Finally, you need to know what to do if you are making a referral – sending a client for additional health services and specialised care at a higher level health facility. You should complete a referral form in full and sign and date it, then make sure it goes to the health facility with the patient; it also has a space for feedback to you by the health facility about what treatment they have given.

If you do not have the standard referral form, you should write a note to the health facility that contains the key information (Box 13.6).

Box 13.6 Referral note

Date of the referral and time
Name of the health facility you are sending the patient to
Name, date of birth, ID number (if known) and address of the patient
Relevant medical history of the patient
Your findings from physical examinations and tests
Your suspected diagnosis
Any treatment you have given to the patient
Your reason for referring the patient
Your name, date and signature.

That concludes our discussion of focused antenatal care. In the study sessions that follow in this Module you will learn more about specialised aspects of antenatal care in specific contexts, including health promotion issues in pregnancy, counselling the pregnant woman about danger symptoms, PMTCT of HIV, the diagnosis and management of malaria, anaemia and urinary tract infections, hypertension, abortion and bleeding in early and late pregnancy. The Antenatal Care Module ends by describing how to set up an intravenous (IV) cannula and infusion tubing to give fluids directly into the blood stream, and how to insert a urinary catheter to drain the bladder of a pregnant woman. Your practical training sessions will ensure that you have achieved these competencies.