What is maternal health?
Maternal health (in Austria and maternal health) refers to the health of women with respect to pregnancy, childbirth and the puerperium. Offers to promote maternal health include sex education, family planning, infertility counseling, antenatal and postnatal maternity care. In the poor countries of the South are education and health care crucial for maternal health and contribute significantly to reducing maternal mortality. But even in developed countries have educationally and socially disadvantaged mothers and their children in poorer health.
Poor maternal health has serious implications for health and child development. Poverty, malnutrition, physical and mental illnesses affect the mental (cognitive), physical (motor), mental and spiritual (regular behavior) development throughout childhood. If the mother's health is severely compromised during pregnancy, the child is likely to get health and development problems, is threatened with the worst case of infant death. The physiological environment, which provides the mother to the embryo and fetus is critical for its well-being long after the birth.
The offers of health consist of screening and other interventions among women of childbearing age and have the goal to reduce the risks of pregnancy. Complications of pregnancy should be prevented or detected as early as possible. Professional midwives can intervene in case of complications of childbirth. After delivery, the mothers advice helps in recovery from childbirth, infant care and nutrition (breastfeeding counseling) and provides advice on family planning.
Factors that affect the health of mother and child
Poverty and lack of access to medical services
The risk during pregnancy or birth is to die in Sub-Saharan Africa 175 times greater than in developed countries, the risk for pregnancy-related illnesses and negative consequences after birth is even greater. Poverty, maternal health and the opportunities for the child are closely related to each other. Deaths in the first week of life in developing countries account for 98% of global deaths of this age. In 2010, 287'000 women worldwide died during pregnancy or childbirth. Poverty is detrimental to the health of mother and child.
A study conducted in Kenya study showed that among the common problems of maternal health in poor areas of bleeding, anemia, high blood pressure, malaria, retained placenta, premature labor, prolonged / complicated birth and preeclampsia include. The proximity to facilities and the availability of transportation can have a significant impact on whether prenatal care is claimed. In Mali, found a study on maternal health services that women who lived in rural areas far from health facilities, rare professional care during pregnancy and birth were given as those in urban areas. A lack of transport options worked out even more than the city alone. Similar results showed a study in rural Ethiopia.
Generally belongs to an appropriate antenatal medical care, but also education, social services and ensure adequate nutrition during pregnancy. Even in developed countries are women who live in poor areas, rather overweight, often have unhealthy behaviors such as smoking and drug use, prenatal care are less likely to claim, or have less access to it. They have a significantly higher risk for negative consequences for both mother and child. There are various reasons why women take no prenatal care services. In an American study, 71% of women had low income difficulty in obtaining access to benefits of prenatal care. In the US, immigrant and Spanish-born women at greater risk than white or black women to receive little or no care. The education level is also an indicator. American adolescents are least likely to receive pension benefits during a pregnancy. In several studies called women and adolescent lack of funds and lack of transportation as the most common barriers to prevention services can relate. The quality of pension benefits is closely linked with income.
HIV / AIDS
Maternal HIV rates vary worldwide between 1% and 40%. The African and Asian countries have the highest rates. HIV during pregnancy can be transmitted at birth or during breastfeeding the child, most often the transfer already occurs during pregnancy. An infected mother transmitting the virus with a probability of about 25% to the child, if she does not receive adequate antiretroviral treatment. But if it be treated during pregnancy, there is a 98 percent chance that the child is not infected.
According to information from UNICEF, the number of dead from HIV / AIDS children increased in the past decade strongly, especially in countries where poverty is high and the level of education is low. Although various preventive measures would be possible, the high cost and lack of infrastructure are two central problems with which the international organizations have to fight if they want to combat mother-to-child transmission of HIV in developing countries. A pregnancy among HIV infection in developing countries is also an even bigger Risk for the mother, for example, of developing tuberculosis or malaria.
Overweight
The body weight should increase by about 10 to 15 kg during pregnancy. Maternal obesity can lead to hypertension, diabetes, respiratory complications and infections and adversely affect the course of pregnancy. Obesity is a major risk factor for gestational diabetes. This in turn leads to the birth of very heavy infants to obesity in childhood and later to diabetes type II.
Malnutrition
The nutrition of the embryo and fetus based on maternal protein, vitamin, mineral and total calorie intake. Children malnourished mothers develop less and are smaller, lighter and weaker at birth as a result of this growth retardation and have more malformations. In particular, the development of the brain may be impaired. In addition, the maternal stress affect the fetus directly and indirectly. Physiological changes under stress have an effect on the developing fetus.
Drugs, tobacco and alcohol
Newborns whose mothers consume during pregnancy heroin, often exhibit withdrawal symptoms at birth and later have more attention deficit disorders and other health problems. The use of stimulants such as methamphetamine and cocaine during pregnancy is associated with a number of problems for the child, such as low birth weight, smaller head circumference, motor and cognitive developmental delays and behavioral problems in childhood.
