MHTF Quarterly, Issue 4: Antenatal and Postnatal Care
The MHTF Quarterly shares resources, research and news in key maternal health areas. Our focus here is on antenatal and postnatal care for improving maternal and newborn health.
Antenatal care (ANC) is essential for connecting pregnant women with the health system, promoting healthy behaviors during pregnancy and the post-partum period, encouraging delivery with a skilled provider, identifying and treating health problems, and raising awareness of danger signs that may arise throughout pregnancy.
Similarly, postnatal care (PNC), intended for all postpartum women regardless of delivery location, ensures that complications in both women and newborns are detected quickly and managed appropriately, while also providing women with the resources they need to remain healthy between pregnancies.
In order to be effective, both ANC and PNC must be high-quality and evidence-based.
The World Health Organization (WHO) currently recommends focused ANC (FANC): a model with evidence-based interventions organized into a series of four individualized visits that include preventative care, treatment, and health promotion. During the four visits, the provider will screen the woman for complications, such as anemia and high blood pressure; measure fetal growth; counsel the woman on birth preparedness and maintaining a healthy pregnancy; and answer any questions of the woman and her partner. With the FANC recommendations in place since 2002, the WHO is currently reviewing the guidelines, with plans to release an updated version in the next year.
The WHO also has guidelines for PNC which “address timing, number and place of postnatal contacts, and content of PNC for all mothers and babies during the six weeks after birth.” Twelve evidence-based recommendations address the needs of women who suffer severe morbidity during delivery; cord care for newborns; postnatal assessments for mothers and newborns; and psychosocial support for women.
Worldwide, just 56% of pregnant women receive all four ANC visits as recommended by the WHO. Coverage of postnatal care is even lower: of the two-thirds of women give birth at home in sub-Saharan Africa, just 13% receive any postnatal visit within two days of birth. Meanwhile, an estimated 60% of maternal deaths in the developing world occur during the six-week period after childbirth.
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