Postabortion care
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This document discusses the public health consequences of abortion in Myanmar. It notes that abortion is illegal except to save a woman's life, and many women resort to unsafe methods performed by traditional birth attendants. This can result in incomplete abortions, bleeding, infections and even death. While some emergency treatment services exist in hospitals, they are difficult to access. Introducing misoprostol or manual vacuum aspiration at primary health centers could help manage abortion complications since these methods are effective, easy to use, and don't require physicians. Overall, reducing unwanted pregnancies through family planning and counseling, as well as expanding post-abortion care, could help address the health impacts of unsafe abortion in Myanmar.
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Abortions and Post Abortion Care
This document discusses abortion as a significant public health problem, noting that an estimated 70,000 women die annually from complications of unsafe abortion procedures primarily in developing countries. It covers definitions and classifications of abortion, causes, clinical features, complications, prevention of unsafe abortion, and post-abortion care. The conclusion calls for a public health approach involving primary, secondary, and tertiary prevention to reduce abortion mortality in sub-Saharan Africa and advance progress on Millennium Development Goals.
Abortion and post abortion care
This document discusses abortion and post-abortion care. It defines abortion and classifies the different types. It also discusses the magnitude of abortion globally and in Africa and Ethiopia. It then covers spontaneous abortion, including risk factors and potential causes. It discusses the clinical features and diagnosis of abortion. It defines post-abortion care and its five key elements. It notes that unsafe abortion is a major cause of maternal mortality worldwide and in East Africa.
Preconceptional counselling
This document discusses preconception counseling, which aims to identify and address risks to a woman's health or pregnancy outcomes through preventative measures and management. It is important as it can improve reproductive health outcomes, reduce maternal morbidity/mortality, and prevent low birth weight, preterm birth, and infant mortality. Preconception care should be provided at various healthcare visits. The goals are screening for high-risk factors, medical/obstetric history, physical exam, and lab testing. Preventive measures include folic acid, maintaining a healthy weight, vaccinations, screening/treating infections, and managing chronic illnesses and addictions.
Female infertility
This document discusses female infertility, including its causes, risks, and treatment options. It defines infertility as the inability to conceive after 12 months of unprotected sex. Common causes include physical obstructions in the reproductive system from conditions like endometriosis, hormonal imbalances, fertilization issues, and problems in early embryonic development. Lifestyle factors like age, stress, smoking, and weight can also impact fertility. Treatment may involve medication, surgery, artificial insemination, or assisted reproductive technologies like IVF. Adoption and counseling are recommended for coping with infertility.
Maternal Mortality
Maternal mortality refers to the death of a woman during pregnancy, childbirth or within 42 days of termination of pregnancy. Some key points:
- Causes of maternal mortality include hemorrhage, sepsis, unsafe abortion, obstructed labor, eclampsia, and complications from existing medical conditions.
- Maternal mortality is highest in Sub-Saharan Africa, where 1 in 16 women face the risk of dying from pregnancy or childbirth-related causes.
- In India, an estimated woman dies every seven minutes from pregnancy or childbirth complications. The maternal mortality ratio in India is around 200 per 100,000 live births.
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Amtsl – active management of third stage of
Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, accounting for over 100,000 deaths per year. Active management of the third stage of labor (AMTSL) involving prophylactic oxytocin, controlled cord traction, and uterine massage can prevent 60% of PPH cases. For women without risk factors, oxytocin is the recommended agent for AMTSL, while carboprost is effective for treatment of PPH. Clinical evidence shows carboprost provides powerful uterine contraction with fewer side effects compared to other uterotonics like methylergometrine. Proper identification of risk factors and preparedness are important for reducing the burden of PPH.
Stillbirth
- Stillbirth is defined as fetal death occurring after 20 weeks of gestation or a fetal weight of at least 500 grams. The worldwide stillbirth rate is over 3 million per year.
- The causes of stillbirth are often unknown, but may include maternal conditions like diabetes or hypertension, fetal conditions like growth restriction, and placental conditions like abruption. Advanced maternal age, obesity, and multiple gestations are also risk factors.
- Evaluation of stillbirth includes fetal autopsy, placental examination, and genetic testing. However, the optimal testing and management for subsequent pregnancies after an unexplained stillbirth remains uncertain due to lack of evidence.
