Maternal Care

Dr. Zeinab Saleh

Contents:
 Maternal and Child Health
1) Definition
2) Objectives
3) Maternity cycle
 Antenatal Care
1) Antenatal visits
2) Prenatal advices
3) Specific health protection
4) Mental preparation
5) Family planning
 Intranatal care
 Postnatal care
 Breast feeding
1) Baby Friendly Hospital initiative (BFHI)
2) Objectives of BFHI
 Maternal Mortality
1) Maternal mortality ratio
2) Causes of maternal mortality
3) Maternal mortality (international view)
4) Documentary movie about maternal mortality in Sierra Leone
Maternal and Child Health (MCH)
Is promotive, preventive, curative, and rehabilitative health
care for mothers and children.

Why we need to take care of both mother and

child??

http://www.wikipaintings.org/en/pablo-picasso/mother-and-child-1902
 Why we should provide MCH services?
Having healthy mother and baby, child and adolescent.

Objectives:
1) Promotion of reproductive health
2) Promotion of physical, psychological and mental
development of both child and adolescent.
3) Decrease maternal, perinatal, infant, and childhood
mortality and morbidity

Maternal Health
Is the health of women during pregnancy, childbirth and
the postpartum period.

Maternity Cycle:
1) Fertilization
2) Antenatal Period
3) Intranatal period
4) Postnatal Period
5) Inter-conceptional Period
 Antenatal Care
 Is caring of pregnant woman during her pregnancy

Why we should provide it?

Achieve healthy mother and baby by the end of pregnancy.

Important Antenatal Care Components:

1) Antenatal visits: once every four weeks until 28
weeks, then once every two weeks until 36week gestation
then once every week until the delivery

 What we are doing?

First visit Complete Health History

Physical Examination
Lab Examination
Subsequent visits Physical Examination
Lab Examination
Maintenance of records: Antenatal card, Postnatal cards
and under five card.
Risk Approach: By providing appropriate care for all
mothers and special care for high risk mothers.
2) Prenatal Advices:
 Diet
 Personal life style
 Drugs and radiation
 Warning sign
3) Specific health Protection:
 Anemia
 Other nutritional deficiencies
 Toxemia of pregnancy
 Tetanus
 Syphilis and other STD(HIV, Chlamydia, Gonorrhea,
HSV, HPV, HBV, and HCV))
 German Measles (Rubella)
 Rh Status
 Perinatal Genetic Screening
4) Mental preparation
5) Family Planning
 Intranatal care
 Is caring of pregnant women during labor
Objectives:
1) Asepsis
2) Delivery with minimum injury
3) Provide proper care for the new borne baby
4) Proper management of complications.
Domiciliary Care

Postnatal care (post-Partal care)

 Is caring of both mother and newborn after delivery.

Objectives:
1) Prevent complications of postnatal period
2) Restoration of mother to optimum health
3) Provide family planning services
4) Provide basic health education
5) Check adequacy of breast feeding
 Breast feeding

Advantages:
 Clean, safe available at correct temperature
 Prevention against malnutrition and obesity
 Promotes bonding between mother and infant
 Development of jaws and teeth
 Contain antimicrobial factors
 Contraception
 Easy to digest

http://thewindowofopportunity.info/stories-from-the-field/
When mother should start breast feeding?
Half an hour after normal delivery and one hour after
operative delivery
What is exclusive breast feeding?
Is giving breast milk and only breast milk (except
medications) for complete first six months

Baby Friendly Hospital initiative (BFHI)

Objectives of BFHI

http://www.humptybumptykids.com/wp-content/uploads/2012/10/benefits-of-breast-feeding.jpg
 1) Have a written breastfeeding policy that is
routinely communicated to all health care staff.
2) Train all health care staff in skills necessary to
implement this policy.
3) Inform all pregnant women about the benefits
and management of breastfeeding.
4) Help mothers initiate breastfeeding within one
half-hour of birth.
5) Show mothers how to breastfeed and maintain
lactation, even if they should be separated from
their infants.
6) Give newborn infants no food or drink other than
breast milk, not even sips of water, unless medically
indicated.
7) Practice rooming in - that is, allow mothers and
infants to remain together 24 hours a day.
8) Encourage breastfeeding on demand.
9) Give no artificial teats or pacifiers to
breastfeeding infants.
 10) Establishment of breastfeeding support groups
and refer mothers to them on discharge from the
hospital or clinic.

Maternal mortality
 Maternal Death is death of women during pregnancy or
within 42 day of termination of pregnancy, irrespective
of duration and site of pregnancy, from any cause
related to or aggravated by the pregnancy or its
management, but not from accidental or incidental
causes.
Maternal mortality ratio=
No of women who died during pregnancy, delivery or within 42
days of termination of pregnancy
X1000000
number of live births in the same area and year

Question: In the year 2003 a country has a population of

11 million women, 70% of women are of reproductive age.
There were 1,100 maternal deaths and about 1896552 live
birth in that country in 2003. What is the Maternal Mortality
Ratio in 2003?
Maternal mortality ratio=
= (1100/1896552) x100,000=58 maternal death per
100,000 live births
Late maternal Deaths: is death of woman from
direct or indirect obstetric causes more than 42
days but less than one year after termination of
pregnancy.
ICD categorized maternal deaths into
 Direct obstetric deaths which result from obstetric
complications of pregnant state (pregnancy, labour,
and puerperium) or from interventions, inappropriate
management or from chain of events resulting from
any of the above. Examples, hemorrhage, hypertensive
disorders, sepsis, and obstructed labour

 Indirect obstetric deaths which result from previous

diseases or diseases develop during pregnancy and
which was not due to direct obstetric causes, but was
aggravated by physiological effects of pregnancy.
Examples, anemia, HIV/AIDS and malaria.
 http://www.waha-international.org/?health-topics&gclid=CJDjzPbd7rwCFc_MtAodfgIAPw

Maternal mortality (International view)

 Every day, nearly 800 women die from preventable
causes related to pregnancy and childbirth. About
287000 women died in 2010
 99% of all maternal deaths occur in developing
countries especially in Rural area
 Between 1990 and 2010, maternal mortality worldwide
dropped by almost 50%
  In 2010, countries with highest maternal mortality
were Chad (1100), Somalia (1000), Central African
Republic, (890), Sierra Leone (890) and Burundi (800)

http://gamapserver.who.int/gho/interactive_charts/mdg5_mm/atlas.html

 According to WHO the Libyan MMR in 2012 was 15 per

100,000 live births

Thank You