Maternal health is the health of women during pregnancy, childbirth, and the puerperium. This includes the health care dimensions of family planning, prejudice, prenatal and postnatal care to ensure a positive and satisfactory experience in many cases and reduce maternal morbidity and mortality in other cases.
The United Nations Population Fund (UNFPA) estimates that 289,000 women die from pregnancy or labor-related causes in 2013. These causes range from severe bleeding to delayed labor, all of which have highly effective interventions. Because women have gained access to family planning and skilled births with emergency obstetric reserve care, the maternal mortality ratio decreased from 380 maternal deaths per 100,000 live births in 1990 to 210 transactions per 100,000 live births by 2013. This has resulted in many countries halve the rate of maternal death.
Despite the worldwide decline in mortality rates, many things have to be done. High levels still exist mainly in poor communities with more than 85% living in Africa and South Asia. The effects of maternal mortality lead to vulnerable families, and their babies, if they survive the birth, are more likely to die before reaching their second birthday.
Both maternal death and severe maternal death (SMM) "are associated with high levels of prevention."
In 2010, the US Joint Commission for the Accreditation of Health Care Organizations described maternal death as a "sentinel event", and used it to assess the quality of the health care system.
Four elements are essential for the prevention of maternal death. First, prenatal care. It is recommended that pregnant women receive at least four antenatal visits to check and monitor maternal and fetal health. Second, skilled births with emergency reserves such as doctors, nurses and midwives who have the skills to manage normal labor and recognize the incidence of complications. Third, emergency obstetric care to address the main causes of maternal mortality is bleeding, sepsis, unsafe abortion, impaired hypertension and labor. Finally, postpartum care which is six weeks after delivery. During this time bleeding, sepsis and hypertensive disorders may occur and newborns are particularly vulnerable soon after birth. Therefore, follow-up visits by health workers assessing maternal and child health in the postnatal period are strongly recommended.
Video Maternal health
Factors that affect mother's health
Poverty and access to health care
According to the UNFPA report, social and economic status, cultural norms and values, and increased geographical distance increase all maternal deaths, and the risk of maternal deaths (during pregnancy or childbirth) in sub-Saharan Africa is 175 times higher than in developed countries. countries, and risks for pregnancy-related illness and negative consequences after birth are even higher. Poverty, maternal health, and outcomes for children are all interconnected.
Women living in impoverished areas are more likely to be obese and engage in unhealthy behaviors such as smoking and drug use, tend to engage in or even have access to legitimate prenatal care, and are at a much higher risk for adverse outcomes for mothers and children. A study conducted in Kenya observed that common maternal health problems in poverty-stricken areas include bleeding, anemia, hypertension, malaria, placental retention, preterm labor, prolonged/complicated delivery, and pre-eclampsia.
In general, adequate prenatal care includes medical care and education, social, and nutritional services during pregnancy. Although there are various reasons why women choose not to engage in proper prenatal care, 71% of low-income women in US national studies have difficulty getting access to prenatal care as they seek. In addition, immigrants and Hispanic women are at higher risk than white or black women because they receive little or no pregnancy care, where education is also an indicator (because education and race are correlated). Adolescents tend to at least receive prenatal care altogether. In some studies, women and adolescents assessed inadequate finance and lack of transportation as the most common barriers to receiving appropriate prenatal care.
Earnings are highly correlated with the quality of prenatal care. Sometimes, proximity to health facilities and access to transportation has a significant impact on whether women have access to prenatal care or not. An analysis conducted on maternal health services in Mali found that women living in rural areas, away from health care facilities tend to receive less prenatal care than those living in urban areas. Furthermore, the researchers found a stronger link between lack of transport and prenatal care and delivery. In addition to proximity as a predictor of prenatal care access, Materia and colleagues found similar results for antenatal and antenatal care in rural Ethiopia.
Pre-existing condition
HIV/AIDS
Maternal HIV levels vary across the globe, ranging from 1% to 40%, with African and Asian countries having the highest rates. While maternal HIV infection mostly has health implications for children, especially in countries where high poverty and low levels of education, having HIV/AIDS during pregnancy may also lead to an increased health risk for mothers. Great concern for HIV-positive pregnant women is the risk of contracting tuberculosis (TB) and/or malaria, in developing countries.
