Dr. A. Ananie Arkutu, FRCOG
Regina C. Faul-Doyle
Smart Design Inc.
Layout and production by
Family Care International, Inc.
588 Broadway, Suite 503, New York, NY 10012, USA
Tel: (212) 941-5300 Fax: (212) 941-5563
This book is dedicated to my wife, Joy, and to my daughters, Ayele, Norvishi, and Senanu.
A very special thanks to Ann Starrs for her tireless and invaluable assistance with editing, testing, and producing this publication, and for her encouragement and support. My thanks also to Caryn Levitt, Rikka Trangsrud, and other staff at FCI for their help in the production and review process. Finally, I would like to express my appreciation to the following people for their cooperation and contributions to the publication of this book:
Editorial review of text and illustrations by:
Joan Combellick, C.N.M. Sylvia Deganus, M.D., Komfo-Anokye Teaching Hospital, Kumasi, Ghana
Betty Farrell, American College of Nurse-Midwives
Staff from the Family Planning Association of Kenya (FPAK)
Jane Ferguson, Adolescent Health Programme, World Health Organization Barbara Kwast, MotherCare
J.M. Kyallo, African Medical and Research Foundation (AMREF), Nairobi, Kenya
Margaret Marshall, American College of Nurse-Midwives
Mary Memia, African Medical and Research Foundation (AMREF), Nairobi, Kenya
Susan Murray, Institute of Child Health, University of London
Elizabeth Odai, Senior Nursing Officer, Dodowa Rural Health Post, Ghana
Chinyelu Okafor, University of Nigeria/Enugu Campus, Nigeria
Joyce Safe, Chief Nursing Officer, Ministry of Health, Tanzania
Assistance in pre-testing was provided by:
Mabel Magowe, Midwifery Training Programme, Institute of Health Sciences, Gaborone Staff at United Nations Children's Fund, Gaborone Gladys Mogapi and other staff at Princess Marina Hospital, Gaborone
Mrs. Kate Agyei-Sakyi, Midwifery Training School, Koforidua
Julianna Lamptey, Adabraka Polyclinic, Accra
Dr. Henrietta Odoi-Agyarko and staff at the Maternal Child Health/Family Planning Unit, Ministry of Health, Accra
Stella Nyinah, Safe Motherhood Programme Officer, UNICEF/Accra
Gertrude Owusu and other staff from the Health Education Unit, Ministry of Health, Accra
Staff at Prampram Health Post, Dangme-West District
Members of the Safe Motherhood Task Force
Dr. J. Taylor, Department of Obstetrics/Gynaecology, Central Hospital, Koforidua
Staff at the following clinics of the Family Planning Association of Kenya (FPAK):
Thika, Ribiero, Eastleigh, Phoenix House, and Nakuru
Florence Manguyu and staff, Kenya Medical Women's Association
Staff at Training Unit, Ministry of Health, Nairobi
Staff at National Council of Churches of Kenya (NCCK)
Safe Motherhood Officers, Health Zone A
Mrs. Augustine Ifesma Ezeilo, Abakpa-Nike Health Centre, Enugu
R.E.N. Ugwu, State MCH/FP Coordinator, Ministry of Health, Enugu
Staff at Uwani Health Centre, Enugu-South
Dr. A. Ananie Arkutu works with the United Nations Population Fund (UNFPA).
The views and opinions expressed in this book are those of the author and not necessarily those of UNFPA.
© Family Care International Inc., 1995. Second Edition. Printed in the USA.
Not-for-profit organisations may use any of the material in this publication freely as long as it is not used for commercial purposes. FCI would appreciate acknowledgements and copies when possible.
Photo Credits (cover): UNICEF/90-061/Nigeria/Sean Sprague, UNICEF/90-046/Mauritania/Lauren Goodsmith,
UNICEF/86-022/Kenya/Yann Gamblin, UNICEF/89-033/Mozambique/John Isaac,
UN Photo Library 11528621 Burkina Faso/Kay Muldoon.