Obstructed labour
Obstructed labor occurs when there is poor or no progress of labor despite strong uterine contractions. It affects 1-2% of deliveries in developing countries and can be caused by issues with the birth canal (e.g. a small pelvis) or the baby (e.g. large size). Diagnosis involves examining the woman and monitoring labor progress with a partograph. Management includes general supportive care, obstetric interventions like assisted delivery or C-section, and treatment to prevent complications for both mother and baby like rupture, infection, asphyxia, or death. Prolonged labor is defined as over 18 hours and can be caused by weak contractions, cervical issues, or structural problems, requiring evaluation
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This document discusses female infertility, including its causes, risks, and treatment options. It defines infertility as the inability to conceive after 12 months of unprotected sex. Common causes include physical obstructions in the reproductive system from conditions like endometriosis, hormonal imbalances, fertilization issues, and problems in early embryonic development. Lifestyle factors like age, stress, smoking, and weight can also impact fertility. Treatment may involve medication, surgery, artificial insemination, or assisted reproductive technologies like IVF. Adoption and counseling are recommended for coping with infertility.
Maternal Mortality
Maternal mortality refers to the death of a woman during pregnancy, childbirth or within 42 days of termination of pregnancy. Some key points:
- Causes of maternal mortality include hemorrhage, sepsis, unsafe abortion, obstructed labor, eclampsia, and complications from existing medical conditions.
- Maternal mortality is highest in Sub-Saharan Africa, where 1 in 16 women face the risk of dying from pregnancy or childbirth-related causes.
- In India, an estimated woman dies every seven minutes from pregnancy or childbirth complications. The maternal mortality ratio in India is around 200 per 100,000 live births.
- Prevention strategies focus on increasing access to antenatal
Amtsl – active management of third stage of
Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, accounting for over 100,000 deaths per year. Active management of the third stage of labor (AMTSL) involving prophylactic oxytocin, controlled cord traction, and uterine massage can prevent 60% of PPH cases. For women without risk factors, oxytocin is the recommended agent for AMTSL, while carboprost is effective for treatment of PPH. Clinical evidence shows carboprost provides powerful uterine contraction with fewer side effects compared to other uterotonics like methylergometrine. Proper identification of risk factors and preparedness are important for reducing the burden of PPH.
Stillbirth
- Stillbirth is defined as fetal death occurring after 20 weeks of gestation or a fetal weight of at least 500 grams. The worldwide stillbirth rate is over 3 million per year.
- The causes of stillbirth are often unknown, but may include maternal conditions like diabetes or hypertension, fetal conditions like growth restriction, and placental conditions like abruption. Advanced maternal age, obesity, and multiple gestations are also risk factors.
- Evaluation of stillbirth includes fetal autopsy, placental examination, and genetic testing. However, the optimal testing and management for subsequent pregnancies after an unexplained stillbirth remains uncertain due to lack of evidence.
Obstructed labour
Obstructed labor occurs when there is poor or no progress of labor despite strong uterine contractions. It affects 1-2% of deliveries in developing countries and can be caused by issues with the birth canal (e.g. a small pelvis) or the baby (e.g. large size). Diagnosis involves examining the woman and monitoring labor progress with a partograph. Management includes general supportive care, obstetric interventions like assisted delivery or C-section, and treatment to prevent complications for both mother and baby like rupture, infection, asphyxia, or death. Prolonged labor is defined as over 18 hours and can be caused by weak contractions, cervical issues, or structural problems, requiring evaluation
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#SRHR #sexualhealth #reproductiverights #familyplanning #womenshealth #LGBT #genderequality #SDGs #ageing #elderly #olderpeople #IDOP2020 #InternationalDayOfOlderPersons
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This document summarizes a case study on infant mortality rate (IMR) and malnourishment in Satna, Madhya Pradesh, India. It begins with definitions of IMR from organizations like UNICEF and WHO. It then provides background on worldwide and Indian IMR trends, noting that Satna has a higher IMR than most other Indian states and countries globally. The document describes conducting surveys of local officials and residents in Satna to understand factors contributing to high IMR and malnourishment. Key factors identified include lack of access to healthcare, sanitation issues, and poverty. The document concludes by suggesting steps like improving nutrition programs and healthcare access to help reduce IMR and malnourishment in Satna.
Assessment of Maternal Health Seeking Behavior and Service Utilization among ...
Health seeking behavior and utilization of maternal healthcare services are proximate factors that influence maternal morbidity and mortality in any society. We therefore assessed the pattern of health seeking behavior and types of maternal healthcare services utilized by women of the reproductive age in parts of Southeastern Nigeria. A cross sectional descriptive method involving the use of a well-structured pretested questionnaire was used to collect data from 521 randomly selected women between the ages of 15-49 years. Informed oral consent was obtained from these women prior to their recruitment for the study. Descriptive statistical analysis was performed on the data obtained using the Statistical Package for Social Science (SPSS). The mean age of the respondents was 32 ± 0.07620 years and most(50.5%) attained secondary education. There was a significant relationship between healthcare services and mother's age (p<0.000) with women between 29-35yrs (52.2%) utilizing healthcare services more than those in other age groups. Place of residence (r =0.568, p≤.001) and religion (r = 0.784, p≤0.001) were also significantly associated with health seeking behaviour. About 58% of the respondents understood that good maternal healthcare can reduce maternal mortality and morbidity. Our findings showed good health seeking behaviour and service utilization in the study area despite the identified hindering factors. These underscore the need to empower women of reproductive age as well as to put mechanisms in place that will increase their access to quality maternal health care services.
