From the WHO report in December 2011, priority interventions related to childbirth are:
- Social support during childbirth (community, primary, referral)
- Prophylactic antibiotic for caesarean section (referral)
- Caesarean section for maternal/foetal indication (e.g. obstructed labour and central placenta previa) ( referral)
- Prevention of postpartum haemorrhage: a) Prophylactic uterotonic to prevent postpartum haemorrhage (community, primary, referral), b) Active management of third stage of labor to prevent postpartum haemorrhage (primary, referral)
- Induction of labour for prolonged pregnancy (referral)
- Management of postpartum haemorrhage: a) uterine massage, b) uterotonics (community, primary, referral), c) manual removal of placenta (only by professional health workers) (primary, referral)
- Initiation or continuation of HIV therapy for HIV positive women (primary, referral)
This report is actually quite interesting and has loads of good links to reference material.
I am particularly interested in the guidelines/interventions that are called out as appropriate at the community level (the report is referring to community health workers). Social support during birth, prevention of postpartum hemorrage, management of postpartum hemorrage.
The major direct causes of maternal morbidity and mortality include haemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labour. (who.int)
Let’s do it! Let’s Train Midwives to Save Lives at the community level! Social support during birth, prevention of postpartum hemorrage, and management of postpartum hemorrage! THAT’s IT!
(stay tuned: tomorrow … the essential interventions, commodities, and guidelines in relation to newborns)