next topic is the impact of
anemia on pregnancy. Anemia in
pregnant women is not without risk,
according to studies of high mortality
rates maternal anemia is closely
related. Anemia also causes low
physical abilities because the cells
don't get enough oxygen. In pregnant
women, anemia increases frequency
of complications in pregnancy and
childbirth. The risk of perinatal death
increases. Partum and post partum
bleeding are more common in
women who are anemic and more
often it is fatal, because anemic
women cannot tolerate the loss
Blood.
The effects of anemia in pregnancy
vary, including:
a. Abortion
b. Preterm / untimely delivery
c. The labor process is long
d. Bleeding after childbirth
e. Shock
f. Infection during and after
delivery
 g. Sick heart
h. Babies are born prematurely
i. Maternal death
j. Babies with congenital defects
k. Lack of iron reserves
l. Fetal deat
 Mrs. Dorothy….Do you have
anything to ask? Ok….so you have
experienced the impact of anemia, so
it needs futher management. And
now I will explain how to prevent it
and how to increase to intake of Fe
and Folic Acid.
 How to Prevent Anemia in
Pregnantcy.
a. By taking 1 tablet of blood
booster every day once it is
known that the woman is
pregnant and advised to consume
green vegetables. Eat foods that
contain balanced nutrition (4
healthy 5 perfect) and increase
the consumption of food contains
iron such as vegetables and fruits.
b. Eat foods rich in iron sources
regularly.
c. Eat foods rich in vitamin C
sources to facilitate iron
absorption.
d. Avoid drinking tea, coffee,
chocolate milk after meals
because they can inhibit
absorption iron.
e. By controlling birth spacing and
limiting pregnancy by being a
family planning participant.
 How to Increase the Intake of Fe and
Folic Acid
a. Consumption of animal protein
(meat, poultry, seafoods, eggs,
milk, and their processed
products)
b. Consume food sources of folic
acid (asparagus, spinach, beans,
beef liver, peas, nuts ground,
orange juice, almonds, brown /
 mashed rice, cauliflower, eggs,
lettuce, instant cereal)
c. Increase your intake of fresh
orange and red fruits (oranges,
bananas, kiwi, watermelon,
pineapple)
d. Consume fortified foods (milk,
cheese, ice cream, flour-based
foods)
e. Consumption of vitamin C, to
increase iron abortion in the
intestine
f. Consume food sources of vitamin
B12 (meat, liver, fish, fermented
foods, yogurt, shrimp, milk)
g. If you need to add supplements
of vitamin B12, Fe and vitamin
C.
h. Consume green vegetables at
least 3 servings / day
i. Consumption of fruit juices rich
in vitamin C at least 1 gls / day

Termination  From the explanation above, do you

understand?
 Ok…to evaluate, I will leave some
quertion for you.
 So…what are the sign and symptoms
of anemia in pregnancy?
 Good…you already understand it.
 The next question…how to prevent
and increase the intake of Fe and
Folic Acid?
Good…I think you can understand
what I have explained. I hope you
and your family will do it at home
and always take care of your health.
 Ok…That’s all the information…
You are very enthusiastic and
cooperative in this discussion. We
are very happy to meet you.
Hopefully I can help you for some
other time. If you have anything…
please come to the Health Center. I
hope all of us are always in health.
Thank you….Good afternoon…