Maternal Health

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 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.

This book demonstrates that the symbol of maternal sacrifice is the notion that 'proper' women put the welfare of children, whether born, in utero or not conceived, over and above any choices and desires of their own. The idea of maternal sacrifice acts as powerful signifier in judging women's behaviour that goes beyond necessary care for any children. The book traces its presence in various aspects of reproductive health, from contraception to breastfeeding. Pam Lowe shows how although nominally choices are presented to women around reproductive health, maternal sacrifice is used to discipline women into conforming to specific norms, reasserting traditional forms of womanhood. This has significant implications for women's autonomy. Women can resist or reject this disciplinary position when making reproductive decisions, but in doing so, they may be positioned as transgressing and/or need to justify their decisions. The book will be of great interest to scholars of sociology, gender studies and health studies.

This open access edited book brings together new research on the mechanisms by which maternal and reproductive health policies are formed and implemented in diverse locales around the world, from global policy spaces to sites of practice. The authors – both internationally respected anthropologists and new voices – demonstrate the value of ethnography and the utility of reproduction as a lens through which to generate rich insights into professionals’ and lay people’s intimate encounters with policy. Authors look closely at core policy debates in the history of global maternal health across six different continents, including: Women’s use of misoprostol for abortion in Burkina Faso The place of traditional birth attendants in global maternal health Donor-driven maternal health programs in Tanzania Efforts to integrate qualitative evidence in WHO maternal and child health policy-making Anthropologies of Global Maternal and Reproductive Health will engage readers interested in critical conversations about global health policy today. The broad range of foci makes it a valuable resource for teaching in medical anthropology, anthropology of reproduction, and interdisciplinary global health programs. The book will also find readership amongst critical public health scholars, health policy and systems researchers, and global public health practitioners.

Our current era of globalization, war, and socioeconomic unrest has revealed public health as a worldwide concern and a major frontier for social justice with maternal and child health at its epicenter. Yet, there has been a relative scarcity of training resources specifically dedicated to this crucial area. "Maternal and Child Health: Global Challenges, Programs, and Policies" addresses this gap in current knowledge by analyzing the range of socioeconomic and environmental factors, health care disparities, politics, policies, and cultural practices that impact the health and safety of mothers, as well as the well-being and optimum development of their children. Individual sections focus on unequal distribution of the world’s resources, politics and power, specific disease concerns, programs, policies and emerging concerns with a focus on what is currently being done, and what needs to be done to improve the health status of women, children, and adolescents. The book’s contributors are some of the world’s most respected experts, carefully selected to represent different global geographic regions and diverse professional disciplines related to maternal and child health from both academic and field practice perspectives. Among the topics in this authoritative volume: The impact of war, globalization, gender inequity, and harmful traditional practices (e.g., female genital mutilation). Specific health concerns, including tuberculosis, malaria, HIV, and malnutrition. Child and adolescent health issues, from abuse and neglect to children in difficult circumstances. Pregnancy-related issues: safety, abortion and post-abortion care, teen pregnancy, and more. Strategies for planning, developing, and maintaining maternal and child health systems in developing countries. The status of global initiatives, such as Integrated Management of Childhood Illnesses and the Millennium Development Goals. The status of evidence-based maternal and child health in the developing world. With such a wealth of information on both practical and conceptual levels, "Maternal and Child Health: Global Challenges, Programs, and Policies" is as relevant to students and researchers in the field as it is to policy makers and those working for global health and development organizations. It also makes an excellent stand-alone text for courses in global health in general and global maternal and child health in particular.

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.

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.