More than 90 percent of maternal deaths that occur world wide occur in Africa and this is highly unacceptable.

Most of these deaths that occur in Africa are preventable.

We can help change the narrative.

Follow my blog as I share information on pregnancy, labor and delivery. I will also share news on Maternal health and new research that will help promote maternal health in Africa.

Also watch out for videos, books and events that will help promote maternal health.

Invite all parents, expectant mums to follow my blog.

Together we can!

Let’s end the needless maternal deaths. No woman should die bringing life into the world.


Have you wondered what the midwife might be looking for especially when she is examining your bumb? Let me make it simple for you.. I have also been lost once

Abdominal examination is part of the general examination done by the midwife for all expectant mums. This is one of the crucial ones since you are pregnant

She will first ask you to empty your bladder and position you on a comfortable bed or couch. She provides privacy and exposes your abdomen.

She inspects your abdomen for the skin color, scars, size, shape and also the strae. All this has its meaning. A previous scar can let her know you had a previous surgery and it will be used in your care

You will also notice that she uses her palm to palpate or feel what is in your abdomen. She is trying to find out how your baby is lying and presenting. Meaning is baby coming with head first, buttocks or some other part?

⛔Fundal height measurements
She will also take note of the uppermost part of the womb called the fundus. The midwife will use a tape measure to measure the length of your bump. She has her reference points. This is very crucial because it gives her an estimation of how old or how well your baby is growing. Example if you are 20 weeks your bump should also be + or – 2 (18 to 22) . Any figure within this is considered normal. If your Bump is 20cm and you are already 30 weeks your midwife will raise an alert there could be growth restriction. If you are 20 weeks gestation and bump is already 30cm with a singleton it also raises alarm. There could be a problem. Twin gestations usually have higher fundal heights. Always compare it to the previous reading to know if your bump is growing. Your midwife only starts measuring when your uterus is palpable meaning she can feel it.

⛔Auscultation /Fetal heart
She will also listen to the fetal heart of the baby with the Fetoscope to make sure she hears your babies heartbeat.. You may be lucky to hear as well. This is unlikely if the pregnancy is in the early stage.

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In all she does

  1. Palpation
    3.Fundal height measurement
  2. Auscultation /listen to the fetal heart

She may not be able to figure out everything, give her every information example previous surgeries, medical conditions like ulcer etc..

It will be done at each visit. Ask questions to know how your pregnancy is doing.



34 year old Finland Prime Minister

In Ghana paid maternity leave lasts for just 84 days, ln reality less than 3 months and this is just for the woman. This has become a major concern for many women since they have to leave their babies that early to resume work.

What makes it even worse is that our facilities are not baby friendly. There are no nursery’s and many women begin to have struggles how to keep their jobs and care for the little ones.

Men have no paid leave compounding the problem of the new mother. She does not get the support of her husband/partner and will have to struggle alone.

Babies tend to suffer and some end up getting sick due to the inadequate care and poor breastfeeding practice they end up receiving.

The Finnish government, led by a 34 year old woman, which was only appointed in December, said both parents would get a paid leave allowance of #164 days, or around 6.6 months paid leave.

The pregnant parent also can receive one month of pregnancy allowance even before the parental leave starts. #wow!

The new policy is designed to be gender-neutral and will come into effect as soon as fall 2021. It will eliminate gender-based allowances that currently grant about four months of paid leave to mothers and about two months to fathers.

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Parents will be permitted to transfer 69 days from their own quota to the other parent. A single parent will have access to the allowance for both parents.

The government estimates that the increased leave will cost 100 million euros (about $110 million). Reuters reports that Finland’s previous center-right government explored parental leave reform in 2018 but decided it would be too expensive.

This is one of the measures they are putting in place to help encourage women to have babies and also help to their population to grow. Finland is said to have an aging population.

This measure will also give both men and women equal opportunities to take part in the care of their new born.

It is my hope that we in Africa, especially Ghana will put measures in place to protect the new born child. They are the future of this country!

There will be increased productivity if women are given a conducive environment, that supports breastfeeding and child care at work.

Men’s should be given some paid leave to support their partners who have just given birth.

And yes before I end this write up… Yes we understand the economies are different, our problems are different! But we can start from some where

Finally Kudos to #GuinessGhana for the introduction of their extended maternity leave to six months.

