Family Health

Unit 6:

Family Health

‫‪English for the Students of Public Health‬‬

‫ ‪156‬‬

‫آﺷﻨﺎﻳﻲ ﺑﺎ ﻣﺘﻦ ﻫﺎي درس‬ ‫درس ﺷﺶ داراي ﺳﻪ ﻣﺘﻦ ﺟﺪاﮔﺎﻧﻪ اﺳﺖ‪ (1):‬ﻣﺘﻦ اﺻﻠﻲ)‪(Reading‬؛ )‪(2‬ﻣﺘﻦ ﺧﻮاﻧﺪﻧﻲ‬ ‫اﺿﺎﻓﻲ )‪(Further Reading‬؛ )‪(3‬ﻣﺘﻦ ﻛﺎﻣﻞ ﻛﺮدﻧﻲ)‪.(Cloze‬‬ ‫ﻣﺘﻦ اﺻﻠﻲ ﺗﺤﺖ ﻋﻨﻮان ‪ Safe Motherhood‬ﺑﻪ اﻳﻨﻜﻪ ﭼﮕﻮﻧﻪ ﻣﺎدران ﺑﻪ دﻟﻴﻞ‬ ‫ﺑﺎرداري و زاﻳﻤﺎن در ﻣﻌﺮض ﻣﺮگ ﻗﺮار ﻣﻲ ﮔﻴﺮﻧﺪ ﻣﻲ ﭘﺮدازد‪.‬‬ ‫ﻣﺘﻦ ﺧﻮاﻧﺪﻧﻲ اﺿﺎﻓﻲ ﺗﺤﺖ ﻋﻨﻮان‬

‫‪in Action‬‬

‫‪ Safe Motherhood‬ﺑﻪ‬

‫ﻓﻌﺎﻟﻴﺖ ﻫﺎﻳﻲ اﺷﺎره دارد ﻛﻪ ﻣﺮاﻗﺒﺖ ﻛﻨﻨﺪﮔﺎن ﻣﺎدران ﻣﺎﻧﻨﺪ ﻣﺎﻣﺎﻫﺎ ﻣﻲ ﺗﻮاﻧﻨﺪ ﺑﺮاي ﺣﻔﻆ‬ ‫ﺳﻼﻣﺖ ﻣﺎدران اﻧﺠﺎم دﻫﻨﺪ‪.‬‬ ‫ﻣﺘﻦ ﻛﺎﻣﻞ ﻛﺮدﻧﻲ ‪The World Health Organization Global Database‬‬ ‫‪on Child Growth and Malnutrition: methodology and applications‬‬ ‫ﺣﺎوي ﭼﻜﻴﺪه ﻳﻚ ﻣﻘﺎﻟﺔ ﭘﮋوﻫﺸﻲ اﺳﺖ ﻛﻪ ﺑﻪ ﻧﺤﻮه ﺑﻬﺮه ﺑﺮداري از ﺑﺎﻧﻚ داده ﻫﺎي وﺿﻌﻴﺖ‬ ‫رﺷﺪ و ﺳﻮء ﺗﻐﺬﻳﻪ ﻛﻮدﻛﺎن ﺳﺎزﻣﺎن ﺟﻬﺎﻧﻲ ﺑﻬﺪاﺷﺖ ﻣﻲ ﭘﺮدازد‪.‬‬ ‫ﻫﺪف ﻛﻠﻲ‪:‬‬ ‫آﺷﻨﺎﻳﻲ ﺑﺎ واژﮔﺎن و اﺻﻄﻼﺣﺎت ﻣﺮﺗﺒﻂ ﺑﺎ ﻣﻔﻬﻮم »ﺑﻬﺪاﺷﺖ ﺧﺎﻧﻮاده« و درك ﻣﻄﻠﺐ اﻳﻦ ﻣﺘﻦ‬ ‫و ﻣﺘﻮن ﻣﺸﺎﺑﻪ در اﻳﻦ زﻣﻴﻨﻪ‪.‬‬ ‫ﻫﺪف ﻫﺎي رﻓﺘﺎري‪:‬‬ ‫ﭘﺲ از ﻓﺮاﮔﻴﺮي اﻳﻦ درس ﺑﺎﻳﺪ ﺑﺘﻮاﻧﻴﺪ‪:‬‬ ‫‪ -1‬ﻣﻔﻬﻮم و ﻣﻌﻨﻲ ﻫﺮ ﻳﻚ از واژﮔﺎن ﻛﻠﻴﺪي زﻳﺮ را در ﺟﻤﻠﻪ ﺗﺸﺨﻴﺺ دﻫﻴﺪ‪:‬‬ ‫‪Reduce, reduction, assist, assistance, assistant (adj.), assistant (n.),‬‬ ‫‪responsibility, responsible, link (v.), link (n.), disable, disability, safe,‬‬ ‫‪risk (n.), risk (v.), threat.‬‬ ‫‪ -2‬ﻣﺘﻦ اﺻﻠﻲ را ﻣﻄﺎﻟﻌﻪ و درك ﻛﻨﻴﺪ و ﺑﻪ ﺳﻮاﻻت ﻣﺮﺑﻮط ﺑﻪ ﻣﺘﻦ ﭘﺎﺳﺦ دﻫﻴﺪ‪.‬‬ ‫‪ -3‬ﺟﺎﻫﺎي ﺧﺎﻟﻲ ﻣﺘﻦ ﻛﺎﻣﻞ ﻛﺮدﻧﻲ)‪ (Cloze‬را ﺑﺎ اﺳﺘﻔﺎده از واژﮔﺎن داده ﺷﺪه ﺗﻜﻤﻴﻞ ﻛﻨﻴﺪ‪.‬‬ ‫‪ -4‬واژﮔﺎن ﺗﺨﺼﺼﻲ‪ ،‬اﺻﻼﺣﺎت‪ ،‬واژﮔﺎن ﻣﺮﻛﺐ و ﺟﻤﻠﻪ ﻫﺎي ﺳﺎده ﻳﺎ ﻣﺮﻛﺐ و ﭘﺎرﮔﺮاف ﻫﺎي‬ ‫ﻛﻮﺗﺎه ﺗﺨﺼﺼﻲ ﻣﺮﺑﻮط ﺑﻪ درس را ﺑﻪ ﻓﺎرﺳﻲ ﺗﺮﺟﻤﻪ ﻛﻨﻴﺪ‪.‬‬

