Session 1 - Maternal And Child Health Flashcards
What factors affect a woman’s birth experience ?
General health
Access to healthcare
Skilled birth attendance
Socioeconomic status
Health literacy
Advocacy
Empowerment
Define maternal health ? (WHO)
the health of women during pregnancy, childbirth and the postpartum period.
It encompasses the health care dimensions of family planning, pre-conception, prenatal and postnatal care in order to ensure a positive and fulfilling experience in most cases and reduce maternal morbidity and mortality in other cases
What is meant by good reproductive and sexual health ? (UNFPA definition )
Good sexual and reproductive health is a state of complete physical, mental and social well-being in all matters relating to the reproductive system.
It implies that people are able to have a satisfying and safe sex life, the capability to reproduce, and the freedom to decide if, when, and how often to do so.’
What are the tests done and the optimal times for antennal screening ?
Week 0 - commence folic acid , diabetic eye screening (if mothers diabetic )
Week 6 - blood for sickle cell and thlassemia
Week 9 - blood for Hb , rhesus
Week 12/13 - Blood for T21, T18 , T13 and early pregnancy scan for screening of this
Week 12 - bloods for syphilis , hep B, HOV,
Week 16/17 - follow up diabetic eye screen for women with diabetes
Week 20/21 - USS for structural abnormalities
Week 20 - reoffer screening for infectious disease
Week 28 - repeat Hb , antibodies
Week 29 - further diabetic eye screening for women w diabetes
Week 32 - discuss newborn screening advice
Maternal mortality ratio
Calculation ?
All maternal deaths occurring within a reference period (usually 1 year)
—————————————————. X 100K
Total # of live births occurring within the reference period
What is maternal mortality rate ?
REPRESENTS THE RISK ASSOCIATED WITH EACH PREGNANCY (I.E. THE RISK OF DYING ONCE PREGNANT)
Pros of using maternal mortality rate ?
GOOD INDICATOR OF GENERAL
POPULATION HEALTH PLUS STATUS OF WOMEN, HEALTH SERVICES ETC.
• ADVOCACY PURPOSES
• THERE ARE METHODS TO GET
AROUND MISSING DATA
Cons of using Maternal mortality rate ?
DOES NOT INCLUDE ALL
PREGNANCIES IN THE DENOMINATOR
• DIFFICULT TO GET DATA
REQUIRED
DOES NOT DETAIL CAUSES OF
MORTALITY
Maternal death definition
ICD-10; DEATH OF A WOMAN WHILE PREGNANT
OR WITHIN 42 DAYS OF THE END OF THE PREGNANCY (EXCLUDING
ACCIDENTAL OR INCIDENTAL CAUSES)
Two types of maternal death
Direct
Indirect
Late maternal death?
INDIRECT OR DIRECT CAUSES >42 DAYS BUT
<1 YEAR POST PREGNANCY
In Uk , what are leading causes of maternal death ?
THROMBOSIS/THROMBOEMBOLISM REMAIN LEADING CAUSE OF
DIRECT DEATH
MATERNAL SUICIDE IS THIRD LARGEST CAUSE OF DIRECT MATERNAL
DEATH (MOST IMPORTANT CAUSE OF LATE MATERNAL DEATH)
Maternal death , why though?
The 3 phase theory ?
Phase 1 - delay in deciding to seek medical care (P themselves wait too long )
Phase 2 - delay in reaching health care facility
Phase 3 - delay in recieving adequate care once at facility (ex theatre is occupied )
Why are there so many inequalities in maternal deaths ?
MULTI-FACTORIAL
INTERSECTIONALITY OF MULTIPLE DISADVANTAGE, E.G. BEING FROM A
MINORITY ETHNIC BACKGROUND, LIVING IN AN AREA OF DEPRIVATION, HAVING LESS CONFIDENCE IN WRITTEN OR SPOKEN
ENGLISH, BEING RECENTLY ARRIVED IN THE COUNTRY AND NOT UNDERSTANDING THE HEALTH SYSTEM
SYSTEMIC PROBLEMS WITH RACISM AND OTHER UNCONSCIOUS BIASES THAT MEAN THAT NOT EVERYONE RECEIVES THE CARE THEY
SHOULD
What are the main causes of maternal mortality ?
Purely medical reasons ?
Most common reason to least ?
Pre existing medical conditions exacerbated by pregnancy
Severe bleeding
Pregnancy induced Hypertension
Infections (usually post birth)
Obstructed labour / Delivery complications
Abortion complications
Blood clots