Waiting for the next company/organization to bring policies that will support child bearing women and breastfeeding in Ghana

Share your thoughts!

midwifesally #finland #paidmaternityleave



Sign of an infected cord include

Infected cord

The umbilical cord is a very good place for infection to get into your baby’s body.


🔴Swelling of the stamp and abnormal discharge

🔴Offensive smell from the stamp

🔴The cord may also take long before detaching.

Always make sure the cord area is kept dry and clean

Do not apply substances that your doctor/midwife has not prescribed.

Always wash your hands and use sterile cotton as well as the prescribed solution recommended by your midwife to dress cord.

Report immediately to the hospital if you notice cord bleeding or any sign of infection.

Neonatal sepsis is real!!!







This is exactly what you should expect

🔴Baby will cry right after birth. The cry will not be weak

🔴The skin color will be pink. Blue or pale skin is an indication of reduced oxygen. Report yellowish skin color as well

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🔴Weight will be between an average of 2.5 to 3.5kg. Babies who are underweight or over weight may need extra care.

🔴Baby will breath with ease between 40 to 60 cpm

🔴The heart rate/pulse will be also checked and it should read between 110 to 160 bpm

🔴Baby will be active.

New born baby with a good skin color

🔴Baby will also be able to breastfeed. Report if baby cannot latch on the breast

🔴Also examine your new born from head to toe. Report any abnormality you see. Check the back as well and report any abnormality.

🔴If baby does not pass meconium or urine in the first few days. Report as soon as possible.

🔴A new born vomiting, having high temperature or convulsing is not normal as well.

🔴Baby may need some resuscitation and some extra care if the above indications are not present. Alert your health care professional right away.

🔴Don’t be afraid to ask your midwife how your child is doing. It’s your right to be informed.

Contact me on +233242281957 or email ruthsallykodam@gmail.com. Thank you. Share.





Keep Her Happy

This is one of the questions most new couples who are expecting for the first time will ask.

While some are scared it can cause miscarriage others believe it can result in developmental problems

Some men will also completely avoid their wives with the intention of protecting the unborn baby and also to give their partners some space.

Some women will also avoid having sex due to the hormonal and emotional changes that occur with pregnancy

It is worth knowing that sex during pregnancy is #safe and does not pose a problem to the mum or unborn baby. Baby is enclosed in its sac/membranes and the opening of the uterus the cervix is also closed. It also has a mucus plan that prevents any thing from entering the uterus.

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What is important is to have considerations. The pregnancy hormones and the early signs and symptoms can make a woman not to desire to be intimate. It’s important for her partner to be considerate to support her through the process. There are times she will want to be intimate, there are times she will refrain. Make use of her happy days.

Some few women who have had repeated abortions or threatened abortions may be advised by their doctors or midwives to avoid sex especially if an incompetent cervix is diagnosed.

Couples can have sex throughout the pregnancy period. It is only to be avoided when your doctor or midwife advises you against it due to your health condition or as mentioned above.

During the last trimester, couples can still have sex. What is needed is to assume a position that will not put pressure on the abdomen and also the woman will be comfortable. It should also be gentle.

During the last trimester when labor is about to set in, it is believed to help trigger the onset of labor. The semen also contains prostaglandin which also helps to soften the cervix and help labor to start.

Its also important to know that, you really do not need sex to maintain your pregnancy. Baby is safe and mum is also safe. Women should not be compelled to have sex if they don’t feel like or are currently not in any relationship whilst pregnant. Labor will still be initiated naturally. Just keep a healthy life style.

It’s important for women to feel supported and loved during pregnancy. Helping her to stay emotionally stable will help her have a positive outcome of pregnancy.

Mum and baby needs your love

Tell her you love her, support her, remind her to stay healthy, and keep her happy. Above all be intimate with her. You will be her Hero…

Also discuss all your concerns about sex before deciding what to do. Remember having unprotected sex during pregnancy (STI) can still result in sexually transmitted infection. Use a barrier method to prevent STI.

Ladies, it’s important that you maintain your personal hygiene daily. Doing this will boost your confidence and also help you to stay emotionally sound. You are very prone to infections during pregnancy due to the hormonal changes. Do take care of yourself and report immediately to the hospital if you have any signs of infection example.. Pain during sexual intercourse, burning sensation during urination, lower abdominal pain, itchy vulva and severe abdominal pains.