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KEY WORDS: Before reading the TEXT, look through the following key words, and then do the KEY WORDS REVIEW.

reduce v 1 to make sth smaller or less in size, amount, or rent= price: We were hoping that they would reduce the rent a the money little. | reduce sth by half/ten percent etc: The workforce that someone has been reduced by half. | [+ to]: All the shirts were pays for the reduced to £10.

2 especially AmE to become thinner by losing weight 3 to boil a liquid so that there is less of it reduce sb/sth to sth phrasal verb 1 to change sth into a shorter simpler form: The report can be reduced to three main points.

2 reduce sth to rubble/ashes etc to destroy sth, especially a building, completely reduction n 1 [countable, uncountable] the fact of sth becoming or being made smaller [+ in]: a slight reduction in the price of oil | strategies for noise reduction | make a reduction (=sell sth more cheaply): We can make a reduction if you buy in bulk.

2 [countable] a smaller copy of a photograph, map, or picture —opposite enlargement assist v 1 to help someone to do sth, especially by doing all the less important things so that they can spend

use of a room, a house etc that belongs to someone else

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English for the Students of Public Health

time doing difficult things: assist (sb) with/in: I was employed to assist the manager with his duties.

2 to make it easier for someone to do sth: They had no maps to assist them.

assistance n [uncountable] help or support: financial assistance | Can I be of any assistance? (=can I help you?) | with the assistance of: a report drawn up with the assistance of experts

assistant adj assistant manager/director/cook etc someone whose job is just below the level of manager, etc assistant n [countable] someone who helps someone else in their work, especially by doing the less important jobs: a clerical assistant responsibility n 1 IN CHARGE [uncountable] a duty to be in charge of or look after sth, so that you make decisions and can be blamed if sth bad happens: She was given promotion and more responsibility. | have responsibility for: The Health Minister has overall responsibility for Iran's hospitals. take responsibility for (=agree to be in charge of sth or someone): My husband took full responsibility for organizing the trip. | assume responsibility for formal (=agree to be in charge of): Richard assumed responsibility for his brother's children. | accept responsibility for: The management accepts no responsibility for cars left in the car park.

2 DUTY [countable] a duty that you have,

blame= ‫ﺳﺮزﻧﺶ‬ ‫ﻛﺮدن‬

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especially because you are in charge of sth: The head of a large company has many responsibilities. have a responsibility to do sth: Every citizen has a responsibility to vote. | it is sb's responsibility to do sth: It is your responsibility to check that all doors and windows are locked. | moral responsibility (=a duty to

do sth because it is morally right) 3 BLAME [uncountable] blame for sth bad that has happened: accept/take responsibility: We refuse to accept responsibility for the breakdown of negotiations.

4 sense of responsibility an ability to behave sensibly so that you can be trusted to do the right thing: Parents need to encourage a sense of responsibility in their children.

