CHAPTER ONE
INTRODUCTION
Pregnancy is the development of one or more offsprings, known as an embryo or fetus, in a woman’s uterus. This spans a period from fertilization of the female sex cell by the male sex cell to the birth of the offspring. This period is also called gestation period. The cells undergo rapid division and growth according to Jukic, Baird, Weinberg, McConnaughey and Wilcox (2013) such that in eight weeks it becomes stable and big enough to be called a fetus. The continous growth of this fetus results in physiological changes in the pregnant woman.
Shrock (2008) stated that during the childbearing period, from conception through postpartum recovery, a woman’s body undergoes extensive changes which frequently necessitate many adoptations. Physical and hormonal changes occur gradually throughout the nine months of pregnancy, and these are reversed in a matter of weeks during postpartum recovery. Skeletal tissue, muscle and connective tissues, blood volume, cardiac output, body weight and posture are affected. The effect it has can bring positive or negative impact on the unborn child and/or the mother.
Pregnant women are usually exposed to care during pregnancy. Such care is termed antenatal or prenatal care. Such care is usually given by trained personnel in hospitals,  primary health centres or by traditional birth attendants. Ante – natal care is thus defined by World Health Organization (WHO, 2003) as the provision of special care for women during pregnancy through the public health service. Until the second half of the 20th century, pregnant women were only given maternity care during delivery.  There used to be very high level of maternal and child mortality until care was given to pregnant women in the course of the pregnancy. This development according to WHO was stimulated by the realization that maternal mortality due to puerperal sepsis, haemorrhage and obstructed labour had declined substantially during the early years of the 20th century. Today further understanding of obstetrics and gyneacology has improved upon services given to women in antenatal clinics. Good care during pregnancy is important for the health of the mother and the development of the unborn baby.
Pregnancy is a crucial time to promote healthy behaviour and parenting skills. Ante-natal care also provides women with appropriate information and advice for a healthy pregnancy, safe childbirth, and postnatal recovery, including care of the newborn, promotion of exclusive breastfeeding and assistance with deciding on future pregnancies in order to improve pregnancy outcomes. An effective ante-natal care package depends on competent health care providers in a functioning health system with referral services and adequate supplies of routine drugs and laboratory support. Different health practitioners have different packages for antenatal care. The new World Health Organization’s model of antenatal care separates pregnant women into two groups,  those likely to need only routine ante-natal care and those with specific health conditions or risk factors that necessitate special care. For the first group, a standard programme of four antenatal visits is recommended with additional visits should conditions emerge which require special care. The World Health Organization (2003) guidelines are also specific as regards the timing and content of antenatal care visits according to gestational age. The guidelines stipulate that “only examinations and tests that serve an immediate purpose and that have been proven to be beneficial should be performed”. These examinations include measurement of blood pressure, testing of urine for presence of sugar and protein and blood test to detect anaemia. Routine weight and height measurement at each visit is considered. Some packages include the use of recreational activities like exercises and games for the pregnant women.