Maternal mortality is unacceptably high. About 287 000 women died during and following pregnancy and childbirth in 2020. Almost 95% of all maternal deaths occurred in low and lower middle-income countries in 2020, and most could have been prevented.
The high number of maternal deaths in some areas of the world reflects inequalities in access to quality health services and highlights the gap between rich and poor. The MMR in low-income countries in 2020 was 430 per 100 000 live births versus 13 per 100 000 live births in high income countries.
Pregnant Woman Giving Birth Video Download
Download 🔥 https://urlca.com/2yGb5g 🔥
To avoid maternal deaths, it is vital to prevent unintended pregnancies. All women, including adolescents, need access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care.
Most maternal deaths are preventable, as the health-care solutions to prevent or manage complications are well known. All women need access to high quality care in pregnancy, and during and after childbirth. Maternal health and newborn health are closely linked. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for the women as well as for the newborns.
Poor women in remote areas are the least likely to receive adequate health care (3). This is especially true for SDG regions with relatively low numbers of skilled health care providers, such as Sub-Saharan Africa and Southern Asia.
The latest available data suggest that in most high income and upper middle income countries, approximately 99% of all births benefit from the presence of a trained midwife, doctor or nurse. However, only 68% in low income and 78% in lower-middle-income countries are assisted by such skilled health personnel (4).
It is clear from the data that the stagnation in maternal mortality reductions pre-dates the start of the COVID-19 pandemic in 2020. The COVID-19 pandemic may have contributed to the lack of progress but does not represent the full explanation.
The level of maternal mortality during the COVID-19 pandemic may have been impacted by two mechanisms: deaths where the woman died due to the interaction between her pregnant state and COVID-19 (known as an indirect obstetric deaths), or deaths where pregnancy complications were not prevented or managed due to disruption of health services.
The global MMR in 2020 was 223 per 100 000 live births; achieving a global MMR below 70 by the year 2030 will require an annual rate of reduction of 11.6%, a rate that has rarely been achieved at the national level. However, scientific and medical knowledge are available to prevent most maternal deaths. With 10 years of SDGs remaining, now is the time to intensify coordinated efforts, and to mobilize and reinvigorate global, regional, national, and community-level commitments to end preventable maternal mortality.
As defined in the Strategies toward ending preventable maternal mortality (EPMM) and Ending preventable maternal mortality: a renewed focus for improving maternal and newborn health and well-being, WHO is working with partners in supporting countries towards:
There are many reasons for the increased risk of pregnancy complications that lead to maternal death, ranging from women getting pregnant at older ages, to inequities in health care, to a rise in chronic health conditions. But about 84% of pregnancy-related deaths are thought to be preventable, according to data from state committees that review maternal deaths.
A quarter of maternal deaths were associated with COVID-19 in 2020 and 2021 combined, according to a report on maternal mortality in October 2022 by the U.S. Government Accountability Office. COVID-19 can pose higher risks to pregnant women, whose bodies are undergoing physiological changes, such as decreased lung capacity and a weakened immune system. And these bodily changes can continue in the postpartum period, Dr. Rainford adds.
Heart disease and stroke are leading causes of maternal mortality, and cardiomyopathy (a weakened heart muscle) is the most common cause of death one week to a year after delivery. In addition, hypertension, which affects a growing number of Americans, can lead to preeclampsia, a condition marked by high blood pressure, proteinuria (protein in the urine), and/or signs of liver and kidney damage that can develop after 20 weeks of pregnancy. Preeclampsia also poses a higher risk for stroke and other problems after delivery.
Early and regular prenatal care improves the chances of a healthy pregnancy. This can start with a visit to the obstetrician before a woman gets pregnant to discuss, among other things, updating immunizations, reviewing medical and genetic histories, and controlling any pre-existing health conditions. A provider will also make recommendations to help ensure the baby will be healthy, such as increasing folic acid intake (this alone provides a 70% reduction in the risk of neural tube defects, which include medical conditions such as spina bifida).
Once a woman becomes pregnant, the first prenatal visit should be scheduled in the first trimester (the first 12 weeks). Follow-up appointments should occur throughout the pregnancy for physical exams, weigh-ins, and blood pressure checks, as well as continued discussions about diet, exercise, and any questions that come up. There may also be blood and imaging tests, including ultrasounds, to assess the health of both the mother and fetus.
The American College of Obstetricians and Gynecologists (ACOG) advises additional visits, as needed, starting in the first three weeks after the baby is born, with a final checkup within the first 12 weeks after giving birth. Some women may require continued medical visits, especially if they experienced any pregnancy complications.
As soon as a woman knows she is pregnant, she should immediately book an appointment with her doctor or the obstetrics practice or clinic where she expects to receive care, obtain confirmation of the pregnancy, if necessary, and start following her doctor's advice, Dr. Rainford explains.
Sometimes, women will need to do research and advocate for themselves to get the support they need, she adds. "It's important to have a good therapeutic relationship with your medical provider," she says. "Women should pay attention to their instincts when they meet a new provider, especially if anything makes them feel uncomfortable."
If a woman develops a complication when her pregnancy is already underway, she should not hesitate to ask for a maternal-fetal specialist, Dr. Rainford adds. (The CDC has a list of warning signs for complications that may develop during pregnancy and up to a year after delivery.)
Research shows that use of tobacco, alcohol, or illicit drugs or misuse of prescription drugs by pregnant women can have severe health consequences for infants. This is because many substances pass easily through the placenta, so substances that a pregnant woman takes also reach the fetus.91 Recent research shows that smoking tobacco or marijuana, taking prescription pain relievers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth.92 Estimates suggest that about 5 percent of pregnant women use one or more addictive substances.93 152ee80cbc