The American Academy of Child and Adolescent Psychiatry has found that 6-year-olds whose mothers smoked during pregnancy, less well on intelligence tests than children whose mothers did not smoke. Smoking during pregnancy may have a variety of adverse effects on the health and development of the child. Common effects of smoking during pregnancy are premature births, low birth weight, fetal and neonatal deaths, respiratory problems and sudden infant death syndrome, and an increased risk for cognitive disorders, attention deficit hyperactivity disorder (ADHD) and other behavioral disorders. A meta-analysis in the International Journal of Cancer shows for children whose mothers had smoked during pregnancy, a 22% risk increase for non-Hodgkin's lymphoma.
Although for moderate drinking (one to two glasses at individual days per week) during pregnancy, no harmful effects were detected, are generally discouraged from consuming alcohol during pregnancy. Excessive alcohol consumption during pregnancy can lead to fetal alcohol syndrome, with physical and cognitive abnormalities in children, such as deformities of limbs, face and heart, learning problems, below-average intelligence to mental disability.
Dental health
The maternal dental health affects the well-being of mother and (unborn) child. The report of 2000, the Surgeon General, the Head of the United States Public Health Service, emphasized the interdependence between dental health and overall health. The dental health during pregnancy influences the future development of the child. The report cites a variety of diseases affecting the dental health, and vice versa, such as diabetes, cardiovascular diseases, stroke and pregnancy complications associated with dental health, and quality of life, functional, psychosocial and economic indicators. Poor dental health has an adverse effect on nutrition, sleep, social relationships, and school work. Pregnancy alters the physiology of women, hormone levels and the immunological reactions, and so also causes an increased susceptibility to diseases of the connective tissue of the gums (periodontal).
Dental caries is transmitted through the exchange of saliva with the bacteria contained therein vertically from mother to child. Maternal oral flora is transmitted to the offspring. The social and behavioral habits, and lack of dental care knowledge transfer to the child and influence its future dental health. Compared with children whose mothers have good dental health, children of mothers with poor oral health have a five times higher risk, even to get bad teeth. Despite the importance of dental health, many pregnant women do not receive adequate dental care, even in cases of obvious dental problems.
Teratogenic
A teratogen is an external effect factor that can cause malformations in the embryo. Chemicals, viruses, and ionizing radiation can lead to a birth defect or impair the child's development. Dose, genetic susceptibility and time of exposure are all factors that determine the extent of the adverse effects. Prescription drugs that are taken during pregnancy, such as streptomycin, tetracyclines, individual antidepressants, progestin, a synthetic estrogen and Accutane, as well as non-prescription, for example, Diet pills can develop a teratogenic effect. Even high doses of aspirin can lead to maternal and fetal bleeding, although low-dose aspirin usually does not hurt.
Herpes
Genital herpes is transmitted at birth in the birth canal to the child. In pregnancies where the mother is infected with the virus, 25% of children get brain damage, a third die. In developed countries choose genital herpes and HIV affected mothers often the way of caesarean section to avoid the risk of transmission of the virus. This option is usually not available in developing countries.
Breast-feeding
After birth, the mother fed the infant with the breast, provided they can do. Breastfeeding has many benefits for the infant. The World Health Organization recommends that mothers breastfeed their children in the first two years of life, while the American Academy of Pediatrics and the American Academy of Family Physicians recommend that mothers do this at least during the first six months, and so continue as long as mutually desired. Infants who are breastfed are less prone to infections eg Haemophilus influenzae, Streptococcus pneumoniae, Vibrio cholerae, Escherichia coli, Giardia lamblia, B-streptococci, Staphylococcus epidermidis, rotavirus, respiratory syncytial virus, and herpes simplex virus 1, for infections of the gastro-intestinal tract and of the lower respiratory tract, as well for middle ear infections. In breastfed babies, there are lower rates of sudden infant death syndrome and infant mortality overall. Rare also are overweight and metabolic disorders, asthma, atopic dermatitis, type I diabetes and cancer.
Also offers women breastfeeding a long-term benefit. They have better blood sugar levels, improve fat metabolism, a lower blood pressure, and they lose the extra weight of pregnancy faster than those who do not breastfeed. In addition, women who are breastfeeding, lower rates of breast cancer, ovarian cancer and rare rare type 2 diabetes.
However, the transmission of HIV through breastfeeding is a huge problem in developing countries, especially in sub-Saharan Africa. The majority of children who acquire HIV through breast milk, do so in the first six weeks of life. The virus is also a major cause of maternal mortality, especially among mothers who breastfeed. A complication is that many HIV-infected mothers can not afford infant formula and thus have no way to prevent transmission of the virus to the child. In cases like this, mothers have no choice but to breastfeed than their children, regardless of their knowledge of the harmful effects.