Overview of Maternal Health.
The Maternal health may be defined as health of the women during Pregnancy and Post partum Period. Health of the women can be discussed under the heading, Preconception, Prenatal, and Postnatal. The main aim is to maintain optimal health so that maternal morbidity and mortality is reduced.
Maternal Health Facts. Following fact has beenhighlighted by world health organization:-
- Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth.
- 99% of all maternal deaths occur in developing countries.
- Maternal mortality is higher in women living in rural areas and among poorer communities.
- Young adolescents face a higher risk of complications and death as a result of pregnancy than older women.
- Skilled care before, during and after childbirth can save the lives of women and newborn babies.
- Between 1990 and 2010, maternal mortality worldwide dropped by almost 50%
Preconception of Maternal Health.
Major emphasis is laid down on Health education related to pregnancy and promotion of health and what healthy lifestyle measures to be adopted In this phase ,screening of diseases like Diabetes mellitus, Hypertension and other disabilities during reproductive age is done in order to reduce the risk factors which may aggravate the conditions during Pregnancy. The major aim is to detect the complications of Pregnancy at an early stage and referred to appropriate Specialist and health services are made available, so that delivery is undertaken in supervision of skilled health care provider.
Classification of Maternal Health. Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. 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, therefore, family cannot afford meternal care after child birth.
- Prenatal Care. Regular Nursing and Medical care is recommended during pregnancy. Major aim is to provide preventive care by regular check up and to provide the information to the women regarding maternal physiological changes during pregnancy. During this period Healthy life style measures are recommended. Prenatal stages play a vital role in reduction of death rates, miscarriage, birth defect and low birth rate respectively. The care can be divided into monthly visits of Doctor during the First two trimester(1-28 weeks). Fortnightly visits after 28 weeks (28weeks-36weeks) and weekly visit after 36weeks to 38weeks). During the visit Physical assessment and fetal Doppler is carried out and at 20 weeks ultrasound is done.
- Postnatal Care. It has been derived from Latin word which means after birth. The period is extended immediately after birth of child and spread for about six weeks. During this period mother is assessed for tears, sustained during pregnancy or suffering constipation or Hemorrhoids. The bladder is assessed for retention of urine, infection problem .During this period mother is briefed regarding the importance of breast feeding , nutrition reproductive and family planning respectively.
Complications of pregnancy
Women during her pregnancy may face routine or fatal complications.
- Maternal Routine complications. Back pain, Carpal Tunnel Syndrome, Contraction, Dehydration, edema, Gastroesophageal reflux disease (GERD), Hemorrhoids’, Lower Abdomen Pain, Increase frequency of urine ,Varicose vein.
- Serious Maternal Problems. Hyperemesisgravidarum, Pelvic griddle pain, Severe Hypertensive state, Deep vein thrombosis, Anemia.
- Serious Fetal Complications. Ectopic Pregnancy (implantation of Embryo outside the uterus), Placenta Abrupto, (Separation placenta from uterus), Multiple pregnancies, prenatal infection.
Causes of Maternal Morbidity and Mortality.
World Health Organization in “2005 World Health Report” has highlighted that a women dies from complications from Childbirth approximately every minute .In the developing world poor maternal conditions accounts fourth leading cause of death in reproductive age. HIV/AIDs are the foremost cause of death followed by Malaria and Tuberculosis. The Most of the maternal deaths and injuries are caused by Biological process but not by disease. Maternal deaths in the developed countries have been prevented ,where as 34% of women dies due post partum hemorrhages in the developing countries as compared 13% women dies due to postpartum hemorrhages in the developed countries.
Safe Mother Hood.
The concept of safe motherhood initiative was launched in 1987, by International agencies to raise the global awareness, and impact of maternal mortality and morbidity and commitment to Safe Mother Hood was renewed in Theme in World Day 7th April 1998. Three pillars of Safe Hood include:-
- High levels of safe motherhood knowledge and awareness among women, husband and the communities at large
- Performance of all deliveries by skilled birth attendants.
- Easy and organized access to emergency obstetrics care for all women.
It has been observed that high quality accessible services has reduced the maternal death to 1% in the developed world .Complications of Pregnancy are the major contributory factor in maternal death, it can be reduced by intervention by trained midwifery present at birth. Transportation and proper referral system is made available and quality emergency services are available, will reduced the number of maternal death.
Fifth of Eight millennium Development Goals of United Nation.
Improving maternal health is the 5th of Eight millenniums goal targeting a reduction in number of women dying during pregnancy and child birth by third quarters by2015.Improvement in maternal health can done by training and building skill capacity of Birth attendants this will help the mother to the delivery in safe environment and in addition to this the birth rate can be reduced by practicing various contraceptive methods and enhancing education level of female will further decrease the rate of maternal mortality and morbidity in the developing countries , poor maternal health is gauged as an indicator of poverty.
Importance of Maternal morbidity and Mortality Indicator.
Maternal mortality data is an important indicator of overall health system quality, because a pregnant women survive in sanitary safe conditions , Skill and adequate staff ,Health facilities well equipped with sufficient stock of Medicines available with good transportation and referral system will increase the maternal survival resulting in increase in life expectancy of women, which is a positive goal for the community this will indicate that the health issues are improving and has a powerful impact on the population.