If after sex you have spotting, bleeding or severe lower abdominal pain during pregnancy, Put a stop to it. Report to the hospital for further investigations and care. Thank you

Share your thoughts as well.

Join our support group on Facebook- Mumschat (Reproductive and Child Health) to learn more.






Healthy weight during pregnancy

The dream of most women during pregnancy is to be able to maintain her weight and to regain the shape she had before getting pregnant. But this does not happen for most women.

It’s very important that we know what is healthy and what is not during pregnancy.

Have you heard the saying “during pregnancy you need to eat for two” Do we really understand this? Does it mean you have to double your food or you increase the amount?

This statement is true, but during pregnancy what it really means is for you to increase the quality of your food. The nutritional content of your food should be improved to meet the demands of the growing fetus.

The amount of calories you need during pregnancy are as follows

1,800 calories per day in the 1st trimester
2,200 calories per day in the 2nd trimester
2,400 calories per day in the 3rd trimester

Just increasing the amount of food you eat without necessarily increasing its nutritional value will only end up giving you extra weight which you may not need after birth. Pay key attention to the nutritional component of every meal you eat during pregnancy. Ask your self, which nutrient will I get if I eat this meal.?Will it add value to me or just add calories I may end up not needing after birth?

It’s important to know how much weight is healthy during pregnancy. Here is a guide

If your weight range before becoming pregnant  was (BMI 18.5-24.9), ideally you should gain between 11.5 kg to16 kg by the end of your pregnancy. 1 to 1.5 kg in the first three months then 1.5 to 2 kg each month until you give birth. If you are above the healthy weight range, you should gain less.

The weight gain is mostly as a result of the baby. There is an increase in blood volume, breast tissue and the uterus. Hormones also play a key role in the weight gain during pregnancy

Always report if you realize you are gaining excess weight or your wait gain has reduced.

Your meal should contain a variety of food from all the six food groups, especially proteins, vitamins, minerals, carbohydrates, and fats and oil. They should be in adequate quantities.

Do not forget that you are what you eat and the outcome of your pregnancy will be a reflection of your nutritional status during pregnancy as well as other important factors.

Make sure whatever you eat is nutritious.

Babies weight adds up to your weight gain during pregnancy

Some tips to help you maintain a healthy weight during pregnancy include:

  • As I said earlier increase the nutritional value of your meal and not necessarily the amount
  • Take healthy snacks, like fruits and vegetables. Nuts etc.
  • In between your meals breakfast, lunch and supper when you feel hungry instead of going for a whole meal again. Take more fruits and vegetables. Nuts and some protein foods make you full as well as Feel satisfied but will not give you that extra calorie you do not need. Fruits and vegetables have lots of nutrients to nourish your baby as well.
  • Exercise is a great way to maintain healthy weight during pregnancy. It keeps you fit and healthy. You can walk or perform activities that will keep you active.
  • Rest in-between your activities.
  • Take enough water so you stay hydrated and healthy
  • Instead of taking lots of processed foods and fast foods eat foods that are whole and unprocessed
  • Juice or drinks made from fresh fruits are healthier options for expectant mums
  • Mums who are diagnosed with gestational diabetes should take their medication to keep insulin levels under control.
  • You can also book an appointment with a nutritionist to help you plan your meals.
  • Take your prescribed haematinics. This can help make up for the nutrients that may not be available in your food.
Fruits helps maintain a healthy weight


Passive exercises, walks etc

Exclusive breastfeeding

If you had a caesarian section make sure your doctor has confirmed you are fit and wound completely healed before doing any vigorous exercise.

Take more fruits and vegetables. water etc

After you have delivered continue to eat nutritious meals, lots of water etc

If you had extra calories you need to speak to a nutritionist to help plan your diet. It’s key.

Reduce carbohydrates, fats and oil. Food should be nutritious.

It is also worth noting that after delivery once the pregnancy hormones start falling. You will loose lots of the fluid your body retained during pregnancy. Make sure you are fit before starting any weight loss regime. Ask your doctor or midwife if it’s OK for you to start any.

Kindly share your thoughts. What worked for you during pregnancy?


Labor is the process by which the fetus and the placenta leave the uterus. It can be through cesarean or vaginally. This article focuses on what to expect during vaginally delivery and also ways to make it easier.

