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Maternal health

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See also: reproductive health and women's health

Maternal health care is a concept that encompasses family planning,

preconception, prenatal, and postnatal care. Goals of preconception care can
include providing education, health promotion, screening and interventions for
women of reproductive age to reduce risk factors that might affect future
pregnancies. Prenatal care is the comprehensive care that women receive and
provide for themselves throughout their pregnancy. Women who begin prenatal
care early in their pregnancies have better birth outcomes than women who
receive little or no care during their pregnancies citation needed. Postnatal care
issues include recovery from childbirth, concerns about newborn care, nutrition,
breastfeeding, and family planning.

Contents
[hide]
1 Problems
2 Proposed
solutions
3 By region
4 See also
5 References
6 External links
[edit] Problems

See also: Maternal death

In many developing countries, complications of pregnancy and childbirth (mainly

at the level of preconception and prenatal care) are the leading causes of death
among women of reproductive age. A woman dies from complications from
childbirth approximately every minute [1]. Most maternal deaths and injuries are
caused by biological processes and can be prevented, not from disease [2], and
have been largely eradicated in the developed world such as postpartum
hemorrhaging which causes 34% of maternal death in the developing world and
only 13% of maternal death in developed countries [3]. One disease that does
cause significant maternal health problems is HIV/AIDS. Mother to child
transmission of HIV in the developing world is a large concern, approximately
45% of infected mothers transmit the disease to their children [4] and HIV is a
major cause of maternal mortality, causing 60,000 maternal deaths in 2008 HIV
rates are especially high in Sub-Saharan and Eastern Africa where maternal
mortality rates are on the rise. [5]

Although high-quality, accessible health care has made maternal death a rare
event in developed countries, where only 1% of maternal deaths occur [6], these
complications can often be fatal in the developing world because single most
important intervention for safe motherhood is to make sure that a trained
provider with midwifery skills is present at every birth that transport is available
to referral services, and that quality emergency obstetric care is available [7]. In
2008 342,900 women died from pregnancy and childbirth worldwide, which was
a significant drop from 1980 when 526,300 women died from the same causes.
This improvement was caused by lower pregnancy rates in some countries;
higher income, which improves nutrition and access to health care; more
education for women; and the increasing availability of “skilled attendants” —
people with some medical training — to help women give birth. As well as
improvements in large countries like India and China, which helped to drive down
the overall death rates[8].

Maternal health problems in developing countries also include complications

from childbirth that don't result in death. For every woman that dies during
childbirth approximately 20 suffer from infection, injury, or disability [9]

Improving access and affordability of health care is a major factor in improving

maternal health. In India the government started paying for prenatal care and
skilled delivery and saw successes in reducing maternal mortality, so much so
that India is cited as the major reason for the decreasing global rates of maternal
mortality [[10]]

According to the World Health Report in 2004, bad maternal conditions account
for the fourth leading cause of death for women after HIV/AIDS, malaria, and
tuberculosis. Ninety-nine percent of these deaths occur in low-income countries;
while only 1 of 4,000 women have a chance of dying in pregnancy or childbirth in
a developed nation, a woman in Sub-Saharan Africa has a 1 in 16 chance of
dying [11]. Furthermore, maternal problems cause almost 20% of the total
burden of disease for women in developing countries.[citation needed]

Almost 50% of the births in developing countries take place without a medically
skilled attendant to aid the mother and the ratio is even higher in South Asia
[12]. Women in Sub-Saharan Africa mainly use traditional birthing attendants,
with little or no medicinal training.[citation needed] This largely accounts for the
high numbers of maternal deaths in this region.[citation needed]

