Quality Care for Mothers and Newborns at Birth in Mexico

Abstract

Estimates of the United Nations (UN) consider that in the world 2.5 million neonates died in the last year from preventable causes such as prematurity, complications during childbirth, and infections. Some died because the care they received was of poor quality. The most striking is that 1.7 million newborns could be saved by improving access to quality care for all pregnant women in humanitarian settings, especially those considered as low-and middle-income countries by the World Bank. Neonatal mortality can be considered as a sensitive indicator of the well-being of a population, the degree of development of a country, as well as health conditions in the mother's environment and the good quality of prenatal and intrapartum care. This will seek the achievement of the Sustainable Development Goals (SDGs) of the United Nations, through universal health coverage (UHC), by 2030. The medical advances that obstetrics has had around history show the interest and importance for the health sector of all countries in the world, the attention of women, especially during the reproductive stage in which it is located at stake the life and health of the human capital of the future. Today, obstetrics is the health science recognized worldwide because it addresses the health of women during the preconception, conception, prenatal, childbirth, postnatal, and postconception stages, as well as the newborn. Every day more progress is made, not only in the increasingly early diagnosis, but also in the care, attention during the months of gestation, and studies and tests to be carried out to have a greater certainty of what happens inside the uterus-definitely, we are going forward. But the latter is not available to all pregnant women, or in all regions of Mexico, because of the asymmetry in the structure, with imbalance in qualified human resources and technology that detract from this quality of care that is intended. Therefore, we are still reporting preventable maternal deaths and preterm infants, and the interest of this chapter is to show the need, as referred by the World Health Organization (WHO), to improve the quality of care with qualified personnel: obstetricians for women and neonatologists or pediatricians for newborn care.

AMBAR: A midwifery‐led training program to improve obstetric and neonatal practices among low‐risk births in Mexico

“…Most births occur in hospitals regardless of the actual level of risk. 6 Routine implementation of evidence-based practices, such as active management of the third stage of labor, delayed umbilical cord clamping, skin to skin contact, among others, is rare. [7][8][9] On the contrary, potentially harmful practices, such as routine episiotomy, fundal pressure, and an excess of cesarean births (CB), are prevalent.…”

“…For example, the Nursing and Midwifery Board of Ireland has stated that “Fundamental to midwifery practice is the provision of safe, competent, kind and compassionate care which is informed by the best available evidence; the midwife's own expertise; and the experiences, preferences and values of the woman.” 5 However, birthing care in Mexico today is far from this ideal. Most births occur in hospitals regardless of the actual level of risk 6 . Routine implementation of evidence‐based practices, such as active management of the third stage of labor, delayed umbilical cord clamping, skin to skin contact, among others, is rare 7‐9 .…”