L4: Maternal Mortality in LMICs PDF

**[L4: Maternal mortality in LMICs]** - Despite decline in mortality, variation in subgroups - In 2020, 95% of preventable deaths related to pregnancy/childbirth occurred in LMICs - Maternal deaths: death of a women while pregnant or within 42 days of termination of pregnancy from a...

**[L4: Maternal mortality in LMICs]** - Despite decline in mortality, variation in subgroups - In 2020, 95% of preventable deaths related to pregnancy/childbirth occurred in LMICs - Maternal deaths: death of a women while pregnant or within 42 days of termination of pregnancy from any cause related to/aggravated by the pregnancy or its management - Indirect: maternal death resulting from previous existing disease or unrelated diseases but was aggravated by the pregnancy - Maternal Mortality Ratio (MMR): number of maternal deaths per 100,000 live births - Maternal Mortality Rate: number of maternal deaths per 100,000 women of reproductive age - Lifetime risk of maternal death: estimated risk of a woman dying from pregnancy/childbirth during her lifetime based on levels/patterns of maternal mortality and fertility rates of the country - Common causes of maternal injury/death: - Excessive blood loss (haemorrhage) - Infection - High blood pressure - Unsafe abortion - Obstructed labour - Most developing countries do not have reliable birth and death registration births/deaths occur at home; conflict makes it hard to quantify - Natural mortality is around 1000-1500 per 100,000 births - Maternal mortality strongly related to health and survival of children - High number of maternal deaths in some areas reflect inequity and access to quality health services - 2020: MMR 430/100k live births in LMICs compared to 13/100k live births in high income countries - Risk factors: - Old/young mothers - Parity - Birth spacing - Risk of dying lowest between age 20-24 and with 2^nd^/3^rd^ births - Every pregnant women faces risks - Antenatal care: medical care received while you are pregnant (up until you give birth), package of interventions for mothers and babies (advice, nutrition...) - ANC can detect risk and danger signs in some women - 77% in LMICs receive 1 but 42% receive the 4 recommended visits - Skilled attendant: accredited health professional who are educated and trained in childbirth - 50% of women in LMICs deliver with a skilled attendant - Emergency Obstetric Care (EMoC): care provided to treat women in emergencies - Haemorrhage can kill in less than 2hrs, women need care EMoC in 6-12hrs to save life - Postnatal care: support for baby after birth, more than 60% of deaths occur in post-partum period - Only 37% of women in least developed countries had postnatal checkups within two days of birth - Reducing maternal and neonatal mortality through - Reducing unintended pregnancies - Reducing unsafe abortion - Reducing overall numbers of pregnancies - Reducing high-risk pregnancies - Referring women with pre-existing conditions before pregnancy to advice and support - Three delays model: - Delay in deciding to seek appropriate care - Delay in reaching appropriate care - Delay in receiving care - Barriers to care: - Demand-side: financial, geographical, lack of knowledge, cultural issues - Supply-side: service quality, availability, human resource crisis - SDG goal: by 2030 reduce global MMR to less than 70 per 100,000 live births - Poorest women are 6x more likely to die from maternal causes than the wealthiest