[edit] Proposed solutions

The World Bank estimated that a total of 3.00 US dollars per person a year can
provide basic family planning, maternal and neonatal health care to women in
developing countries.[13] Many non-profit organizations have programs
educating the public and gaining access to emergency obstetric care for mothers
in developing countries. The United Nations Population Fund (UNPFA) recently
began Campaign on Accelerated Reduction of Maternal Mortality in Africa
(CARMMA) CARMMA is focused on providing quality healthcare to mothers. One
of the programs within CARMMA is Sierra Leone providing free healthcare to
mothers and children, which is what USAID would be encouraging and funding
more of if selected. This initiative has widespread support from African leaders
and was started in conjunction with the African Union Health Ministers [14]

Improving maternal health is the 5th of the UN's Millennium Development Goals
by reducing the number of women dying during pregnancy and childbirth by
three quarters by 2015 [15] and increasing the usage of contraception and
family planning. The current decline of maternal deaths is only half of what is
necessary to achieve this goal, and in several regions such as Sub-Saharan Africa
the maternal mortality rate is actually increasing. Decreasing the rates of
maternal mortality and morbidity in developing countries is important because
poor maternal health is both an indicator and a cause of extreme poverty.
According to Tamar Manuelyan Atinc, Vice President for Human Development at
the World Bank, “Maternal deaths are both caused by poverty and are a cause of
it. The costs of childbirth can quickly exhaust a family’s income, bringing with it
even more financial hardship." [16]

Developed countries had rates of maternal mortality similar to those of

developing countries until the early 20th century, therefore several lessons can
be learned from the west. During the 19th century Sweden had high levels of
maternal mortality, and there was a strong support within the country to reduce
mortality rate to fewer than 300 per 100,000 live births. The Swedish
government began public health initiatives to train enough midwives to attend
all births. This approach was also later used by Norway, Denmark, and the
Netherlands who also experienced similar successes [17]
Increasing contraceptive usage and family planning also improves maternal
health. In Nepal a strong emphasis was placed on providing family planning to
rural regions and it was shown to be effective [18]. Madagascar saw a dramatic
increase in contraceptive use after instituting a nationwide family planning
program, the rate of contraceptive use increased from 5.1% in 1992 to 29% in
2008 [19]

[edit] By region

Worldwide the Maternal Mortality Ratio has decreased, with South-East Asia
seeing the most dramatic decrease of 59% and Africa seeing a decline of 27%
There are no regions that are on track to meet the Millenium Development Goal
of decreasing maternal mortality by 75%. [20] For current maternal mortality
rates see http://www.mdgmonitor.org/map.cfm?goal=4&indicator=0&cd=.

[edit] See also

Infant

Maternal Health Task Force

Sex_education

[edit] References

This article is missing citations or needs footnotes. Please help add inline
citations to guard against copyright violations and factual inaccuracies.
(July 2007)
http://www.unicef.org/mdg/maternal.html

http://www.sciencedaily.com/releases/2010/02/100218092852.htm

http://www.nytimes.com/2010/04/14/health/14births.html?_r=3&pagewanted=1

http://www.who.int/mediacentre/news/releases/2010/maternal_mortality_201009
15/en/index.html

http://www.un.org/ecosocdev/geninfo/afrec/vol21no4/214-maternal-health.html

http://www.unfpa.org/public/site/global/lang/en/pid/5479

De Brouwere, Vincent, Tonglet, René, Van Lerberghe, Wim (1998) “Strategies for
reducing maternal mortality in developing countries: what can we learn from the
history of the industrialized West?” Tropical Medicine & International Health 3, 10
[21]

http://gamapserver.who.int/gho/static_graphs/MDG5_MM_trends.png

[edit] External links

WHO Maternal Health

Country profile on maternal and newborn health by Making Pregnancy Safer,
WHO

United Nations Millennium Campaign | Goal 5: Maternal health

White Ribbon Alliance for Safe Motherhood

Family Care International

Partnership for Maternal, Newborn, and Child Health

Safe Motherhood

UNICEF Maternal Health Databases

March of Dimes

EngenderHealth Maternal Health Care: Saving Women's Lives

Rotary Maternal Health Projects in Nigeria Reduction of Maternal and Child

Mortality - Prevention and Treatment of Obstetric Fistula

Women Deliver

Maternal Health Taskforce

The Collaborative on Quality Care for Pregnancy & Childbirth

Breastfeeding Nutrition

[22]

