Hesperian Health Guides

Fè preparasyon pou kitaj la

Nan chapit sa:

Help the woman to be comfortable

Tell the woman what you will be doing. Answer any questions that she has.

You should find a private place to do the MVA where others are not watching, and be sure to keep everything about her care confidential.

Preventing pain during MVA

MVA can be painful. There are some things you can do to reduce the pain:
a woman sitting near a woman on on exam table, touching her arm.
The touch of a supportive friend can do a lot to lessen a woman's pain.
  • Always tell the woman what you are doing and encourage her to ask questions.
  • Move smoothly and do not rush.
  • Show the woman how to take slow,
    deep breaths. This can help her body relax. You can take slow deep breaths too! This will help you be gentle and careful.


Even when you are very gentle, there can be pain. Medicine to stop pain can be expensive and may cause unhealthy side effects, but you may want to offer it to women if you can get it. Women should not have to suffer pain unnecessarily.

And remember — pain medicine cannot replace gentle and respectful care.

There are 2 types of medicine to lessen pain from MVA. You can give pills by mouth or give an injection near the cervix to numb that part of the body. This is also the time to give medicines to prevent infection.



To prevent pain
MW Ch23 Page 420-1.png
MW Ch23 Page 420-2.png
  • give 500 to 1000 mg of paracetamol

    and
by mouth, 20 minutes before you start the MVA
To prevent infection
  • give 200 mg of doxycycline

    or
    if the person is breastfeeding:
by mouth
  • give 500 mg of azithromycin
by mouth

Prepare tools and supplies for doing MVA

There are several different devices used to do MVA. In this chapter, we explain how to use an MVA kit made by an organization named Ipas. (See more information about how to purchase MVA kits.)

MVA kits have 2 main parts:
One part is a 50 cc syringe with a wide opening that creates a vacuum to pull the contents of the womb out. The other main part of the kit is a set of plastic tubes called cannulas. One end of the cannula will be attached to the syringe. The other end will be put inside the womb.
illustration of the below: a syringe.
plunger
barrel
button (pinch valve) opens and closes valve
arm of plunger
syringe
a gloved hand holding cannulas of different sizes.
Easy Grip Cannulas
How the syringe works

When the button on the syringe is pushed in, the valve is opened and the contents of the womb are sucked through the cannula into the syringe.

syringe with cannula attached.
syringe
cannula


Fr MW Ch23 Page 421-1.png A 1-valve syringe
MW Ch23 Page 421-2.png A 2-valve syringe
MW Ch23 Page 421-3.png The MVA plus syringe
Note: Some older smaller syringes were good only for pregnancies up to 8 weeks. Follow the instructions carefully for the syringe you have.

Sterilize your tools

Sterilize all the tools that you will put inside the vagina or the womb and lay them out on a sterilized cloth, paper, or dish. You must wear sterile gloves any time you touch a sterile tool.

MW Ch23 Page 421-4.png
plastic gloves
gauze or a
long swab
ring forceps
MVA syringe
tenaculum
speculum
cannulas
a flashlight.
MW Ch23 Page 421-6.png

You will also need a small bowl of antiseptic like Hibiclens or betadine to clean the outside of the cervix. And be sure you have a good source of light.




Nou te mete paj sa a ajou: 05 jan 2024