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 (healthinessbox.com)

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.

Maternal Health Improvement Path

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 7^th April 1998. Three pillars of Safe Hood include:-

1. High levels of safe motherhood knowledge and awareness among women, husband and the communities at large
2. Performance of all deliveries by skilled birth attendants.
3. 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 5^th 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.

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