Safe Motherhood: Care for Pre-, Ante-, and Postnatal

More than 150 million women become pregnant in developing countries each year and an estimated 500,000 of them die from pregnancy-related causes. Maternal health problems are also the causes for more than seven million pregnancies to result in stillbirths or infant deaths within the first week of life. Maternal death, of a woman in reproductive age, has a further impact by causing grave economic and social hardship for her family and community. The most of women’s health problems in the developing countries are lack access to modern health care services and increase the magnitude of death from preventable problems.

The major determinants of maternal morbidity and mortality include pregnancy, the development of pregnancy-related complications, including complications from abortion and, the management of pregnancy, delivery, and the postpartum period. However, a lot of factors contribute to the low health status of women in the developing countries including Indonesia. These factors include socio economic development of the country has serious impact on morbidity and mortality, and poor agricultural development results in inadequate household food and has direct influence on nutritional status of mothers.

Maternal death often has a number of interlined causes, which may start as early as birth or in early childhood. For example, a girl who is not fed properly during her early years will be stunted and therefore more likely to have obstructed labor. Also, a woman’s risk of dying from infection and hemorrhage is increased considerably when being malnourished.

Other factors are poor sanitary, adverse social and physical environment, lack of access to modern health care services, and poor education of women’s reproductive and health behavior.

The truth is that most of these deaths and conditions are preventable – research has shown that approximately 80 per cent of maternal deaths could be averted if women had access to essential maternity and basic health-care services. The maternal mortality rate is declining only slowly, even though the vast majority of deaths are avoidable.

Basically, the main things to watch, just 3 simple things. Those are Prenatal, Antenatal and Postnatal Care.

Start from Prenatal:

Family Planning is a means of promoting the health of women and families and part of a strategy to reduce the high MMR, IMR, and CMR, preventing maternal mortality by reducing exposure to pregnancy and therefore to risks associated with pregnancy and childbirth in the event of wanted births, preventing pregnancy and abortion when pregnancy is unwanted.

Based on the above factors family planning programs can be taken as the means to offer the service, to all who desire it, the opportunity to determine when to have children, the number of their children and spacing of births.  Accordingly Information about FP should be made available in order to promote access to FP services to all individuals desiring them. Many reports indicate that contraceptive prevalence often rises among older, higher parity women, or those at greatest risk of abortion. There is also a high prevalence in contraceptive use among more educated, urban women with better access to services.

Antenatal:

Ante Natal Care (ANC) is the care given to pregnant mothers that they have safe pregnancy and healthy baby. It also helps in minimizing complications of pregnancy, labor the postpartum and neonatal periods.  The purpose of ANC is to care for pregnant mothers and to have all births attended by trained health workers, and to identify pregnancies where risk is high and provide special care for the mother and the infant. There is a large body of evidence from routine statistics and special studies to suggest that women who have received prenatal care experience lower rates of maternal mortality.

In 2008, more women are receiving antenatal care and skilled assistance during delivery. In North Africa, the percentage of women seeing a skilled health worker at least once during pregnancy jumped by 70 per cent. Southern Asia and Western Asia reported increases of almost 50 per cent, with coverage increasing to 70 per cent of pregnant women in Southern Asia and 79 per cent in Western Asia. Skilled health workers attended 63 per cent of births in the developing world, up from 53 per cent in 1990. Progress was made in all regions, but was especially dramatic in Northern Africa and South-Eastern Asia, with increases of 74 per cent and 63 per cent, respectively.

Unfortunately, large disparities still exist in providing pregnant women with antenatal care and skilled assistance during delivery. Poor women in remote areas are least likely to receive adequate care.

Postnatal:

Post Natal Care (PNC) a care up to six weeks in the postpartum period. Incorrectly given least attention and usually neglected.   PNC – first day after delivery PNC – from first day to 6 weeks during postnatal care always give equal attention and care for both the mother and the new born.

The objectives of postnatal care are observe physical status, advise, and support on breast-feeding, advise on Family Planning, provide emotional support, health education on weaning and food preparation, discuss about menstruation (when it will restart) and when to start sexual relation.

An effective program to prevent maternal deaths will include services at the community, health center and referral level, all of which must be coordinated to ensure their effective functioning.   Preventing the main causes of maternal death will require a spectrum of services including prenatal and delivery care, family planning, and treatment for the complications of unsafe abortion (with provision of safe abortion depending on the law). Provision of comprehensive and integrated care increases the chance of achievement of the objectives of maternal health care. Let’s Safe Mother! (Harumi)