5 a responsibility to sb a duty to help or serve someone because of your work, position in society etc: A doctor's first responsibility is to her patients.

responsible adj 1 GUILTY [not before noun] if someone is responsible for an accident, mistake, crime etc, it is their fault or they can be blamed [+ for]: The police arrested those responsible for the burglaries. | When he loses his temper, he isn't responsible for his actions. | If any of the children got hurt, I should feel responsible. | hold sb responsible (for) (=blame someone for sth): I shall hold you personally responsible for anything that goes wrong.

2 IN CHARGE OF [not before noun] having a duty to be in charge of or to look after someone or sth [+ for]: Each commissioner is responsible for a

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department. | They're not my children, but I still feel responsible for them. 3 responsible job/position/post a job in which the

ability to make good judgments and decisions is needed 4 SENSIBLE sensible and able to make good judgments so that you can be trusted: You can leave the children with Stuart - he's very responsible. —opposite irresponsible 5 be responsible to if you are responsible to

someone, that person is in charge of your work and you must explain your actions to them: The cabinet members are directly responsible to the president.

6 CAUSE if sth is responsible for a change, problem, event etc, it causes it [+ for]: Social changes are responsible for many of our modern problems.

link v 1 be linked if people or events are linked, they are connected in some way: Police think the murders are linked.| [+ with/to]: They believe that this illness is T

linked to the use of chemical pesticides.

2 to connect computers, broadcast systems etc, so that electronic messages can be sent between them: link sth to: You can link your TV to your stereo for better sound. | link sth with: We'll link your PC with our network via modem. 3 to connect two or more things together: These traditional stories link the past and the present.

4 to believe that one fact or situation is connected with or caused by another: link sth to/with: There

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are compelling reasons for linking crimes like burglary and car theft with poverty. 5 to join one place to another: the coastal highway linking Saigon and Hanoi

link n [countable] 1 a relationship between two things or ideas, in which one is caused or affected by the other [+ between]: the link between smoking and cancer 2 a relationship between two or more people, countries, organizations etc [+ with/between]: They have severed all political links with the Left. 3 rail/road/telephone link sth that joins two places

and allows you to travel or communicate between them: a transatlantic conference via satellite link 4 link in the chain one of the steps involved in a process disable v 1 to make someone unable to use a part of their body properly: Carter was permanently disabled in the war.

2 to deliberately make a machine or piece of deliberately equipment impossible to use: This system is designed done in a to destroy or disable enemy ballistic missiles.

disability n 1 [countable] a physical problem that makes someone unable to use a part of their body properly: She manages to lead a normal life in spite of her disabilities.

2 [uncountable] the state of not being able to use

way that is intended or planned

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parts of your body properly: learning to cope with disability

safe adj 1 NOT CAUSING HARM not likely to cause any physical injury or harm: Flying is one of the safest forms of travel. | the safe disposal of radioactive waste | Don't go too near the edge - it isn't safe. | it is safe to do sth: Is it safe to swim here? | [+ for]: Parents want playareas that are safe for their children.

2 NOT IN DANGER [not before n.] not in danger of being lost, harmed, or stolen: Will you feel safe in the house on your own?| [+ from]: We were safe from attack in the shelter. keep sth safe: I'm trusting you with these documents - so make sure you keep them safe. | safe and sound (=unharmed, especially after being in danger): The missing children were found safe and sound.

3 a safe place is one where sth is not likely to be stolen or lost: Keep the receipt in a safe place. 4 safe journey/arrival/return etc a journey etc that ends safely: They prayed for their father's safe return. | safe journey spoken (=what you say to someone when they start a long journey)

5 NO RISK not involving any risk and very likely to succeed: a safe investment | a safe method of contraception | (as) safe as houses (=completely safe) — safely adv: Drive safely! | I think we can safely assume that she will pass the exam.

risk n 1 POSSIBILITY OF BAD RESULT [countable, uncountable] the possibility that sth bad,

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unpleasant, or dangerous may happen: If you're considering starting a business, think carefully about the risks involved. | [+ of]: the risk of serious injury | reduce/increase the risk of: Wear rubber gloves to reduce the risk of infection.| [+ that]: There was some risk that fire would break out again. 2 take a risk to decide to do sth even though you know it may have bad results: The fuel tank could blow up, but that's a risk we'll have to take. 3 at risk be in a situation where you may be harmed: We must stop these rumours; the firm's reputation is at risk. | be at risk of: People with fair skins are more at risk of skin cancer. | put sb/sth at risk: I've no respect for a man who would put his children at risk like that.

