Emergency Obstetric Care: Strategy for Reducing Maternal Mortality in Developing Countries

Abstract

Twenty-five years have passed since the global community agreed in Nairobi to address the high maternal mortality by implementing the Safe Motherhood Initiative. However, every year nearly three million women die due to pregnancy related causes. This tragedy is avoidable if women have timely access to required emergency obstetric care.Emergency obstetric care refers to life-saving services for maternal and neonatal complications provided by skilled health workers. Since the beginning of the 1980's, several efforts have been intensified to improve maternal and child health status and reducing the high morbidity and mortality. There was built on a worldwide consensus to provide improved maternal and child health care for addressing the high morbidity and mortality. All participant countries agreed to integrate emergency obstetric care services in their national health care system. Emergency obstetric care is one of the strategies for reducing the maternal mortality as pregnancy related complications are unpredictable. However, many women in developing countries do not have access to essential health care services including emergency obstetric care. Basic emergency obstetric care by skilled birth attendants or timely referral for further comprehensive emergency obstetric care can reduce maternal deaths and disabilities significantly. This paper is based on the results published in PubMed, Medline, Lancet, WHO and Google Scholar web pages from 1990 to 2013.

Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey

“…Also, over 60% of maternal deaths occur in the period around childbirth and few hours/days thereafter [6,7]. Thus, by simply accessing 4 essential/emergency obstetric care services through institutional delivery, several needless maternal and newborn mortalities could be averted [6].…”

“…Obstetric complications of pregnancy (hemorrhage, infections, obstructed labor, unsafe abortion, and eclampsia) are known leading causes of maternal mortality [6,7]. Also, over 60% of maternal deaths occur in the period around childbirth and few hours/days thereafter [6,7]. Thus, by simply accessing 4 essential/emergency obstetric care services through institutional delivery, several needless maternal and newborn mortalities could be averted [6].…”

“…The rationale for this premise is well-established. Obstetric complications of pregnancy (hemorrhage, infections, obstructed labor, unsafe abortion, and eclampsia) are known leading causes of maternal mortality [6,7]. Also, over 60% of maternal deaths occur in the period around childbirth and few hours/days thereafter [6,7].…”

Magnitude, Characteristics, Maternal and Feto-Neonatal Outcomes of Obstetric Emergencies in Western Ethiopia, Nekemte, Ethiopia

“…Women of the higher socioeconomic status usually receive better pregnancy outcomes. Because they are relatively better informed, likely to develop better choices, more likely to develop and implement birth readiness and are more empowered to make decisions in case they come across with obstetric emergencies (10,15,16) In this study, 414 (78.1%) of pregnant women who have visited the selected hospitals for obstetric emergencies had received ANC at least once. Study was done in Kenya to assess fetomaternal outcome of obstetric emergencies reported that 93.4% of women attended an antenatal clinic at least once.…”

Developing Nursing Management Protocol for Maternity Nurses Regarding Emergency Obstetric Care

“…The core elements of obstetrics emergency protocols include availability of skilled personnel to carry out effective interventions during pregnancy, delivery and postnatal period, availability of essential drugs and supplies and patient referrals. Skilled health professionals working in favorable environment should be available and able to attend to every pregnancy, delivery and must be available 24 hours a day, seven days a week [6].…”