Basic Maternal And Newborn Care

"This reference manual is intended for use by skilled providers (including midwives doctors and nurses) who care for womans experiencing normal pregnancies, births, and postpartum periods, as well as their normal newborns, in low-resource settings."

The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.

The main aim of this practical Handbookis to strengthen counselling and communication skills of skilled attendants (SAs) and other health providers, helping them to effectively discuss with women, families and communities the key issues surrounding pregnancy, childbirth, postpartum, postnatal and post-abortion care. Counselling for Maternal and Newborn Health Careis divided into three main sections. Part 1 is an introduction which describes the aims and objectives and the general layout of the Handbook. Part 2 describes the counselling process and outlines the six key steps to effective counselling. It explores the counselling context and factors that influence this context including the socio-economic, gender, and cultural environment. A series of guiding principles is introduced and specific counselling skills are outlined. Part 3 focuses on different maternal and newborn health topics, including general care in the home during pregnancy; birth and emergency planning; danger signs in pregnancy; post-abortion care; support during labor; postnatal care of the mother and newborn; family planning counselling; breastfeeding; women with HIV/AIDS; death and bereavement; women and violence; linking with the community. Each Session contains specific aims and objectives, clearly outlining the skills that will be developed and corresponding learning outcomes. Practical activities have been designed to encourage reflection, provoke discussions, build skills and ensure the local relevance of information. There is a review at the end of each session to ensure the SAs have understood the key points before they progress to subsequent sessions.

Intended to provide evidence-based recommendations to guide health care professionals in the management of women during pregnancy, childbirth and postpartum, and newborns, and the post abortion, including management of endemic deseases like malaria, HIV/AIDS, TB and anaemia. This edition has been updated to include recommendations from recently approved WHO guidelines relevant to maternal and perinatal health. These include pre-eclampsia & eclampsia; postpartum haemorrhage; postnatal care for the mother and baby; newborn resuscitation; prevention of mother-to- child transmission of HIV; HIV and infant feeding; malaria in pregnancy, interventions to improve preterm birth outcomes, tobacco use and second-hand exposure in pregnancy, post-partum depression, post-partum family planning and post abortion care.

Having a child remains one of the biggest health risks for women worldwide. Fifteen hundred women die every day while giving birth. That's a half a million mothers every year. UNICEF's flagship publication, The State of the World's Children 2009, addresses maternal mortality, one of the most intractable problems for development work.The difference in pregnancy risk between women in developing countries and their peers in the industrialised world is often termed the greatest health divide in the world. A woman in Niger has a one in seven chance of dying during the course of her lifetime from complications during pregnancy or delivery. That's in stark contrast to the risk for mothers in America, where it's one in 4,800 or in Ireland, where it's just one in 48,000. Addressing that gap is a multidisciplinary challenge, requiring an emphasis on education, human resources, community involvement and social equality. At a minimum, women must be guaranteed antenatal care, skilled birth attendants and emergency obstetrics, and postpartum care. These essential interventions will only be guaranteed within the context of improved education and the abolition of discrimination.

The midwife's role is examined in the community and family-health context in this handbook on effective maternal and newborn care for midwives and other healthcare providers. The skills, competencies, and knowledge required to make informed decisions about neo- and postnatal care are covered, including anatomy and the physiology of reproduction, high-risk pregnancies, and labor and birth. Theoretical and practical issues illuminate a midwife's role in the prevention of illness in mothers and babies, with attention to the unique challenges of midwifery in developing nations. Insights from current research studies and critical questions about midwife practice will help those new to health care understand the unique challenges of this form of health-service delivery.

The emphasis of the manual is on rapid assessment and decision making. The clinical action steps are based on clinical assessment with limited reliance on laboratory or other tests and most are possible in a variety of clinical settings.