4 CAUSE OF DANGER [countable] sth or someone that is likely to cause harm or danger [+ to]: Polluted water supplies are a risk to public health. | health risk (=sth likely to harm people's health): Meat from the infected animals is regarded as a serious health risk. | fire risk (=sth that could cause a dangerous fire): The tyre dump is a major fire risk. security risk (=someone who may tell important secrets to an enemy country) risk v 1 to put sth in a situation in which it could be lost, destroyed, or harmed: When children start smoking, they don't realize that they're risking their health. | risk sth on sth: You'd be crazy to risk your money on an investment like that! | risk your life: Martina risked her life to save her dog from the fire.

rumours= ‫ﺷﺎﻳﻌﺎت‬

tyre(BE)= tire(AE)

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2 to get into a situation where sth unpleasant may happen to you: risk defeat/death/dismissal etc: The government risks an embarrassing defeat if it calls an election now. | risk being defeated/killed/dismissed etc: Workers who broke the strike risked being attacked when they left the factory.

3 to do sth that you know may have dangerous or unpleasant results: risk doing sth: Are you prepared to risk traveling without an armed guard?

threat n 1 [countable, uncountable] a statement that you will cause someone pain, unhappiness, or trouble: Your threats don't scare me!| [+ of]: the threat of strike action | make/issue a threat against: Threats have been made against the book's author. | give in to threats (=do what someone wants because they threaten you): The government will not give in to terrorist threats. | carry out a threat (=do what you threatened to do) | empty threat (=a threat to do sth that you cannot really do): Take no notice - they're empty threats. | death/ bomb etc threat: Police are investigating death threats made against the singer.

2 [countable usually singular] the possibility that sth very bad will happen [+ of]: There's a serious threat of famine. | be under threat of closure/attack etc (=be likely to be closed, attacked etc): The factory is still under threat of closure.

3 [countable usually singular] someone or sth that is regarded as a possible danger [+ to]: Automation presents the biggest threat to the workforce. | pose a threat: Nuclear weapons continue to pose a threat.

strike= ‫اﻋﺘﺼﺎب‬

famine= ‫ﻗﺤﻄﻲ‬

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KEY WORD REVIEW: Fill in the blanks in each of the following sentences using the correct form of the words from the list below. There are some more words than you will need. Some of the words could be used more than once. _____________________________________________________________________________________

assist assistance disable disabling link linkage reduce reduction responsible responsibility risk safe threat 1. The health budgets of many countries have been severely ………. 2. One of the greatest ………. to the health and growth of a child under the age of two is the birth of a new baby. 3. Having a skilled birth attendant………. at the delivery in a health facility and check on the mother in the 12 hours after delivery reduces the likelihood of either the mother or the baby becoming ill or dying. 4. Family planning is the ……….of both men and women; everyone needs to know about the health benefits. 5. A nutritious diet during childhood and adolescence ………. problems in pregnancy and childbirth. 6. Microbiologists found that the disease might have been ………. with diet. 7. Women who do not have enough iodine in their diet are more likely to have miscarriages and risk having an infant who is mentally or physically ………. 8. Breastfeeding can ………. the severity and frequency of diarrhoea. 9. Delaying a first pregnancy until a girl is at least 18 years of age will help ensure a ………. pregnancy and delivery, and will reduce the risk of her baby being born underweight. 10. The younger the mother, the greater the ………. to her and her baby.

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11. Immunization protects against several dangerous diseases. A child who is not immunized is more likely to suffer illness, become permanently ……….or become undernourished and die. 12. A pregnant woman needs the best foods available to the family: milk, fruit, vegetables, meat, fish, eggs, grains, peas and beans. All these foods are ……….to eat during pregnancy. 13. Data analysis was performed by two female psychologists, with the ………. of a physician. 14. Water should come from a ………. source and be kept clean. 15. The health ………. of pregnancy and childbirth increase after four pregnancies. 16. Women who do not have enough iodine in their diet are more likely to have miscarriages and ………. having an infant who is mentally or physically disabled. 17. For every 200 children who are infected, one will be ………. for life. 18. Giving a baby any food or drink other than breastmilk increases the ………. of diarrhoea and other illnesses. 19. It is ………. to immunize a child who has a minor illness, a disability or who is malnourished. 20. Using breastmilk substitutes, such as infant formula or animal’s milk, can be a ………. to infants’ health. This is particularly the case if parents cannot afford sufficient substitutes, which are quite expensive, or do not always have clean water with which to mix them. 21. All births, especially first births, are………. in a maternity clinic or hospital. 22. The ………. in vaccine-preventable diseases (e.g., diphtheria, tetanus, measles, poliomyelitis, and Haemophilus influenzae type b meningitis) has reduced infant morbidity and has had a modest effect on infant mortality.