Maternal weight
Pregnancy weight usually drops between 11-20 pounds (5-9 kg) to improve outcome for mother and child. Increased rates of hypertension, diabetes, respiratory complications, and infections are prevalent in cases of maternal obesity and can have detrimental effects on pregnancy outcomes. Obesity is a very strong risk factor for gestational diabetes. Research has found that obese mothers who lose weight (at least 10 pounds or 4.5 kg) among pregnancies reduce the risk of gestational diabetes during subsequent pregnancies, while mothers who gain weight actually increase the risk.
Oral hygiene
Mother's oral health has been shown to affect the well-being of pregnant women and unborn fetuses.
The Surgeon 2000 General Report emphasizes the interdependence of oral health on the health and well-being of the individual as a whole. Oral health is very important during the perinatal period and future development of the child. Proper oral health management has benefits for both mother and child. In addition, lack of understanding or maintenance of good oral hygiene for pregnant women can have adverse effects on them and their children. Therefore, it is very important to educate the mother about the importance of oral health. In addition, collaboration and support among physicians in various fields, especially among family practitioners and obstetricians, is vital in addressing maternal oral health concerns. In 2007, the Maternal Mouth Health Project was developed to provide routine oral care for low-income pregnant women in Nassau County, NY. From the beginning, the program has treated more than 2,000 pregnant women, many of whom have significant gum and/or teeth problems.
Oral health has many implications for the overall general health and quality of life of an individual. The Surgeon General's Report lists various systemic diseases and conditions that have oral manifestations. The oral cavity serves both as a site and gate entry diseases for microbial infections, which can affect general health status. In addition, several studies have shown an association between periodontal disease and diabetes, cardiovascular disease, stroke, and adverse pregnancy outcomes. Furthermore, this report establishes the relationship between oral health and quality of life, including functional, psychosocial, and economic indicators. Poor oral hygiene can affect diet, nutrition, sleep, psychological status, social interaction, school, and work.
The protection and control of oral health and disease protects the health and quality of life of women before and during pregnancy. In addition, it has the potential to reduce the transmission of pathogenic bacteria that occurs from mother to child. Along with pregnancy, there comes a physiological change for a woman. Changes, including fluctuating hormones, increase women's susceptibility to oral infections such as periodontal disease. This disease damages the body's ability to repair and maintain soft tissues. It also causes indirect damage through bacterial induction of both the inflammatory and immune responses of the host. During pregnancy, mild inflammation of the gums, "gingivitis pregnancy", is quite common and if left untreated can cause periodontal disease. There is an increase in the number of studies that build the relationship between, periodontal disease and negative health outcomes, which include tooth loss, cardiovascular disease, stroke, poor diabetes control, and poor birth outcomes. For example, one study found that moderate or severe periodontal disease in early pregnancy was associated with delivery of babies of gestational age. Other studies have also found an association between periodontal disease and the development of pre-eclampsia and premature birth.
