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Pillars of Safe Motherhood

Pillars of Safe Motherhood

by: Dr. Surinder Kaur Gambhir
Sr. Consultant - Obstetrics & Gynecology Paras Bliss, Panchkula

Safe motherhood means that no woman, foetus or baby should die or be harmed by pregnancy or birth. Safe motherhood begins with the assurance of basic safe living as a girl and as a woman in society. It can also be defined as a global effort that aims to reduce death and illnesses among women and infants, especially in developing countries.

The goal of safe motherhood is to improve the well-being of the mother through a comprehensive approach of providing promotive and rehabilitative health care.

Six Pillars of Safe Motherhood-

  • Family Planning

Information and services to plan the timing and spacing and number of pregnancies is necessary. Timing and spacing of pregnancy depend on age, family desires and family supports. Economic and social circumstances and access to health care may all play a vital role.

  • Inform and empower girls to delay pregnancy until they are physically and emotionally mature.
  • The recommended birth spacing is at least 2 years after a live birth or at least 6 months after a miscarriage or induced abortion. Interval of less than 6 months imposes an increased risk on health.
  • Ante-Natal Care

Ante-natal care helps women maintain normal pregnancies through focussed assistance and individualized care. Aim of ante-natal care is to detect and track existing conditions or complication, prevent complication, prepare for the birth and be ready for complications. It also includes health promotion and education. According to WHO, at least 5 ante-natal visits should be done of pregnant women who don’t have complicated labour. The risks involved in the pregnancy, screening and danger signs should be told. Tetanus immunization should be done. Prevention, detection and treatment of anaemia should be done through selective haemoglobin testing, routine iron-folic acid distribution, malaria treatment in some regions and ancylostomiasis (hookworm) treatment, counselling and syndromic management of STD for all pregnant women should be done. Diagnosis and treatment of syphilis through RPR testing and antibiotic place delivery according to complications identified.

  • Obstetric Care – Clean and Safe Delivery

All birth attendants should have the knowledge, skills and equipment to perform the clean and safe delivery. Emergency care for the high-risk pregnancies and complications should be made available to all women who need it.

The presence of skilled birth attendants at delivery is a leading predictor of clean and safe delivery. There should be some strategies for comprehensive obstetric care at all levels.

  • Basic Essentials of Obstetric Care at Health Centre Level

Prevention and control of haemorrhage including active management of third stage of labour and removal of retained placental products.

  • Vacuum extractor
  • Repair of perineal lacerations
  • Control of convulsions with parenteral medication
  • Treatment of sepsis with antibiotics
  • Evacuation of retained products for incomplete abortion.
  • Essential newborn care
  • Functional referral system and advocating for emergency transport system should be there for high risk pregnancies
  • Post-Natal Care

Post-partum care should be provided to mother and baby including lactation assistance. Provision of family planning services and managing danger signs. One post-natal visit is necessary for home delivery with 24 hrs and next visit should be during the first week. Early detection and treatment of complications of mother and newborn, advise on breastfeeding, thermal control. Immunization, nutrition and hygiene should be explained.

  • Post- Abortion Care

It is necessary to prevent complications where possible and ensure that complications of abortion are detected early and treated appropriately. Quality services should be provided for termination of fewer than 12 weeks of pregnancy to reduce unsafe abortion practices and complications of pregnancy.

  • STD & HIV/AIDS Control

HIV screening is done to prevent and manage transmission of infection to a baby and to assess risk for future infection. Counselling should be done to encourage the people for testing and prevention. Inspire and motivate boys and men to be sexually responsible partners and value daughters equally as sons.

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