How will you feel when you are empowered with most of the information you need to have before having your baby? You will feel secured, confident and not scared about the outcome of labor.

It is therefore important for all expectant mums to know what to expect during labor and delivery and even beyond. This will also help them to make informed choices.

Note: Before labor begins make sure you have made a birth plan and also make sure your home and items needed for the safe arrival of your baby are made ready.

Mums should know that labor consist of three stages:

In the first stage:, the cervix dilates from 1 cm to 10 cm. The cervix which is the opening of the womb must be fully open (10 cm) before the midwife or the gynecologist allows you to push out your baby. Contractions are also present which makes it a painful experience. Some of the things you can do to make your first stage labor easier include:

  • Walk around in the comfort of your home or hospital if your waters have not broken.
  • Take a lot of fluids example water and fruit juice.
  • Conversing or chatting with friends and love ones that will help to take your mind of the pain.
  • Having a sacral massage from your partner, nurse or midwife.
  • Having a warm shower.
  • Listening to soft music.
  • Swimming if your waters have not broken yet.
  • Performing deep breathing exercise during contractions.
  • Watch a video that to child birth.
  • Eat enough food.
  • Ensure enough rest and comfort to preserve your energy.
  • Ensure a safe environment.
  • Do not push or bear down during the first stage of labor since it can cause your cervix to tear which wil
  • l result in profuse bleeding.
  • Feel free to discuss your fears with your midwife.
Sally’s Pregnancy School. +233242281957

The second stage starts when the cervix is fully dilated and ends when the baby is born. An this stage the woman will need strength to push out the baby. The midwife will skillfully guide her through the process so she will have her baby born without any complications to herself and her baby. Some important things that will make the second stage easier include:

  • It will be beneficial for the woman to know and practice the type of delivery position they will have to use. Examples, squatting, standing or lying on your back .Practicing the position you will love to use helps you to become familiar with that position and also become more comfortable with it.
  • Practice kegel’s exercise to reduce tearing of the perineum and improve healing after having perinea tear. This exercise strengthens the perinea muscles and also reduces the threshold of pain during delivery.
  • It is important for the new mum to know how to perform deep breathing exercise during contractions to reduce the threshold of pain.
  • The woman should also rest between contractions and only push when contractions are present.
  • It is also important to corporate with your midwife to make the labor experience a memorable one.
  • Midwives should be vested with all the skills they need to have to reduce birth injuries and complications.

After the baby is born, it is dried and put on the mother’s abdomen for kangaroo mother care and the initiation of breast feeding. The cord is clamped and cut preferably after cord has stopped pulsating.

The third stage is the delivery of the placenta. There is a gush of blood from the uterus, the cord lengthenes and the uterus is the palpated below the umbilical level.

  • The woman should co-operate with the midwife so that the placenta comes out fully. If portion of the placenta remain in the uterus, it will cause bleeding and later infections.
  • The midwife would have to inspect the placenta well to make sure that all parts are complete and that the woman’s perineum is well cleaned and inspected. All tears should also be repaired.

After this, the woman is cleaned she is made comfortable in bed, her vital signs and important observation are made and recorded. The woman is then transferred to the ward and peperium begins. Remember to report any sign of dizziness, fainting and heavy bleeding to your midwife just after your delivery.

Remember to take good care of yourself and your baby especially within the first six weeks. Report immediately of there is any abnormality or you feel ill.

Share your birth experience with me.



A must read!

Many interpretations exist for “Asram”  This is what mums had to say about it.

Opinions from Mumschat

1.I know Asram to be an evil spirit given to baby.its given to baby through their dress,cot shit like every thing that has to do with the baby’s things. Its not be given to baby when u are washing the dresses or cot sheet u add blue to wash.The Asram can kill a baby ,I know my cousin son died through that because she refused to wash the boys dresses or cot sheet with blue water. So is like when you give birth and anytime you are washing the baby dresses or cot shit, you must add blue to the water to prevent anyone who is having that evil spirit from giving the baby that spirit

2.You can get while pregnant, especially those who like eating flour food,kenkey,gari,and buy tomatoes without covering it ,with the food, is eating it in public. Indiscret eating.