Another important oral disease related to maternal health is dental caries. Dental caries is the process of tooth decay, and the development of what is commonly known as cavities. Tooth caries is transmitted from mother to child vertically; the colonization of cariogenic bacteria mainly occurs from mother to child through the activity of sharing saliva. Mother's oral flora can eventually prophesize oral flora in heredity. In addition, other maternal factors such as social, behavioral, and biological factors may affect a child's experience with tooth decay. Some of these factors include a lack of knowledge a mother has about oral health, which can affect the development of caries among her children. Compared with children whose mothers had good oral health, children whose mothers had poor oral health were five times more likely to have poor oral health. Poor oral health care has profound implications for the development of children. As mentioned in the Surgeon General Report, oral health affects the quality of life, especially children, with respect to the functional, psychological, economic, and overall emotional well-being of an individual. To demonstrate the adverse effects of bad oral health, take examples of the consequences a simple cavity can have in a child. First, it hurts. This can cause a child to lose school or have poor concentration, ultimately sacrificing school performance. In addition, because of the pain, it may result in poor weight gain or growth. Also, children can show a decrease in self-esteem due to cosmetic problems. In addition, it can affect language and undermine the conversation. Disorders of speech development can also lead to low self-esteem. Finally, cavities though easily preventable, can cause a family financial burden. General dental services are rare and expensive for individuals who do not have dental insurance. This can also lead to unwarranted visits to the emergency department. Poor oral hygiene seeps into other aspects of life, poses a threat to overall wellbeing, if not handled on time and effectively
The importance of oral health is clear, however, many women do not receive dental services before, during, and after pregnancy, even with obvious signs of oral disease. There are several play factors about pregnant women who are not looking for dental care, including the role of the health care system and the disposition of the woman herself. There is a common misconception that it is not safe to get dental services while pregnant. Many prenatal and oral health providers have limited knowledge about the impact and safety of dental services; hence they may delay or hold care during pregnancy. In addition, some prenatal providers do not realize the importance of oral health to general health as a whole, thus failing to refer their patients to a dental service provider. First and foremost, misconceptions about the impact of dental services when a pregnant woman needs to be cleaned. There is consensus that prevention, diagnosis, and treatment of oral diseases is very useful and can be done in pregnant women who have no additional risk of the fetus or mother when compared with the risk of not providing oral care. Equally important is building collaboration among physicians, especially maternal health providers, with other dental care providers. There should be coordination between public health providers and oral health, primarily due to the interdependence of the two fields. Thus, it is very important to educate and train health care providers about the importance of oral health, designing methods to incorporate into their respective practices. Most providers provide education to pregnant women who address the importance of oral health, because these women ultimately control the fate of themselves and their offspring. For example, providers can illustrate to the mother how to reduce cavities by wiping their children's gums with a soft cloth after feeding or bottle feeding. Providing knowledge and practical application of good oral health care practices to mothers can help improve overall maternal and child health. There are other factors that play a role when analyzing the low use of dental services by pregnant women, especially among ethnic and racial minorities. The main factors are lack of insurance and or access to dental services. For this reason, more data needs to be collected and analyzed so that programs are effectively set up to reach all segments of the population.
Maps Maternal health
Effects on child health and development
Prenatal health
Prenatal care is an essential part of basic maternal health care. It is recommended that pregnant women receive at least four antenatal visits, in which a health worker can check for signs of ill health - such as lean weight, anemia or infection - and monitor fetal health. During these visits, women were counseled about nutrition and hygiene to improve their health before, and after, childbirth. They can also develop a delivery plan that outlines how to achieve care and what to do in an emergency.
Poverty, malnutrition, and substance abuse can contribute to cognitive, motor, and behavioral problems in childhood. In other words, if a mother is not in optimal health during the prenatal period (when she is pregnant) and/or the fetus is exposed to teratogen (s), the child is more likely to experience health or developmental difficulties, or death. The environment in which the mother provides for the embryo/fetus is essential for her well-being after pregnancy and birth.
Teratogens are "any agent that has the potential to cause birth defects or negatively alter cognitive and behavioral outcomes." Dosage, genetic susceptibility, and exposure time are all factors for the degree of teratogenic effects on the embryo or fetus.
Prescription drugs taken during pregnancy such as streptomycin, tetracycline, some antidepressants, progestin, synthetic estrogen, and Accutane, as well as over-the-counter medicines like diet pills, can produce teratogenic results for embryo/fetal development. In addition, high doses of aspirin are known to cause maternal and fetal bleeding, although low-dose aspirin is usually harmless.
Newborns whose mothers use heroin during pregnancy often show symptoms of withdrawal at birth and are more likely to have attention problems and health problems as they grow older. The use of stimulants such as methamphetamine and cocaine during pregnancy is associated with a number of problems for children such as low birth weight and small motor and head circumference and cognitive developmental delays, as well as behavioral problems in childhood. The American Academy of Child and Adolescent Psychiatry found that 6-year-olds whose mothers smoked during pregnancy scored lower on tests of intelligence than children whose mothers did not.
Smoking cigarettes during pregnancy can have many adverse effects on the health and development of offspring. The general outcomes of smoking during pregnancy include premature birth, low birth weight, fetal and newborn deaths, respiratory problems, and sudden infant death syndrome (SIDS), as well as increased risk for cognitive impairment, attention deficit hyperactivity disorder (ADHD) and other behavioral problems. Also, in a study published in the International Journal of Cancer, children whose mothers smoked during pregnancy had a 22% increased risk for non-Hodgkin's lymphoma.