Assessment of Maternal Health Seeking Behavior and Service Utilization among...
Health seeking behavior and utilization of maternal healthcare services are proximate factors that
influence maternal morbidity and mortality in any society. We therefore assessed the pattern of health seeking
behavior and types of maternal healthcare services utilized by women of the reproductive age in parts of
Southeastern Nigeria. A cross sectional descriptive method involving the use of a well-structured pretested
questionnaire was used to collect data from 521 randomly selected women between the ages of 15-49 years.
Informed oral consent was obtained from these women prior to their recruitment for the study. Descriptive
statistical analysis was performed on the data obtained using the Statistical Package for Social Science (SPSS).
The mean age of the respondents was 32 ± 0.07620 years and most(50.5%) attained secondary education. There
was a significant relationship between healthcare services and mother's age (p<0.000) with women between 29-35yrs (52.2%) utilizing healthcare services more than those in other age groups. Place of residence (r =0.568,
p≤.001) and religion (r = 0.784, p≤0.001) were also significantly associated with health seeking behaviour.
About 58% of the respondents understood that good maternal healthcare can reduce maternal mortality and
morbidity. Our findings showed good health seeking behaviour and service utilization in the study area despite
the identified hindering factors. These underscore the need to empower women of reproductive age as well as to
put mechanisms in place that will increase their access to quality maternal health care services
Female genital mutilation
The International Institute for Science, Technology and Education (IISTE). Science, Technology and Medicine Journals Call for Academic Manuscripts
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Assessment of Maternal Health Seeking Behavior and Service Utilization among ...
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Postabortion care
- 1. Public health consequences of abortion in Myanmar
- 2. Taking a glance at abortion situation High unmet need ↑Unwanted pregnancy ↑Unsafe abortion 17.7% (2007) CPR in 2007: 41% 66/1,000 (2007) MMR in 2007: 316/100,000LB 1, 2 (FRHS – 2007) 11% of pregnancies in married adolescent (15-19) end in abortion1 25% of hospital admission due to abortion – unsafe2
- 3. Country’s legal and sociocultural context Law: abortion is illegal except when necessary to save women’s life Population policy: Pronatalist Religious based belief: abortion as killing a human being Social factor: pregnancy of an unmarried woman as taboo
- 4. How women end their pregnancies? (Pummeling, Sticks and Kathy Pan) TBAs- 44% Bamboo sticks Bicycle spoke Cotton buds Bird feather quill Twig from tree Fertility and pregnancy loss, Dr. Cynthia Maung and Suzanne Belton Self-30% Thway Say “Hot” medicine
- 5. Where and who did abortion? TBAs’ home Private clinic Home % interviewed youth indicated 1 78% 40% 36% 1 Family and Youth survey, 2004 country report, Department of population Unsafe abortion Incomplete abortion Bleeding Infection
- 6. What are the consequences of abortion? Bleeding Infection Trauma Hospitalization Mortality ↑Cost Unsterilized and unskilled acts ensue in incomplete and septic abortion:
- 7. How to manage the consequences and prevention of such an event? Consequences: B I T Emergency treatment Management Unwanted pregnancy Family planning Barriers and concerns Counseling Post Abortion Care
- 8. Where PAC services are available? Emergency treatment Services available in some hospitals Difficult to reach the facility
- 9. Consequences of abortion Maternal deaths due to abortion related condition: 15 – 24% in rural area (2005 NCSMM) Maternal deaths due to abortion related condition: 60% in hospital setting (hospital based data1) 1 Integration of PAC: roles of TMO and midwives in Myanmar, Thein Thein Htay et al, 2003
- 10. If emergency treatment services are available in primary level, which will be the most suitable? D & C MVA Misoprostol Severe Complication EfficacyEase of use 2 – 4% 1 – 2% Physician Trained Health worker >95% >95% Rare Trained Health worker >90%
- 11. How does Misoprostol work? Bleeding after delivery Bleeding after abortion Use of the drug Cheap, easy to store, transport and use
- 12. Thanks
Editor's Notes
- The percent with an unmet need for family planning is the number of women with unmet need for family planning expressed as a percentage of women of reproductive age who are married or in a union. Women with unmet need are those who are fecund and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the birth of their next child.