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MAMA ALERT · UMLING BLOCK · MEGHALAYA

High-Risk Pregnancy Symptom Cards

26 bilingual cards · Khasi audio guidance · Direct 108 emergency link

MAMA ALERT is a set of 26 colour-coded pregnancy danger-sign cards built for ASHA workers, pregnant women and their families in Umling Block, Ri-Bhoi District, Meghalaya. Each card describes one warning sign — from a recurring headache to vaginal bleeding to fits — and tells the family in plain language what to do, when to worry, and which facility to reach. This wiki is the digital reference for that card set, with linked Khasi-language audio for every card.

Most maternal complications in remote villages are not missed because the danger sign is hidden — they are missed because nobody at home knows whether what they are seeing is normal, or because care is sought too late. The cards close that recognition gap. A single swollen foot in the evening is normal; both feet swollen overnight is not. The card explains the difference and points to the right next step.

At a glance

26

Symptom Cards

3

Severity Levels

108

Ambulance Link

Severity at a glance

Every card belongs to one of three colour groups. The colour tells the family how urgent the situation is — and which facility to head for.

🟡 Yellow Alert Watch & plan Tell the ASHA, drink fluids, rest, and visit the Sub-Centre or PHC at the next ANC visit. The symptom is mild now but can grow.

🟠 Orange Alert Same-day care Go to the PHC or CHC the same day. Do not wait until tomorrow. Do not self-medicate.

🔴 Red Alert Emergency now Call 108 immediately. The woman must reach a CHC or District Hospital as fast as possible.

All 26 cards

🟡 Yellow Alert · watch and plan

CARD 01Yellow

Headache · Keeps Coming Back

A recurring or daily headache that does not go away with rest.

CARD 02Yellow

Swollen Feet · Check Every Morning

Feet remain swollen after a night of rest, or swelling is uneven.

CARD 03Yellow

Baby Not Moving · Count 10 Kicks

Fewer than 10 movements felt over two hours of quiet observation.

CARD 04Yellow

Cannot Eat or Drink · 2+ Days

Severe vomiting or inability to keep food down for over two days.

CARD 05Yellow

Pale Eyelid & Nails

Inside of lower eyelid looks white or pink instead of red — anaemia sign.

CARD 06Yellow

Body Feels Hot · Above 38°C

Fever above 38°C / 100.4°F during pregnancy needs evaluation.

CARD 07Yellow

Age Risk · Under 18 / Over 35

Mothers below 18 or above 35 carry higher pregnancy risk.

CARD 08Yellow

Last Baby Less Than 2 Years Ago

A short gap between pregnancies puts more strain on the body.

CARD 17Yellow

Burning Urine · With Fever

Painful or frequent urination with fever — needs antibiotics.

CARD 16Yellow

Twins or More

Multiple-baby pregnancy needs hospital delivery and extra ANC.

CARD 15Yellow

Previous C-Section

A scar from a past C-section means the next delivery must be at hospital.

CARD 23Yellow

Previous Baby Died · Special Care

A history of stillbirth or neonatal death needs hospital delivery.

🟠 Orange Alert · same-day care needed

CARD 09Orange

Severe Headache + Vision Change

A bad headache plus dim or blurred vision — possible pre-eclampsia.

CARD 10Orange

Cannot See Clearly · Blurred Vision

Sudden loss of clear vision in the third trimester is a danger sign.

CARD 11Orange

Face, Hands, Feet — All Swollen

Generalised swelling, not just feet — same-day BP and urine check needed.

CARD 12Orange

Blood Pressure 140/90 or Above

High BP in pregnancy can lead to eclampsia — never self-medicate.

CARD 13Orange

Strong Belly Pain · Does Not Stop

Severe, non-stop abdominal pain — never give a painkiller and wait.

CARD 14Orange

Cannot Breathe Properly

Breathlessness even while sitting still — needs same-day evaluation.

🔴 Red Alert · call 108 immediately

CARD 18Red

Vaginal Bleeding

Any bleeding from the birth canal in any month of pregnancy is an emergency.

CARD 19Red

Fits / Body Shaking · Eclampsia

Convulsions in pregnancy — a true life-threatening emergency.

CARD 20Red

No Movement for 12+ Hours

Baby has not moved for half a day or more — go to hospital tonight.

CARD 21Red

She Has Collapsed

Loss of consciousness — call 108 first, do not give food or water.

CARD 22Red

Very Pale · Cannot Stand

Severe paleness with weakness — possible massive blood loss.

CARD 24Red

Cannot Stand Up

Severe weakness, cannot walk even with support — call ambulance.

CARD 25Red

No Urine for 12+ Hours · Very Dry

Severe dehydration — needs IV fluids the same day.

CARD 26Red

Cord or Limb Visible at Birth

Umbilical cord or baby limb visible outside — emergency C-section needed.

Frequently asked questions

What is MAMA ALERT?

MAMA ALERT is a set of 26 paper cards used by ASHA workers and pregnant women in Umling Block, Meghalaya. Each card describes one pregnancy danger sign in English and Khasi, and explains exactly what to do when it appears.

Who are the cards for?

Pregnant women, their husbands, mothers-in-law and any family caregiver in the household — plus ASHA workers, ANMs and Medical Officers who use the cards as a reference during home visits and ANC clinics.

When should I call 108?

Any Red Alert card means call 108 immediately. That includes vaginal bleeding, fits, loss of consciousness, no fetal movement for 12 hours, severe paleness, no urine for 12 hours, and a visible cord or limb. Do not wait, do not give medicines from home.

Are the cards in Khasi?

Yes — every card has a Khasi version. Use the language switcher at the top of every page to move between English and Khasi. Khasi audio guides are also linked on each card page.

Where are the cards used?

The cards are deployed across all villages of Umling Block, Ri-Bhoi District, Meghalaya, under the MNCH-HCD project of Tattva Foundation. Plans are in place to scale to neighbouring blocks.

How to use this wiki

• Pregnant women and families — find the symptom that matches what you see, follow the action steps, and if the card is red, call 108 immediately.
• ASHA workers — use the card pages during home visits. Each page lists the referral pathway and which facility to send the woman to.
• ANMs and Medical Officers — the card pages describe what investigation to keep ready when a woman with that symptom arrives.