Although the use of alcohol in moderation of caution (one to two servings several days a week) during pregnancy is generally not known to cause fetal alcohol spectrum disorders (FASD), the US Surgeon General suggests against alcohol consumption altogether during pregnancy. Excessive use of alcohol during pregnancy can lead to FASD, which usually consists of cognitive and physical abnormalities in children such as facial abnormalities, limbs of the disabilities, face, and heart, learning problems, below average intelligence and intellectual disability (ID).
Although HIV/AIDS can be passed on to offspring at different times, the most common time that a mother gives to a virus is during pregnancy. During the perinatal period, the embryo/fetus can contract the virus through the placenta.
Gestational diabetes is directly linked to obesity in offspring to adolescence. In addition, children whose mothers are diabetic are more likely to develop type II diabetes. Mothers with gestational diabetes are more likely to have very large babies (10 pounds or more).
Because embryo or fetal nutrition is based on maternal proteins, vitamins, minerals, and total caloric intake, infants born to malnourished mothers are more likely to exhibit malformations. In addition, maternal stress can affect the fetus either directly or indirectly. When a mother is under pressure, physiological changes occur within the body that can harm a growing fetus. In addition, mothers are more likely to engage in behaviors that can negatively impact the fetus, such as tobacco smoking, drug use, and alcohol abuse.
Childbirth
Genital herpes is passed to the child through the birth canal during labor. In pregnancy where the mother is infected with the virus, 25% of babies born through infected birth canal become brain damaged, and 1/3 die. HIV/AIDS can also be transmitted during labor through contact with mother's body fluids. Mothers in developed countries may often choose to undergo a cesarean section to reduce the risk of transmission of the virus through the birth canal, but this option is not always available in developing countries.
Postpartum period
Globally, more than eight million of the 136 million women who give birth each year suffer from excessive bleeding after childbirth. This condition - medically referred to as postpartum hemorrhage (PPH) - causes one in every four maternal deaths that occur each year and accounts for more maternal deaths than any other individual cause. Death due to postpartum hemorrhage disproportionately affects women in developing countries.
For every woman who died of pregnancy-related causes, it is estimated that 20 to 30 have serious complications. At least 15 percent of all births are complicated by potentially fatal conditions. Women who survive such complications often require long recovery time and may face lasting physical, psychological, social and economic consequences. Although many of these complications are unpredictable, almost everything can be treated.
During the postpartum period, many mothers breastfeed their babies. Transmission of HIV/AIDS through breastfeeding is a major problem in developing countries, namely in African countries. The majority of infants infected with HIV through breast milk do so within the first six weeks of life. However, in healthy mothers, there are many benefits for breastfed babies. The World Health Organization recommends that mothers breast-feed their children for the first two years of life, while the American Academy of Pediatrics and the American Academy of Family Physicians recommend that mothers do so for at least the first six months, and continue throughout mutually desirable. Babies who are breastfed by healthy mothers (not infected with HIV/AIDS) are less susceptible to infections such as Haemophilus influenza, Streptococcus pneunoniae, Vibrio cholerae, Escherichia coli, Giardia lamblia , group B streptococci, Staphylococcus epidermidis , rotavirus, syncytial respiratory virus and herpes simplex virus-1, as well as respiratory and lower respiratory tract infections and otitis media. Lower infant mortality rates were observed in breast-fed infants in addition to sudden sudden infant death syndrome (SIDS). The decrease in obesity and diseases such as metabolic disease in childhood, asthma, atopic dermatitis, type I diabetes, and childhood cancers are also seen in breastfed children.
Long-term effects for mom
Maternal health problems include complications of labor that do not result in death. For every woman who died in childbirth, about 20 suffered from an infection, injury, or disability
Nearly 50% of births in developing countries are still underway without a skilled medical officer to help mothers, and this ratio is even higher in South Asia. Women in Sub-Saharan Africa are largely dependent on traditional healers (shaman infant), who have little or no formal health care training. In recognition of their role, several countries and non-governmental organizations are working to train midwifes on the topic of maternal health, in order to increase opportunities for better health outcomes among mothers and infants.
