As technologies become advanced, health care techniques are also better.  Despite of that, maternal mortality is still one of the top facts threatening women’s life.  In 2008, maternal mortality rate (MMR) is 240 and then 200 in 2010.  This means there were 200 annual numbers of female deaths per 100,000 live births in 2010.  Cause of death is aggravated pregnancy or its management (excluding accidental or incidental causes). 

Everyday, approximately 830 women die from preventable causes related to pregnancy and childbirth.  99% of all maternal causes occur in developing countries like Myanmar in which home deliveries with traditional birth attendance (Lat-The) can be found in great numbers in rural areas.  Here is the tips which may promote maternal health and staying safe.

 

Antenatal Care

Proper antenatal care is one of the essential facts to ensure a safe birth.  It should be started as soon as pregnancy is recognized.  This is an entry point to reproduction health care.  During antenatal care, estimation of delivery date, examining of maternal health conditions, ultrasonography for fetal maturity assessment, screening for infectious diseases, and prevention of infectious diseases from mother to child transmission and administration of required immunization will be achieved.

 

Perinatal Care

There are four stages of labor to management during perinatal care.  Among these, third stage of labor is the most important.  It begins once the baby is born and ends when the placenta and the empty bag of water attached to the placenta (membranes) is delivered.  Active management of the third stage helps to prevent postpartum hemorrhage.  It includes immediate oxytocin injection, controlled cord traction and uterine massage.

 

Postnatal Care

Postnatal care may include control of hemorrhage, prevention of infection, supervision of maternal and child health and pain management.  This is also important because hemorrhage and infections may become life threatening if not care.

 

Supervision of a health care professional

This is very important for all stages of labor.  In Myanmar, maternal death is mostly found in rural areas where health care professionals, required medicines and facilities are not easily available.  In many rural areas, home deliveries can be found in great numbers with traditional birth attendance (Lat-The) or nurse or midwife.  This may leads to increase maternal mortality rate and so hospital delivery should be encouraged.

 

Postpartum hemorrhage

It is one of the life threatening causes in child birth and may results in death, especially in home deliveries.  It is defined as the loss of more than 500 ml of blood within the first 24 hour following child birth.

 

Infection

Infection is no doubt dangerous for both mother and child.  Strict aseptic techniques should be used even in home deliveries.  Administration of appropriate antibiotics is needed after child birth and preparation should be done before delivery.  Screening and prevention of preventable diseases should also be done.

 

Hypertensive disorders and obstructed labor

During pregnancy, hypertensive disorders such as pre-eclampsia and eclampsia may be found.  Pre-eclampsia is a pregnancy induced condition occurred in association with proteinuria.  Eclampsia is the occurrence of one or more convulsions superimposed on pre-eclampsia.  Obstructed conditions and abnormal deliveries such as breech presentation, shoulder dystocia and inability to push can also be found.

These are needed to do medical management, instrumental deliveries (vacuum or forcep deliveries) or emergency lower segment caesarean section.  So, in home deliveries, transportation should be prepared before child birth to use in case of emergency.

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