The Global Library of Women's Medicine Safer Motherhood Section - non-profit

offering freely downloadable material for healthcare professionals

[show]
v•d•e
Public health

Auxology • Biological hazard • Chief Medical Officer •

Environmental health • Globalization and disease • Health
economics • Sociology of health and illness • Medical sociology •
Social psychology • Deviance (sociology) • Sociology of health and
General illness • Medical anthropology • Health literacy • Health policy
(Health care system • Healthcare reform • Public health law) •
Maternal health • Mental health • Pharmaceutical policy • Public
health genomics • Public health laboratory • Reproductive health •
Tropical disease

Preventi Health promotion • Family planning • Human nutrition • Hygiene

ve (Hand washing • Food safety • Infection control • Oral hygiene) •
medicin Occupational safety and health (Occupational hygiene •
 Ergonomics • Injury prevention) • Patient safety (organization) •
Pharmacovigilance • Safe sex • Sanitation (Community-led total
e
sanitation • Sanitary sewer • Waterborne diseases • Water
management) • Smoking cessation • Vaccination • Vector control

Community health • Global health • Biostatistics • Epidemiology •

Populati Health impact assessment • Health system • Public health
on informatics • Health software (Epi Info • OpenEpi) • Social
health medicine • Social determinants of health (Health disparities •
Healthcare inequality • Race and health)

[show]

Organizations, Education and History Health impact assessment •

World Health Organization • European (European Centre for

Disease Prevention and Control • Committee on the Environment,
Agencies Public Health and Food Safety) • India (Ministry of Health and
and Family Welfare) • U.S. (U.S. Public Health Service (Centers for
organizati Disease Control and Prevention) • Public Health - Center for
ons Public Health Practice • Center for Minority Health • Council on
Education for Public Health • Public Health – Seattle & King
County) • World Toilet Organization • Globalization and Health

Health education • Bachelor of Science in Public Health • Master

of Public Health • Doctor of Public Health • European Programme
Education
for Intervention Epidemiology Training (EPIET) • Professional
Further Education in Clinical Pharmacy and Public Health

Sara Josephine Baker • Samuel Jay Crumbine • Carl Rogers

History Darnall • Joseph Lister • Margaret Sanger • John Snow • "Typhoid
Mary" • Germ theory of disease • Social hygiene movement

[show]
v•d•e
Family planning and Reproductive health

Rights Reproductive rights (Contraceptive security · Genital integrity)

Sex education · Pre-conception counseling · Genetic

Education
counseling

Reproductive life plan · Childfree · Parenting (Childbirth,

Planning
Adoption, Foster care)

Implement Birth control · Safe sex

 Health Men's · Women's (Vulvovaginal)

Maternal health · Obstetrics · Prenatal care · Pregnant

Pregnancy patients' rights · Unintended pregnancy · Pregnancy options
counseling · Abortion · Teenage pregnancy

Andrology · Gynaecology · Obstetrics and gynaecology ·

Medicine Reproductive endocrinology and infertility · Genitourinary
medicine

Sexual dysfunction · Infertility (Assisted reproductive

Disorder technology) · Reproductive system disease · Sexually
transmitted disease (clinic, test)

{{Birth control methods}} · {{Pregnancy}} · {{Sex}} ·

Related
{{sexual abuse}} · {{STD/STI}} · {{Assisted reproductive
navboxes
technology}}
Retrieved from "http://en.wikipedia.org/wiki/Maternal_health"

Categories: Sexual health | Obstetrics | Maternal health | Millennium

Development Goals | Women's health

Hidden categories: All articles with unsourced statements | Articles with

unsourced statements from November 2008 | Articles with unsourced statements
from July 2007

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