3.Asram is when your baby refuse to grow
Asram retards growth of children they grow up and become  smaller in size than their real age

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4.Asram is generally growth retardation or malnutrition especially marasmus with the way it is described

Mums who experienced it also shared their experience

1.I went to “nipa hia mmoa” for herbal medicine against asram when i was pregnant (superstition nkoaa)

2.Hmm.When I gave birth my baby had a line on the frontal head and so many veins were visible on the head. When he was shaved my inlaw said its asram eei,i never missed my antenatal drugs too.
So we started seeing a herbalist and he is ok now.
I was a first tym mum so I didnt know anything abt it mpo

Some mums do not also believe it exists..

1.There’s no asram, eat well, take ur medication n pray during ur pregnancy. It shall be well

2.Usually when a baby is not ‘so well’ , then they term it as such. Upon proper diagnosis, it could be hydrocephalous, malnutrition,jaundice or even colic.  
Let me leave the spiritualities for the elders

A seasoned nurse who works with children in Ghana has shared her view on what Asram is and how it could be prevented. In her live presentation she made it clear to mums that “ Asram is basically, malnutrition,dehydration, infections etc and lack of proper care.

She encouraged parents to exclusively breastfeed their babies,  give nutritious complementary foods and also protect their children from infections.

It’s also important that women report to the clinic early when their children are sick for early diagnosis and treatment.  Follow the link to watch the video.

Good for your baby’s skin

https://www.facebook.com/groups/382839082183194/permalink/781147822352316/  kindly watch.


Many women within active reproductive years, still avoid family planning even when it is readily available and cheap.

One of the leading causes of maternal deaths/complications in early pregnancy is due to unsafe abortion.

In trying to find awnsers, I interviewed three women who had a recent abortion. To actually understand why with services widely available in the city, they still refuse to take any method of contraception. Only a question was asked. Why didn’t you take steps to avoid pregnancy when you knew you did not want to be pregnant now?

First client, a mum of 3 children with the eldest child 7 years. Currently pregnant

“Hmmm, people say it is not. And when I do it it can cause me to have very bad complications “

Second client says she uses an emergency contraception every time she has sex. She uses it as a method of contraception. She does not use regular family planning methods because she believes they are not safe for her. She has used some methods before but stopped because of misconceptions and myths around family planning. She has no idea emergency contraceptives are not meant for everyday use.

Thirdly, I interviewed a gentleman. His mother in law has told them not to use family planning methods since they are dangerous. He has never received in depth education on family planning.

Two clients lived in Ashaiman and one in Tema, all in the capital of Ghana, Accra.

It is evident that many women avoid family planning due to the myths that surround it. Information received is not from trained health personnel. This is a huge setback to the use of contraception.

It is will be very beneficial if women should consider the risk associated with unplanned pregnancy and unsafe abortions. They are more expensive and can be costly. It can as well disrupt your plans. There is also the risk of bleeding due to an unsafe abortion, infection and sometimes affects women psychologically.

It’s also unsafe and risky to use abortions as a means of contraception.

More education is needed to help couples who do not plan to get pregnant use modern methods of contraception to avoid unwanted pregnancies and all the problems associated with it.


Swolen hands and feet during pregnancy

🔴During pregnancy you may realize that your feet and arms are swollen. It does not occur in every woman. Your ring, bracelets or anklets become tight on you.

🔴Some may be due to the natural changes that occur during pregnancy. In this case you realize though your hands and feet are swollen, your BP and urine protein and other vitals are normal. You may not need any treatment. It will go away after pregnancy

Sally’s Pregnancy School. +233242281957

🔴On the other hand, you have swollen hands and feet. It comes along with other signs and symptoms like #headache, #highblood pressure, #protein in urine and #epigastricpain.

🔴It’s important to report swollen hands and feet to your health care provider to rule out other conditions like pre eclampsia. The earlier it is detected the better the out come.

🔴To reduce the swelling…. It is adviced that…

  1. Do not assume a particular position for a long time. Sit-walk-rest. Mix your activities
  2. When sitting you can rest your feet on a small chair
  3. During sleep rest the legs on pillows. The next morning you will realize it has reduced

4.Your nutritionist will also advise on dietary changes.

You may not be able to tell whether it’s the normal one or not. Talk to your doctor about swollen hands and feet. If diagnosed with pre eclampsia kindly adhere to treatment. It is the leading cause of maternal health complications In Ghana.

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