Hesperian Health Guides

Hesperian Health Guides

Chapter 5: Preventing Infection

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HealthWiki > A Book for Midwives > Chapter 5: Preventing Infection


Preventing infection saves lives

Infection makes people sick and can even kill them. It is one of the most common causes of death after childbirth. Procedures that involve putting medical tools inside a woman’s womb, like inserting an intrauterine device (IUD) or doing manual vacuum aspiration (MVA), can also cause infection. Much of the work of a midwife, and any procedure inside the womb (invasive procedure), can only be safe if you are able to follow the steps we outline in this chapter to prevent infection.

a pair of scissors.
Germs can live on tools, even tools that look clean.
blood dripping from a finger.
Germs live in body fluids like blood.

This chapter explains how to avoid infection by killing or controlling harmful germs. Germs are organisms that carry sickness. Germs are everywhere, but they are so small that they can only be seen with a microscope. The dangerous germs in blood, stool, body fluids (like semen and amniotic waters), and dirt can cause serious sickness when they get into someone’s body.

Contents

Infection is caused by germs

Some sicknesses, like arthritis, diabetes, asthma, and epilepsy, are not caused by germs. They cannot be passed from one person to another.

Other sicknesses, like measles, hepatitis, tetanus, womb infection, HIV, and the flu, are called infections and are caused by germs. People get sick when the germs that cause these infections get inside their bodies.

How germs get into the body

Germs can get inside the body in different ways.



Some germs pass through semen or vaginal mucus (body fluids)
when people have sex. HIV and other sexually transmitted infections
like chlamydia and gonorrhea can spread this way.
Some germs pass through blood when the blood or body fluid of an infected person get into a cut or through the skin — like with a needle that has been used for piercing or injections. HIV, hepatitis B, and hepatitis C can spread this way.
Some germs live in dirty water and pass when people drink it. Cholera and diarrheal diseases spread this way.
a hand cutting a baby's cord with a razor blade.
Some germs live in dirt, on skin, or in the air, and are not dangerous unless they get into a person’s blood. These germs can get into the blood when an instrument that has germs on it is used inside a woman’s womb, or to cut the skin or a baby’s cord. Tetanus and womb infection can spread this way.
Some germs pass through the air when a sick person coughs or sneezes. Colds, flu, and tuberculosis can spread this way.


Keep sick people away from births
a woman holding her head and thinking.
Oh dear! Juana is in labor and I have a fever!
I will have to ask another midwife to help her.

One simple thing midwives can do to prevent infection is to keep sick people away from women who are pregnant or giving birth. Keep anyone who has a sore throat, cough, fever, or other illness that passes through germs away from births. And do not let anyone with a sore on his or her hands or face touch a new baby.

a woman with a medical bag thinking.
But I am the only midwife in my village! I must go to the birth!


If you are sick but you must go to a birth, you can cover your mouth and nose with a scarf, a folded cloth or a mask. Wash your hands often and cover your mouth when you sneeze or cough. Be sure to wash your hands after each time you sneeze or cough. Try not to touch the new baby too much.

Anyone may carry germs that cause sickness

People do not always know that they have an infection. And there is no way to tell for sure what germs a person has just by looking at her. Some people have germs in their blood or other body fluids but do not seem sick.

a woman thinking as she kneels next to a woman who has just given birth.
Wait! I need gloves before I touch her placenta.

To be safe, and to stop the spread of dangerous infections like hepatitis and HIV, health workers must treat everyone as if they might have dangerous germs in their body fluids. Health workers can prevent germs from spreading:

  • by wearing gloves and other protective clothing, to prevent blood and other body fluids that contain germs from getting on themselves or others.
  • by cleaning and sterilizing the tools they use during births and other procedures.
Note: Good general health can help avoid infection. Healthy eating, enough rest, and emotional and spiritual well-being are all important for staying healthy. Sometimes they are enough to help people fight germs that get inside the body so the person does not get sick.


But during birth and invasive medical procedures, a woman’s body is more open and vulnerable to infection, and good general health is usually not enough. Germs that are usually kept out of the body can get into the womb. Any cut in the skin also makes a person more vulnerable to infection because the skin usually helps keep germs out of the body. Even an injection can cause an infection if the syringe has harmful germs on it.


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