Antenatal care and safer motherhood-Unicef view

Insufficient maternal care during pregnancy and delivery is largely responsible for the appalling annual toll of 515,000 maternal deaths and the estimated 8 million infant deaths (over half of them foetal deaths) that occur either just before or during delivery or in the first week of life. During the pregnancy, regular contact with a doctor, nurse or midwife allows health personnel to manage the pregnancy; immunize the mother-to-be against tetanus to protect her and her infant; promote good nutrition, hygiene and rest; and detect potential complications making it advisable to give birth in a health facility equipped to handle high-risk deliveries and aftercare. The World Health Organization (WHO) recommend a minimum of four antenatal visits. Labour and delivery, too, should be supervised by doctors, midwives or nurses with the midwifery skills to handle normal deliveries safely and recognize the onset of complications beyond their capacity to handle, referring the mother for emergency care.

Women are most in need of skilled care during delivery and the immediate postpartum period when roughly three quarters of all maternal deaths occur. Traditional birth attendants trained or untrained, can neither predict nor cope with serious complications. The single most critical intervention for safe motherhood is thus to ensure that a competent health worker with midwifery skills is present at every birth, and transport is available to a referral facility for obstetric care in case of emergency.

Maternal care rales tend to be low, and maternal mortality rates high, in countries where women have low status, and also in areas with poor access to routine health services in general. Vast disparities persist in maternal health coverage between the industrialized and developing countries; rich and poor; urban and rural; educated and uneducated. All women should have access to basic maternity care, through a continuum of services offering quality antenatal care, clean and safe delivery, and postpartum care for mother and infant, with a functioning referral system linking the whole.