Pregnancy is recognized as a crucial part of reproductive health that affects everyone. It lasts nine months and is conventionally divided into three trimesters. Adolescent and early pregnancy violates girls' rights and can have life-threatening results, as child marriage is a key driver of early pregnancy. Every day in 2015, about 830 women died due to complications of pregnancy and childbirth. Abortion was legalized in Nepal in 2002 and has contributed to a sharp decline in maternal mortality. When disasters strike, pregnant women face psychological, physical and chemical stressors and lack of access to health care and resources. Preparedness programs should provide facilities that are safe and secure for women and children.

1. Pregnancy as a
Reproductive Health
Prepared By :
Rajan Gurung
Roll no : 11
M.Sc. In public health and disaster engineering
Pokhara university
30th july ,2019

2. Reproductive Health (RH)
• The concept of RH was introduced at the international
world conference on population and development
(ICDP) at cairo in 1994 and it was accepted by WHO.
• Reproductive health therefore implies that people are
able to have a satisfying and safe sex life, healthy
fertility life, wished child, and that they have the
capability to reproduce and the freedom to decide if,
when, and how often to do so.
• It is recognized that RH is a crucial part of overall health
and is central to human development which affects
every body.

3. Pregnancy as a RH
• State of carrying a developing embryo within a the female body.
• It last for 9 months, measured from last menstrual period (LMP).
• Conventionally divided into 3 trimesters.

4. Key facts
adolescent and early pregnancy
• Early pregnancy violates the rights of girls, causing the life to
threatening results in terms of sexual and reproductive health .
• Child marry is one of the key drivers of early pregnancy, since there is
a social expectation to have children soon after marriage.
• Unsafe sex among the youngsters, mis use of contraceptive measures
.
• Lack of awareness, sex education and its implementation .
• Rape case is now being the serious issue.

5. Maternal mortality
• Every day in 2015, about 830 women died due to complications of
pregnancy and child birth.
• Risk of woman in a developing country dying from a maternal related
cause during her lifetime is about 33 times higher compared to a
woman living in a developed country.
• Maternal mortality is a health indicator that shows very gaps
between rich and poor, urban and rural areas, both between
countries and within them.
• Maternal mortality rates have dropped significantly from 539 per
100,000 live births in 1996 to 258 deaths per 100,000 live births in
2015.
• Leading causes of maternal mortality are postpartum
haemorrhage(46%), obstructed labour (16%), hypertension and
eclampsia(14%), and puerperal sepsis(12%) in 2015.

6. Abortion and Unintended pregnancy in Nepal
• Abortion was legalized in Nepal in 2002, available upto 12 weeks
gestation on request and upto 18 weeks incase of rape or incest, and
at any time if the pregnancy poses a danger to the woman’s health
and life.
• Abortion legalization has contributed to a sharp decline in maternal
mortality, which fell from 580 maternal deaths per 100,000 live births
in 1995 to 190 per 100,000 in 2013.
• An estimated 323,000 abortions were performed in Nepal in 2014.
• Varies among the development regions.
• Especially janajatis and dalit suffers this kind of problem.

7. Percentage of pregnancies that were
unintended by region, Nepal, 2014
0
10
20
30
40
50
60
70
National Far Western Mid Western Western Central Eastern
development region
development region

8. WHO response
• Reducing marriage before 18 years. Estimates suggest a 10% in child
marriage could contribute to a 70% reduction in a country’s maternal
mortality rate.
• Increasing the use of contraception by adolescents at risk of
unintended pregnancy. If this need was to be met, 2.1 million
unplanned births, 3.2 million abortions, and 5600 maternal deaths
could be averted each year.
• Reducing coerced sex among adolescents.
• Reducing unsafe abortion among adolescents.

9. What happens to pregnant women when
disaster strikes
• Environmental disasters expose pregnant women to psychological,
physical and chemical stressors.
• Displaced women faces a large number of uncertainty around
financial stability, care, childbirth arrangements and their futures.
• A relationship between environmental disasters and birth outcomes
was reported following hurricane katrina in 2005, where pregnant
women with high hurricane exposure were three times more likely to
have a low birth weight baby than women without high hurricane
exposure.
• Infection due to contaminated water, pollutions, insect bite.
• The lack of resources, such as food and clean water, lack of access to
health care and medications becomes quite serious during disasters.

10. Preparedness and Emergency programme
• Mental health preparations.
• Prevention of violence against women during a disaster
• Promotion lactation and relactation during a disaster.
• Encourage patients to develop an evacuation plan
• Encourage patients to develop an emergency birth kit.
• Encourage local and state governments to provide facilities that are
safe and secure for women and children.
• Providing caring for the pregnant woman.

11. Conclusion
Access to the media exposure on public health issues can be the
effective efforts to reduce adolescent pregnancy. Women who have
low maternal education, low wealth index, unemployment, and ethnic
groups such as Dalits,and madhesi needs to be targeted while
designing and implementing policies and programs.

12. THANK YOU !!!