Maternal 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. Postnatal care issues include recovery from childbirth, concerns about newborn care, nutrition, breastfeeding, and family planning.

Problems

Most women do not have access to the health care and sexual health education services that they need. 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. More than one woman dies every minute from such causes; 585,000 women die every year (WHO). Less than one percent of these deaths occur in developed countries, demonstrating that they could be avoided if resources and services were available (WHO). Any woman can experience sudden and unexpected complications during pregnancy, childbirth, and just after delivery. Although high-quality, accessible health care has made maternal death a rare event in developed countries, these complications can often be fatal in the developing world.

Consequently, mothers in developing nations die in childbirth at a hundred or more times the rate in developed nations (MDG). Access to emergency obstetric care, the most important remedy for women in these regions is not highly regarded as a priority.According to Rafiqul Chaudhury and Zafrullah Chowdhury, in countries like Bangladesh, 68.7% of the women give birth without the assistance of trained birth attendants. Instead relatives or traditional midwives, who are often not capable of handling complications during the delivery serve as birth assistants.

Factors that prevent women in developing countries from getting the health care they need include distance from health services, cost (direct fees as well as the cost of transportation, drugs, and supplies), multiple demands on their time, and women’s lack of decision-making power within the family. The poor quality of services, including poor treatment by health providers, also makes some women reluctant to use services.

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. Furthermore, maternal problems cause almost 20% of the total burden of disease for women in developing countries.

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 (UNICEF). Women in Sub-Saharan Africa mainly use traditional birthing attendants, with little or no medicinal training. This largely accounts for the high numbers of maternal deaths in this region.

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. Many non-profit organizations have programs educating the public and gaining access to emergency obstetric care for mothers in developing countries.

The services needed are said to include:

• Routine maternal care for all pregnancies, including a skilled attendant (midwife or doctor) at birth
  • Medical training for traditional birthing attendants might be one way to help provide this service.
• Emergency treatment of complications during pregnancy, delivery and after birth
• Postpartum family planning and basic neonatal care
• Educating women and their communities about the importance of maternal health care, and according women the social status to make health care decisions and seek medical attention.
• Any form of education, even 6 years worth of education for girls can drastically improve overall maternal health (UNICEF)
• Research on social and psychological factors affecting maternal health
• Development of better interventions (and evaluations of interventions) for complex problems (e.g., behavioral, social, biological, cultural) arising in marginalized communities

By region

According to the "Investing in Development" portion of the Millennium Development Goals, there are major trends for improvement in maternal health.

Regions that have met MDG (goals) for maternal health:

Sub Saharan Africa
Southeastern Asia
Southern Asia
Oceania

Regions that are making slow progress:

Northern Africa
Western Asia
• Latin America and Caribbean

Regions that are making no and negative progress:

Eastern Asia
• Europe (Commonwealth of Independent States)
• Asia (Commonwealth of Independent States)

Although there has been significant improvement in maternal health over the last century, the last decade has shown a slow rate of improvement in maternal mortality and morbidity, especially in Latin America and the Caribbean (MDG). Only about 17% of countries are on track to meet these Millennium Development Goals.