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READING

Safe Motherhood Some 1,400 women die every day from problems related to pregnancy and childbirth. Tens of thousands more experience complications during pregnancy, many of which are life-threatening for the women and their children – or leave them with severe disabilities. The dangers of childbearing can be greatly reduced if a woman is healthy and well nourished before becoming pregnant, if she has a health check-up by a trained health worker at least four times during every pregnancy, and if the birth is assisted by a skilled birth attendant such as a doctor, nurse or midwife. The woman should also be checked during the 12 hours after delivery and six weeks after giving birth. Governments have a particular responsibility to make prenatal and postnatal services available, to train health workers to assist at childbirth, and to provide special care and referral services for women who have serious problems during pregnancy and childbirth. Most governments have ratified an international agreement, the Convention on the Elimination of All Forms of Discrimination against Women, that includes a legally binding commitment to provide the services pregnant women need.

lifethreatening endangering life

prenatal= concerning unborn babies and the care of pregnant women

ratify= ‫ﺗﺼﻮﻳﺐ‬ ‫ﻛﺮدن‬

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Timing Births Every year some 515,000 women die from problems linked to pregnancy and childbirth. For every woman who dies, approximately 30 more develop serious, disabling problems. Family planning could prevent many of these deaths and much of this disability. Delaying a first pregnancy until a girl is at least 18 years of age will help ensure a safer pregnancy and delivery, and will reduce the risk of her baby being born underweight. This is especially important in countries where early marriage is the custom. A girl is not physically ready to begin bearing children until she is about 18 years of age. Childbirth is more likely to be difficult and dangerous for an adolescent than for an adult. Babies born to very young mothers are much more likely to die in the first year of life. The younger the mother, the greater the risk to her and her baby. Young women need special help to delay pregnancy. Young women and their families should be given information about the risks of early pregnancy and how to avoid them. After the age of 35, the health risks of pregnancy and childbirth begin to increase again. If a woman is over the age of 35 and has had four or more pregnancies, another pregnancy is a serious risk to her own health foetus BE fetus AE and that of the foetus. The risk of death for young children increases by nearly 50 per cent if the space between births is less than two years. One of the greatest threats to the

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health and growth of a child under the age of two is the birth of a new baby. Breastfeeding for the older child stops too soon, and the mother has less time to prepare the special foods a young child needs. She may not be able to give the older child the care and attention he or she needs, especially when the child is ill. As a result, children born less than two years apart usually do not develop as well, physically or mentally, as children born two years apart or more. A woman’s body needs two years to recover fully from pregnancy and childbirth. The risk to the mother’s health is therefore greater if births come too close together. The mother needs time to get her health, nutritional status and energy back before she becomes pregnant again. Men need to be aware of the importance of a two-year space between births and the need to limit the number of pregnancies to help protect their family’s health. If a woman becomes pregnant before she is fully recovered from a previous pregnancy, there is a higher chance that her new baby will be born too early and weigh too little. Babies born underweight are less likely to grow well, more likely to become ill and four times more likely to die in the first year of life than babies of normal weight.

Comprehension Check A. Answer the following questions. 1. What is safe motherhood? 2. Who can reduce the dangers of child bearing? 3. Who can help a woman in pregnancy? 4. What is the reason for reducing the danger of child bearing?

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5. When should a pregnant woman have a check up? 6. Which factor can make a pregnancy safer? 7. Who need special help to delay pregnancy? 8. Who need to be aware of the importance of a two-year delay between pregnancies? 9. When is the safe time for pregnancy?

B. TRUE OR FALSE: Put T for true and F for false statements. 1 …… Some 2600 women die everyday from problems related to

child birth. 2 …… There are no complications during pregnancy. 3 …… The dangers of child bearing can be greatly reduced if a

woman is healthy. 4 …… Women should be checked during 32 hours after delivery. 5 …… Women should be checked 9 weeks after giving birth. 6 …… Governments have a particular responsibility to give service to pregnant woman in need. 7 ……An 18-year-old girl is physically ready to begin bearing children. 8 …… The health risks of pregnancy begin to decrease after the age of 35. 9 …… Men don’t need to be aware of the importance of a twoyear birth spacing. 10 …… If a woman becomes pregnant, before she is fully recovered, she is not at risk for another pregnancy.

C. Choose the best choice to complete the sentences. 1. Pregnancy and child birth….. a) is so easy for every women b) have no complications and disabilities c) have so many problems, dangers and complications d) child birth appear with no problems

2. Who can help a pregnant woman? A…… a) worker

b) manager

c) nurse

d) farmer

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3. When should we have a check up for a pregnant woman? a) 25 hours before delivery c) 6 weeks after giving birth

b) 30 hours after giving birth d) 9 hours after delivery

4. Who needs special help to delay their pregnancy? a) older woman c) woman under 18 years

b) 28 years old woman d) single woman

5. Who needs to be aware of a two-year spacing for pregnancy? a) young women c) men

b) old women d) 25 years old women

6. What is the reason for reducing the danger of child bearing? a) healthy woman c) many pregnancies

b) ill woman d) poor woman

7. The risks of death for young children ……… with 2 years space between births. a) decreases by 35 percent c) decreases by 40 percent

b) increases by 25 percent d) increases by 50 percent

8. The risks to mother's health is …….. a) smaller if births come too close together b) greater if births come with delay c) smaller if births come with no delay d) greater if births come too close together

