The Causes and Prevelence of Obstetrical Emergencies

The poor state of maternal health has spurred Maternal Life International- a non-profit organization based in Montana- to direct their efforts for better maternal and neonatal healthcare at Haiti. Their objective is to build family health offices in the country to assist pregnant women and newborns.

Death and illnesses among women, infant, and child are preventable. In pregnancy, existing health risks can distinguish or prevent any future health problems for women and their children. According to U.S. Department of Health and Human Services (2016), some high-risk factors that may consider are the following: hypertension, heart disease, diabetes, depression, genetic conditions, sexually transmitted diseases, tobacco and alcohol abuse, inadequate nutrition and unhealthy weight. By having this government Healthy 2020 initiative, factors that can affect the pregnancy and childbirth such as poverty,

Childbirth is one of the greatest privileges on the earth anyone could have and we, as women, should feel proud to be major contributors for it. Thus, a mother has to play a key role in aiding the healthcare workers to mitigate the health crisis associated with childbirth by performing her duties faithfully. One such associated health crisis is “Premature (preterm) birth” which occurs when the baby is born too early, before 37 weeks of gestational period (CDC, 2015). The rate of preterm birth ranges from 5% to 18% of babies born across 184 countries (WHO, 2015).

Infant deaths in the neonatal period are caused by complications arising from preterm births, birth defects, maternal health conditions, complications of labor and delivery, and lack of access to appropriate care at the time of delivery. Infant deaths in the post-neonatal period are driven by sudden unexpected infant death (SUID) (including sudden infant death syndrome [SIDS]), injury, and infection (MMRW, 2013). An increasing proportion of post-neonatal infant deaths occur among infants who were born preterm but survived the neonatal period (Callaghan, 2006). On the other hand there is lesser knowledge of the incidence and etilogy of fetal mortality which according to MacDorman et al, makes fetal mortality an overlooked public health issue. Lee et al, echoed the same idea when they said infant mortality has been the main focus of public health programming while fetal deaths have gone untargeted. However, with the decrease in infant mortality rates there have been recent approaches such as perinatal period of risk analysis framework (PPOR) that highlight the need to include fetal

Abortion, for the vast majority of people is not a subject that is easy to talk about. According to the World Health Organization, out of the 211 million pregnancies, 46 million end up in abortion and 18 million of those abortions are done in what WHO considers unsafe conditions (World Health Report, 2007). Unsafe conditions are defined by WHO as, “ abortions performed by people lacking the necessary skills or in an environment lacking the minimal medical standards, or both” (World Health Report, 2007). The maternal death rate for women who have unsafe abortions is 350 out of 100,000, and there are other complications that are not fatal but can lead to disease or disability (World Health Report, 2007).

Maternal mortality represents more than the loss of lives for individual women, as it also reflects the larger value and prioritization of women 's health and threatens the health and survival of families, young children, and even the communities in which they live (Royston and Armstrong, 1989). Maternal mortality is unacceptably high (WHO, 2015b). Globally, approximately 830 women die every day from pregnancy- or childbirth-related complications (ibid.). The causes of maternal mortality are predominately preventable and can be classified into three fundamental causes: (1) medical - consisting of direct medical problems and pre-existent/coexistent medical problems that are aggravated by pregnancy, (2) underlying - social and legal conditions, and (3) health systems laws and policies that address availability, accessibility, and quality of reproductive health services (PHP et al, 2011).

The author is a nurse in a level two trauma facility in a community of approximately fifty thousand people in Oregon. The community is a college-town surrounded by a large agricultural area. There is a minimal ethnic diversity within the community. The diversity present occurs mainly from internationally students and faculty from the college. There is a growing population of women who desire low interventional births in the community. The author has worked on the labor and delivery unit of the hospital for the last 14 years. The hospital is the only one in the area to offer trial of labor services to women who have previously undergone a cesarean section. The unit on average experiences around 1000 deliveries annually.

Furthermore, modern abortion procedures are extremely safe. So safe, in fact, that the risk of a woman dying from an abortion is less that one out of 100,000. On the other hand, the number of women who die during childbirth is 13.3 out of 100,000. Access to legal, professionally performed abortion reduces both injury and death caused by “back-alley” abortions. These back-alley abortions account for 68,000 maternal deaths a year in the 33 countries where abortion is either not legal, or unavailable (World Health Organization, Oct. 2006).

Centre for Maternal and Child Enquiries (CMACE) (2011) Saving mothers’ lives; reviewing maternal deaths to make motherhood safer: 2006-2008. BJOG 18(1): 1-203. London. Blackwell Synergy.

An argument for the case of minimal medicalized intervention during birth can be made in terms of low-risk pregnancies and reserving medical interventions for high-risk deliveries and emergency situations. The purpose of this paper is to ensure that members of the childbearing community, including healthcare professionals, are familiar with alternative interventions to cesarean section and thoroughly consider the risks and benefits of said interventions so that natural child-birthing methods can be promoted in low-risk situations.

The fifth goal is to increase maternal health in countries with a focus on reducing the maternal mortality rate by three-fourths and universal access to reproductive health both by 2015. Despite a 43% reduction in maternal deaths since 1990, there are still a large number of women who die during childbirth from preventable causes such as hemorrhaging (United Nations, 2015, p. 38).

Obstetricians and midwives both have a standard that they all need to be aware of and know when working with women in antenatal, birth and post natal. They need to both be able to help assist the women in choosing a mode of care that is suitable for her needs. (Ranzcog.edu.au, 2011)

In his article, "Why are so many U.S. women dying during childbirth?", Munz (2012) pointed out that U.S. is experiencing a rise in maternal mortality. It has doubled for the last 25 years and the experts are uncertain about the increase. Experts are not entirely clear for the rise in the maternal deaths in the U.S., but there are some aspects that may be link to this.

Prenatal care is widely accepted as an important element in improving pregnancy outcome. (Gorrie, McKinney, Murray, 1998). Prenatal care is defined as care of a pregnant woman during the time in the maternity cycle that begins with conception and ends with the onset of labor. A medical, surgical, gynecologic, obstretic, social and family history is taken (Mosby's Medical, Nursing, and Allied Health Dictionary, 1998). It is important for a pregnant woman as well as our society to know that everything that you do has an effect on your baby. Because so many women opt not to receive the benefits of prenatal care, our society sees the ramification, which include a variety of complications primarily

From taking this class, I have gained significant understanding of biological determinants of women’s health. Learning about the number of unique biological risks women face is important to understand for me because I am a woman and this risks are likely to pertain to me as well. One of topic of biological aspect of women’s health we covered in class were risks factors associated with pregnancy, its complication and pregnancy itself. Understanding about maternal death and number of causes such as hemorrhage, sepsis, hypertensive, and abortion