Breastfeeding provides women with some long-term benefits. Breastfeeding women experience better glucose levels, lipid metabolism, and blood pressure, and faster gestational weight loss than those who do not. In addition, breastfeeding women experience lower rates of breast cancer, ovarian cancer, and type 2 diabetes. However, it is important to remember that breastfeeding benefits greatly for women who are not HIV-infected. In countries where high HIV/AIDS rates, such as South Africa and Kenya, virus is the leading cause of maternal mortality, especially in breastfeeding mothers. A complication is that many HIV-infected mothers can not afford formula milk, and thus have no way of preventing transmission to children through breast milk or avoiding health risks for themselves. In such cases, mothers have no choice but to breastfeed their babies regardless of their knowledge of harmful effects.
Maternal mortality rate (IMR)
Worldwide, Mortality Rate (MMR) has declined, with Southeast Asia experiencing the most dramatic decrease of 59% and Africa having decreased by 27%. No region is on track to meet the Millennium Development Goals to reduce maternal mortality by 75% by 2015.
Maternal death - sentinel event
In the ACOG/SMFM consensus of September 2016, published simultaneously in the journal Obstetrics & amp; Gynecology and by the American College of Obstetricians and Gynecologists (ACOG), they note that while they do not yet have a single, comprehensive definition of severe maternal morbidity (SMM), the rate of SMM increases in the United States such as maternal mortality. Both "are associated with high prevention rates."
The US Joint Commission for Accreditation of Health Care Organizations calls maternal death a "sentinel event", and uses it to assess the quality of the health care system.
Maternal death data is said to be an important indicator of overall health system quality as pregnant women survive in clean, healthy, and well-stocked facilities. If a new mother develops, it indicates that the health care system is doing its job. If not, a problem may exist.
According to Garret, improving maternal survival, along with life expectancy, is an important goal for the world health community, as they point out that other health problems are also increasing. If this area improves, disease-specific improvement is also better for a positive impact population.
MMR in developing countries
The decline in maternal mortality and morbidity in developing countries is important because poor maternal health is an indicator and the cause of extreme poverty. According to Tamar Manuelyan Atinc, Vice President for Human Development at the World Bank:
"Both maternal mortality is caused by poverty and is the cause of it.The cost of labor can quickly spend family income, bringing more financial difficulties."
In many developing countries, complications of pregnancy and childbirth are the leading causes of death among women of reproductive age. A woman dies of complications from labor about every minute. According to the World Health Organization, in the World Health Report 2005 , poor motherhood is the fourth leading cause of death for women worldwide, after HIV/AIDS, malaria and tuberculosis. Most maternal deaths and injuries are caused by biological processes, not of illness, which can be prevented and most have been eradicated in developed countries - such as postpartum haemorrhage, which accounts for 34% of maternal deaths in developing countries but only 13% of maternal deaths in developed countries.
Although high-quality, accessible healthcare has made maternal death a rare event in developed countries, where only 1% of maternal deaths occur, these complications can often be fatal in the developing world because one of the most important interventions for maternal safety is ensuring that trained providers with midwifery skills are present at every birth, that transportation is available for referral services, and that quality emergency obstetric care is available. In 2008 342,900 women died during pregnancy or childbirth around the world. Despite the high number, this is a significant decline from 1980, when 526,300 women died for the same cause. This increase is due to 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 birth attendants" - people with basic obstetric and emergency care training - to help women give birth. This situation is mainly led by improvements in major countries such as India and China, which help lower the overall mortality rate. In India, the government began paying for pregnancy and childbirth care to ensure access, and see success in reducing maternal mortality, so much so that India is said to be the main reason for the global decline in maternal mortality.
MMR in developed countries
Until the early 20th century developed and developing countries had the same maternal mortality rate. Since most maternal deaths and injuries can be prevented, they have largely been eradicated in the developed world.
The US has "the highest maternal mortality rate in the industrial world."