9. Babies born underweight are……….. a) more likely to grow well b) less likely to become ill c) so strong to fight with diseases d) more likely to become ill

10. Babies of normal weight are……. a) less likely to grow well c) die in the first year

b) more likely to become ill d) more likely to grow well

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FURTHER READING

Safe Motherhood in Action With any pregnancy there is a risk that something may go wrong. Most of these complications cannot be predicted. The first delivery is the most dangerous for both mother and child. A pregnant woman needs to be checked at a clinic or health facility at least four times during every pregnancy. It is also important to seek the advice of a skilled birth attendant (such as a doctor, nurse or midwife) about where the baby should be born. Because dangerous problems can arise without warning during pregnancy, childbirth or just after the birth, all families need to know the location of the nearest hospital or clinic and have plans and funds for quickly getting the woman there at any hour. If possible, the mother-to-be should move, temporarily, closer to a clinic or hospital so that she is within reach of medical help. If a family knows that a birth is likely to be difficult or risky, the birth should take place in a hospital or maternity clinic. All births, especially first births, are safer in a maternity clinic or hospital. All families need to know about special risk factors and be able to recognize the warning signs of possible problems. Risk factors before pregnancy: • an interval of less than two years since an earlier birth • a girl is under 18 or a woman is over 35 years of age

predict= to say that sth will happen or that sth will happen in a particular way

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• the woman already has four or more children • the woman has had a previous premature birth or baby weighing less than 2 kilograms at birth • the woman has had a previous difficult or Caesarean birth • the woman has had a previous miscarriage or stillbirth Every pregnancy deserves attention, as there is always a risk of something going wrong. Many dangers can be avoided if the woman goes to a health centre or to a skilled birth attendant when she first suspects she is pregnant. She should then have at least four check-ups throughout each pregnancy and also be checked during the 12 hours following each delivery and six weeks after each birth. If there is bleeding or abdominal pain during pregnancy, a health worker or a skilled birth attendant should be consulted immediately. Having a skilled birth attendant assist at the delivery in a health facility and check on the mother in the 12 hours after delivery reduces the likelihood of either the mother or the baby becoming ill or dying. A skilled birth attendant (such as a doctor, nurse or trained midwife) will help ensure a safer pregnancy and healthy baby by: checking the progress of the pregnancy so that if problems arise the woman can be moved to a hospital for the birth checking for high blood pressure, which can be

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dangerous to both mother and child checking for anaemia and providing iron/folate supplements regularly prescribing an adequate dosage of vitamin A to protect the mother and her newborn baby against infection (in vitamin A deficient areas) giving antimalarial tablets, if necessary preparing the mother for the experience of childbirth and giving advice on breastfeeding and caring for herself and her newborn advising the pregnant woman and her family on where the birth should take place and how to get help if problems arise during childbirth or immediately after delivery advising on how to avoid sexually transmitted infections AFE MOTHERHOOD During delivery, the skilled attendant knows: 9 when labour has gone on for too long (over 12 labour BE =labor AE hours) and when a move to a hospital is necessary 9 when medical help is required and how to obtain it 9 how to reduce the risk of infection (clean hands, clean instruments and a clean delivery area) 9 how to deliver the afterbirth safely and care for the mother after the baby is born 9 how to put recommended drops in the baby’s eyes to prevent blindness. After delivery, the skilled attendant should: check on the woman’s health in the 12 hours

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after birth and six weeks after delivery advise women on how to prevent or postpone another birth advise women on how to avoid sexually transmitted infections such as HIV or how to reduce the risk of infecting their infants. A pregnant woman needs the best foods available to the family: milk, fruit, vegetables, meat, fish, eggs, grains, peas and beans. All these foods are safe to eat during pregnancy. Women will feel stronger and be healthier during pregnancy if they eat foods that are rich in iron, vitamin A and folic acid. These foods include meat, fish, eggs, green leafy vegetables, and orange or yellow fruits and vegetables. Health workers can provide pregnant women with iron tablets to prevent or treat anaemia and, in vitamin A deficient areas, an adequate dosage of vitamin A to help prevent infection. Salt used should be iodized. Women who do not have enough iodine in their diet are more likely to have miscarriages and risk having an infant who is mentally or physically disabled. A pregnant woman can damage her own health and the health of the foetus by smoking or living in an environment where others smoke, by drinking alcohol or by using narcotic drugs. It is important not to take medicines during pregnancy unless they are absolutely necessary and prescribed by a trained health worker. If a pregnant woman smokes, her child is likely to be born underweight and is also more likely to have coughs, colds, croup, pneumonia or other breathing problems. To ensure

