Caring Without Borders: Worldwide

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Here you will find information, documents, links, and resources that are relevant to maternal health care, regardless of where you live.  
Maternal Health in Haiti: Environmental Impacts
       "The UN estimates there are 120,000 pregnant women in Haiti.  Trauma following the recent earthquake is likely to result in thousands of cases of premature birth and an increase in delivery complications" - UNICEF
       Below is a video that details the impact of the Haitian earthquake on maternal health care.  It is an important illustration of how certain environmental determinants of health are inevitable and have the capacity to create dire and sometimes fatal circumstances.

       Click HERE to stream the video in a new window.  
In Silence: Maternal Mortality in India
       Below is a video created by Human Rights Watch that documents maternal health care and implications of maternal mortality in India.  Click HERE to stream the video in a new window.  
Keep A Child Alive - Maternal Mortality in Kenya
       Below is a video created by UNICEFKENYA that documents the hardships faced by a young mother who resides in an informal settlement in Kenya.  Click HERE to stream the video in a new window.  

Background Information on Worldwide Maternal Health 

       The following information has been taken directly from the Human Rights Watch website.  Please click HERE to visit their website.  Similar information can be found as it pertains to specific areas of the world that are lacking severely in proper maternal health care.  As indicated on the navigation bar at the top of the page, you may find information on this site as it is specifically related to maternal health care in the areas of India, Haiti, and the Great Lakes Region of Africa

  • Where do maternal deaths occur?
       The high number of maternal deaths in some areas of the world reflects inequities in access to health services, and highlights the gap between rich and poor. Almost all maternal deaths (99%) occur in developing countries. More than half of these deaths occur in sub-Saharan Africa and one third occur in South Asia.
       The maternal mortality ratio in developing countries is 290 per 100 000 births versus 14 per 100 000 in developed countries. There are large disparities between countries, with some countries having extremely high maternal mortality ratios of 1000 or more per 100 000 live births. There are also large disparities within countries, between people with high and low income and between people living in rural and urban areas.
       The risk of maternal mortality is highest for adolescent girls under 15 years old.1Complications in pregnancy and childbirth are the leading cause of death among adolescent girls in most developing countries.2
       Women in developing countries have on average many more pregnancies than women in developed countries, and their lifetime risk of death due to pregnancy is higher. A woman’s lifetime risk of maternal death – the probability that a 15-year-old woman will eventually die from a maternal cause – is 1 in 4300 in developed countries, versus 1 in 120 in developing countries.

  • Why do women die?
       Women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy. Other complications may exist before pregnancy but are worsened during pregnancy. The major complications that account for 80% of all maternal deaths are:
  1. severe bleeding (mostly bleeding after childbirth)
  2. infections (usually after childbirth)
  3. high blood pressure during pregnancy (pre-eclampsia and eclampsia)
  4. obstructed labour
  5. unsafe abortion.
       The remainder are caused by diseases such as malaria, anaemia and HIV/AIDS during pregnancy.  Maternal health and newborn health are closely linked. More than three million newborn babies die every year, and an additional three million babies are stillborn.

  • How can women's lives be saved?
       Most maternal deaths are avoidable, as the health-care solutions to prevent or manage complications are well known. All women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth. 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.
  1. Severe bleeding after birth can kill a healthy woman within two hours if she is unattended. Injecting oxytocin immediately after childbirth effectively reduces the risk of bleeding.
  2. Infection after childbirth can be eliminated if good hygiene is practised and if early signs of infection are recognized and treated in a timely manner.
  3. Pre-eclampsia should be detected and appropriately managed before the onset of convulsions (eclampsia) and other life-threatening complications. Administering drugs such as magnesium sulfate for pre-eclampsia can lower a woman’s risk of developing eclampsia.
  4. Obstructed labour occurs when the baby's head is too big for the mother’s pelvis or if the baby is abnormally positioned for birth. A simple tool for identifying these problems early in labour is the partograph – a graph of the progress of labour and the maternal and fetal condition. Skilled practitioners can use the partograph to identify and manage a slow labour before the lives of the mother and baby are threatened. If necessary, a caesarean section can be performed.

       To avoid maternal deaths, it is also vital to prevent unwanted and too-early pregnancies. All women, including adolescents, need access to family planning, safe abortion services to the full extent of the law, and quality post-abortion care.

  • Why do women not get the care they need?
       Poor women in remote areas are the least likely to receive adequate health care. This is especially true for regions with low numbers of skilled health workers, such as sub-Saharan Africa and South Asia. While levels of antenatal care have increased in many parts of the world during the past decade, only 66% of women in developing countries benefit from skilled care during childbirth. This means that millions of births are not assisted by a midwife, a doctor or a trained nurse.
       In high-income countries, virtually all women have at least four antenatal care visits, are attended by a skilled health worker during childbirth and receive postpartum care. In low- and middle-income countries, less than half of all pregnant women have a minimum of four antenatal care visits. Other factors that prevent women from receiving or seeking care during pregnancy and childbirth are:
  1. poverty
  2. distance
  3. lack of information
  4. inadequate services
  5. cultural practices.
       To improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system.

Emergency Procedures Checklist 

  To download a copy of the emergency procedures checklist, you can find it listed below in PDF format.  To view the complete checklist in simple text format, please click HERE.  
emergencyprocedureschecklist.pdf
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