Since 2016, ProPublica and NPR have investigated factors leading to an increase in maternal mortality in the United States. They report that "the rate of life-threatening complications for new mothers in the US has more than doubled in two decades because of pre-existing conditions, medical errors and unequal access to care." According to the Centers for Disease Control and Prevention, c. 4 million women who give birth in the US each year, more than 50,000 a year, experience "dangerous and even life-threatening complications." From 700 to 900 people die every year "related to pregnancy and childbirth." The "pervasive problem" is a rapidly increasing "maternal morbidity" (SMM), which does not yet have a "single and comprehensive definition".
According to a report by the US Centers for Disease Control and Prevention, in 1993 the Heavy Material Morbidity rate, rising from 49.5 to 144 "per 10,000 delivery hospitals" by 2014, an increase of nearly 200 percent. Blood transfusion also increased during the same period from 24.5 in 1993 to 122.3 in 2014 and is considered a major driver of the increase in QMS After excluding blood transfusion, the SMM rate increases by about 20% over time, from 28.6 in 1993 to 35.0 in 2014. "
Proposed solution
The World Bank estimates that a total of US $ 3.00 per person per year can provide basic family planning, maternal and infant health care for women in developing countries. Many nonprofit organizations have programs that educate the public and gain access to emergency obstetric care for mothers in developing countries. The United Nations Population Fund (UNPFA) recently started the Accelerated Maternal Mortality Reduction Campaign in Africa (CARMMA), focusing on providing quality healthcare for mothers. One of the programs in CARMMA is that Sierra Leone provides free health care for mothers and children. The initiative has widespread support from African leaders and begins with the African Union Minister of Health.
Improving maternal health is the fifth of the eight United Nations Millennium Development Goals (MDGs), targeting a reduction in the number of women who die during pregnancy and childbirth by up to three quarters by 2015, primarily by increasing the use of trained, contraceptive and family planning aides. The current decline in maternal mortality is only half of what is required to achieve this goal, and in some areas such as Sub-Saharan Africa the actual maternal mortality rate is on the rise. However, one country that may meet their 5th MDG is Nepal, which appears to have reduced maternal mortality by more than 50% since the early 1990s. Due to the 2015 deadline for the MDG approach, an understanding of policy developments leading to inclusion of maternal health in the MDGs is critical to future advocacy efforts.
According to UNFPA, maternal deaths will be reduced by about two-thirds, from 287,000 to 105,000, if the need for modern family planning and maternal and newborn health care are met. Therefore, investing in family planning and improving maternal health care brings many benefits including reducing the risk of complications and improving health for mothers and their children. Education is also important with research showing "that uneducated women are nearly three times more likely to die during pregnancy and childbirth than women who finish high school." Evidence suggests that more educated women tend to have healthier children. Education will also increase employment opportunities for women that result in improved status, contribute to family savings, reduce poverty and contribute to economic growth. All of these investments bring significant benefits and effects not only to women and girls but also to their children, families, communities and countries.
Developed countries have maternal mortality rates similar to those of developing countries until the early 20th century, hence some lessons can be learned from the west. During the 19th century Sweden had a high maternal mortality rate, and there was strong domestic support to reduce mortality rates to less than 300 per 100,000 live births. The Swedish government initiated a public health initiative to train enough midwives to attend all births. This approach was also later used by Norway, Denmark, and the Netherlands which also experienced similar success.
Increased use of contraceptives and family planning also improves maternal health through reducing the number of high-risk pregnancies and by lowering the interval between pregnancies. In Nepal strong emphasis is placed on providing family planning to rural areas and proven to be effective. Madagascar saw a dramatic increase in contraceptive use after instituting a national family planning program, the rate of contraceptive use increased from 5.1% in 1992 to 29% in 2008.
See also
- Pregnancy complications
- Child development
- Maternity Duty Unit
- Global health
- Global Strategy for Women's and Children's Health
- Healthcare providers
- Birth attendant
- Sex education
- Reproductive Health Coalition
References
Bibliography
External links
- "5. Improve maternal health". Millennium Development Goals . UNICEF.
- "Maternal Health". World Health Organization.
- WHO Creates a Safe Country Profile Pregnancy on maternal and newborn health
- The Early Butterfly of Pregnancy Melbourne
Source of the article : Wikipedia
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