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the physical growth and mental development of the child, pregnant women and young children need to be protected from smoke from tobacco or cooking fires; from pesticides, herbicides and other poisons; and from pollutants such as lead, found in water transported by lead pipes, vehicle exhaust and some paints. If a pregnant woman is abused, she and the foetus could be seriously harmed. Pregnant women who are physically abused may be unable to have any more children. Members of her family should be aware of these dangers and she should be protected from her abuser. If women have access to health care and professional advice during pregnancy, during delivery and after delivery, many dangers of pregnancy and childbirth can be avoided. All women have the right to the services of a skilled birth attendant such as a doctor, nurse or midwife, and to emergency obstetric care if needed. Quality health care enables women to make informed decisions about their health by offering information and counselling. It should be easy for women who need maternal care to reach the health facility, and cost should not prevent women from using these services. Health care providers should have the skills needed to provide quality care. They should be trained to treat all women with respect, to be sensitive to cultural norms and practices, and to respect women’s right to confidentiality and privacy.

counselling BE= counseling

AE

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A. Vocabulary Drills I. Find single words in the text which match the following definitions. 1. medical problems or illnesses that happens while someone is already ill and makes medical treatment more difficult: 2. an opinion you give someone about what they should do: 3. weighing less than is expected or usual: 4. the process of giving birth to a child: 5. choices or judgments that you make after a period of discussion or thought: 6. an amount of money that is collected and kept for a particular purpose: 7. the act of accidentally giving birth too early for the baby to live: 8. acting to prevent malaria: 9. to change an event, action etc to a later time or date:

II. Find words in the text which have the same meaning as: 10. clinic used by women who are pregnant: 11. general medical examinations that a doctor or dentist gives you to make sure you are healthy: 12. a woman who is going to have a baby: 13. baby who is born before the usual time of birth: 14. signs that tells you that something bad, annoying, or dangerous might happen: 15. an skilled health worker who helps women give birth: 16. emergency care concerned with the birth of children: 17. people or experts who give health care: 18. generally accepted standards of a particular society and its way of life: 19. diet full of the natural substances that your body needs to stay healthy or to grow properly: 20. factors that are likely to cause harm or danger:

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B. Comprehension Check 1. TRUE OR FALSE: Put T for true and F for false statements. 1…… In any pregnancy, most of the complications can be predicted. 2…… All families don’t need to know about birth risk factors. 3……Pregnant woman don’t need to meet a trained mid wife. 4…… A skilled birth attendant can't help a pregnant woman. 5…… A girl under 18 or a woman over 35 years is not at risks before pregnancy. 6…… The H.I.V. test is not necessary for pregnant woman. 7…… Narcotic drugs have no risk for pregnant women. 8…… Pregnant woman need maternal care. 9……If anaemia, malaria or hook worms are suspected, the pregnant woman should consult a health worker. 10……Pregnant women need to be protected from vehicle exhausted.

2. Answer the following questions: 1- What are the risk factors before pregnancy? 2- What are the warning signs that need immediate help? 3- What are the damage factors for pregnant woman? 4- Which nutritious diet is good for pregnant woman? 5- What is the child growth and development?

CLOZE PASSAGE Fill in the blanks with the appropriate words from the list below. Each word could be used more than once. Analyzed ~ awareness ~ classify ~ collaboration~ database derived ~ identifying ~ objective ~ presented Published ~ respectively ~ surveys

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The World Health Organization Global Database on Child Growth and Malnutrition: methodology and applications Mercedes de Onis and Monika Blössner Accepted 7 January 2003 Background For decades nutritional surveys have been conducted using various definitions, indicators and reference populations to ……….. child malnutrition. The World Health Organization (WHO) Global Database on Child Growth and Malnutrition was initiated in 1986 with the ……….. to collect, standardize, and disseminate child anthropometric data using a standard format. Methods The database includes population-based ……….. that fulfill a set of criteria. Data are checked for validity and consistency and raw data sets are ……….. following a standard procedure to obtain comparable results. Prevalences of wasting, stunting, under- and overweight in preschool children are ……….. using z-scores based on the National Center for Health Statistics (NCHS)/WHO international reference population. New surveys are included on a continuous basis and updates are ……….. bimonthly on the database’s web site. Results To date, the database contains child anthropometric information ………..from 846 surveys. With 412 national surveys from 138 countries and 434 sub-national surveys from 155 countries, the……….. covers 99% and 64% of the under 5 year olds in developing and developed countries, ………... This wealth of information enables international comparison of nutritional data, helps ……….. populations in need, evaluating nutritional and other public health interventions, monitoring trends in child growth, and raising political ……….. of nutritional problems. Conclusions The 15 years experience of the database can be regarded as a success story of international ……….. in standardizing child growth data. We recommend this model for monitoring other nutritional health conditions that as yet lack comparable data. Keywords Child growth, malnutrition, global monitoring, stunting, wasting, underweight, overweight, preschool children

