The Impact Of Maternal Care

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).

Nurses are the first to deal with patients such as, the aging population in the clinical or community setting, so they are well qualified to give expert testimony on health care reform. Before nurses can take a stance and gain a voice in the political arena, they must take on a new hat as an “advocate.” They can start their journey as a patient advocate by joining an association like The American Nurses Association (ANA). Associations like the ANA can mentor nurses venturing into the profession of patient advocacy; in addition to mentoring, the nursing associations can offer legislative days, policy internships, and conduct policy workshops to educate nurses on how to positively affect the legislation and policies at the state or federal level on health care

According to Healthy People 2020, "Improving the well-being of mothers, infants, and children, is an important public health goal for the United States. Their well-being determines the health of the next generation and can help predict future public health challenges for families, communities, and the health care system" (Healthy People 2020, 2015). Infant mortality is defined as the death of an infant before his or her first birthday, while fetal mortality is defined as the intrauterine death of a fetus at any gestational age (MMRW, 2013 and MacDorman, Kirmeyer & Wilson, 2012). In the United States an estimated 13,000 fetal deaths occurred ≥ 28 weeks gestation making up 28% of all perinatal deaths in 2006, the latest year with available national data (Lee,

Energized by the U.S. Supreme Court decision upholding most of the Affordable Care Act (ACA), the American Nurses Association (ANA) is continuing its wide ranging efforts to ensure that Registered Nurses (RNs) have an even greater role in providing high quality care as implementation of the landmark law progresses. As guiding principles, ANA contends that health care is a basic human right, and that all deserve access to essential health care services. As nurses witness every day, a lack of primary and preventive care can cause people's manageable chronic conditions to spiral, leading to poorer patient outcomes and increased overall health care costs. (Anonymous, 2012). According to Billings and Halstead (2012), nurses are poised to participate in transforming this nation's health care system. Participation requires nurses to possess political advocacy skills so that nursing voice is brought to the policy debates and policy development.

To ensure that we as nurses are advocates for not only our patients, but also out communities as a whole, it is imperative for us to fully understand our scope of proactive and our voices that can be heard as an individuals but also as a collaborative voice in legislations by being in empowered professional groups such as the ANA. Promoting better health care polices benefits our society with better health outcomes as well as better financial futures since a healthier society wastes less money and resources when compared to one that does not promote health initiatives. One way to ensure that we as nurses are up to date on current policy and legislation issues is to join a professional group such as the ANA. Advocacy for health care policy requires knowledge and efforts of such large groups and active lobbyists that professional organizations can offer its members (Abood, 2007). Being well informed by a reputable and trust worthy group not only keeps one up to date on all current healthcare issues, but also gives access to resources to actively engage in proposed solutions so that nurses may better advocate for the patients and populations who are so greatly affected by healthcare

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).

In the United States, the process of childbirth is far more dangerous for African American women than it is for White women. For African American women, the path to a healthy birth is riddled with barriers. There are many health disparities between the two races. African American women face much higher low-birth and infant mortality rates; the Centers for Disease Control and Prevention has published that although infant mortality rates in the U.S. have dropped by over 10% in the past ten years, a large gap continues to exist between the health of the races during the entire childbirth process. (World Health Organization, 2010) In the United States, Black infants are more than twice as likely to die within the first year of life as a White infant, and this disparity has not seen advancements in the last century. Many of these deaths can be attributed to low birth weight, and preterm birth among black infants.

Pregnant mothers are viewed as a business made for doctors and hospitals as insurances typically cover infant birth and hospital bills. As Patricia Burkhardt, Clinical Associate Professor, NYU Midwifery Program could not speak the truth any better, she states, “Hospitals are a business. They want those beds filled and emptied. They don’t want women hanging around the labor room.”

Economic growth has much improved the infant mortality rate though better healthcare facilities and living conditions. Japan has fallen to one of the world’s lowest infant mortality levels at 3.6 per 1,000 live births in 2006 (Saigusa, 2006). Infant mortality is largely affected by the health of the mother, which makes pre-natal health imperative in keeping infant mortality rates low. Since Japan offers health care to all, access to prenatal care is easier to get therefore making mothers healthier and help in finding complications earlier in the pregnancy.

As nurses, we have a huge role in advocating for our clients and patients. What better way in advocating for our patients by joining a professional nursing organization. Membership organizations, such as the American Hospital Association’s Section for Small or Rural Hospitals, the National Rural Health Association (NRHA) and state rural health associations, work with legislators to make them aware

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.

In 2013, 289 000 women died during pregnancy and childbirth and it was estimated that everyday 800 women all over the world died from childbirth or childbirth-related problems (World Health Organization, 2014). Often, maternal mortality is found to occur more often in developing countries than developed countries. Maternal mortality refers women who died from the situation like during pregnancy, termination of pregnancy within 42 days, regardless of duration and place of pregnancy, from aggravation caused by the pregnancy or pregnancy management (Nwagha et al, 2010). Maternal mortality may be resulted from direct or indirect cause. Direct causes are from obstetric complications of pregnancy, labour, and puerperium, and interventions whereas indirect causes are from the worsening of current conditions by pregnancy or delivery (Givewell, 2009). This paper aims to examine the causes for maternal mortality in both developed and developing countries and will end with a proposal for government to ensure women are given reproductive health rights.

Kenya is a country that has been making a lot of progress in approaching some of the Millennium Development Goals (MDG) and certain health indicators. However, reducing maternal mortality still remains a challenge in this nation. The reason behind this slow progression results from the interaction of social, cultural, economic and logistical barriers, combined with a high fertility rate (World Bank), and inadequate and under funded health services (WHO). Strengthening the health system and improving quality of healthcare delivery can overcome these challenges.

In front of cheering crowds celebrating the day Kenya attained self-rule –Madaraka day – President Uhuru Kenyatta announced maternity fees at all public health facilities had been abolished. This policy was developed to tackle low uptake of skilled delivery by alleviating the financial burden attached to delivery in public health facilities and ultimately improve neonatal and maternal outcomes[1]. At the time, 56% of Kenyan women deliver at home alone or with the assistance of Traditional Birth Attendants (TBAs) and relatives, contributing to the persistently high national maternal mortality ratio (488 maternal deaths per 100,000 live births) [2]. Maternal and neonatal deaths occur most frequently during labor, delivery and immediately following childbirth [3], [4]. Delivery