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TRANSLATION ACTIVITY: I. Translate the following words or terms into Persian. 1. 2. 3. 4. 5. 6. 7. 8.

midwife delivery pregnancy underweight adolescent childbirth childbearing discrimination

9. breastfeeding 10. miscarriage 11. stillbirth 12. pesticides 13. herbicides 14. overweight 15. underweight 16. mother-to-be

II. Translate the following phrases into Persian. 1. young child 2. risk factors 3. child growth 4. Timing Births 5. health facility 6. warning signs 7. healthy baby 8. family’s health 9. women’s right 10. health facility 11. cultural norms 12. maternity clinic 13. Caesarean birth 14. safe pregnancy 15. nutritional data 16. physical growth 17. Family planning 18. early pregnancy 19. prenatal services 20. postnatal services 21. disabling problems 22. nutritional status 23. mental development

24. physically abused 25. professional advice 26. cultural practices 27. nutritional surveys 28. anthropometric data 29. preschool children 30. risk of infection 31. health check-up 32. high blood pressure 33. space between births 34. skilled birth attendant 35. sub-national surveys 36. trained health worker 37. skilled birth attendant 38. risks of early pregnancy 39. vitamin A deficient areas 40. health risks of pregnancy 41. emergency obstetric care 42. population-based surveys 43. international collaboration 44. public health interventions 45. nutritional health conditions 46. sexually transmitted infections

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III. Translate the following sentences into Persian. 1. Every year some 515,000 women die from problems linked to pregnancy and childbirth. 2. Family planning could prevent many of these deaths and much of this disability. 3. The younger the mother, the greater the risk to her and her baby. 4. A pregnant woman needs to be checked at a clinic or health facility at least four times during every pregnancy. 5. If possible, the mother-to-be should move, temporarily, closer to a clinic or hospital so that she is within reach of medical help. 6. Young women and their families should be given information about the risks of early pregnancy and how to avoid them. 7. The risk of death for young children increases by nearly 50 per cent if the space between births is less than two years. 8. Childbirth is more likely to be difficult and dangerous for an adolescent than for an adult. Babies born to very young mothers are much more likely to die in the first year of life. 9. A pregnant woman needs the best foods available to the family: milk, fruit, vegetables, meat, fish, eggs, grains, peas and beans. All these foods are safe to eat during pregnancy. 10. A pregnant woman can damage her own health and the health of the foetus by smoking or living in an environment where others smoke, by drinking alcohol or by using narcotic drugs. 11. If women have access to health care and professional advice during pregnancy, during delivery and after delivery, many dangers of pregnancy and childbirth can be avoided. 12. After the age of 35, the health risks of pregnancy and childbirth begin to increase again. If a woman is over the age of 35 and has had four or more pregnancies, another pregnancy is a serious risk to her own health and that of the fetus. 13. Having a skilled birth attendant assist at the delivery in a health facility and check on the mother in the 12 hours after delivery reduces the likelihood of either the mother or the baby becoming ill or dying.

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14. Some 1,400 women die every day from problems related to pregnancy and childbirth. Tens of thousands more experience complications during pregnancy, many of which are life-threatening for the women and their children – or leave them with severe disabilities. 15. The dangers of childbearing can be greatly reduced if a woman is healthy and well nourished before becoming pregnant, if she has a health check-up by a trained health worker at least four times during every pregnancy, and if the birth is assisted by a skilled birth attendant such as a doctor, nurse or midwife. 16. Governments have a particular responsibility to make prenatal and postnatal services available, to train health workers to assist at childbirth, and to provide special care and referral services for women who have serious problems during pregnancy and childbirth. 17. Children born less than two years apart usually do not develop as well, physically or mentally, as children born two years apart or more. A woman’s body needs two years to recover fully from pregnancy and childbirth. The risk to the mother’s health is therefore greater if births come too close together. The mother needs time to get her health, nutritional status and energy back before she becomes pregnant again. 18. Risk factors before pregnancy: Dan interval of less than two years since an earlier birth Da girl is under 18 or a woman is over 35 years of age Dthe woman already has four or more children Dthe woman has had a previous premature birth or baby weighing less than 2 kilograms at birth Dthe woman has had a previous difficult or Caesarean birth Dthe woman has had a previous miscarriage or stillbirth