Obstetrics

Obstetrics

Definitions and importance: Emergency obstetric and newborn care (EmONC) is a package of medical interventions to treat life-threatening complications during pregnancy and childbirth. These services can save the lives of the estimated 280,000 women and 3 million newborns who die annually during pregnancy, childbirth, and the postpartum period. Millions of disabling conditions can also be prevented through timely and effective EmONC.

Multiple forms of EmONC appear in clinical and public health literature, classified by type and breadth of services. Emergency obstetric care (EmOC) includes urgent services to prevent maternal death (e.g., access to essential pharmaceuticals, including antibiotics, anticonvulsants, and uterotonics). EmOC has been the primary focus of international research and program development. Emergency newborn care (EmNC) is a package of life saving measures for newborns (e.g., clean cord care and neonatal resuscitation). Emergency obstetric and newborn care recognizes the paradigm shift from care for mothers and newborns independently, to a package of services provided to the maternal-infant dyad.

Basic emergency obstetric and newborn care (BEmONC) is defined as seven essential medical interventions, or ‘signal functions,’ that treat the major causes of maternal and newborn morbidity and mortality: 1) antibiotics to prevent puerperal infection; 2) anticonvulsants for treatment of eclampsia and preeclampsia; 3) uterotonic drugs (e.g., oxytoxics) administered for postpartum hemorrhage; 4) manual removal of the placenta; 5) assisted or instrumental vaginal delivery; 6) removal of retained products of conception; and 7) neonatal resuscitation.

Comprehensive emergency obstetric and newborn care (CEmONC) also includes blood transfusions, surgery (e.g., cesarean section), neonatal intubation and advanced resuscitation (intubation and respirator available). These advanced care components require access to advanced supplies and trained personnel, which may be burdensome for resource-poor health systems. Nonetheless, the World Health Organization urges developing countries to integrate universal access to high-quality, life-saving emergency procedures into health facilities.

Prevalence: Essential components of EmONC have been widely accessible in developed countries for decades. However, in low-income countries, where 99% of maternal and neonatal deaths occur, health systems may not have the capacity to provide such emergency services. Therefore, EmONC is viewed as a human rights issue in health system preparedness, and a high-level priority in the maternal health community for the post-2015 global agenda.


Barriers identified in the literature must be overcome, in order to institute a successful EmONC program. These include, but are not limited to: inadequate training/skills mix to deliver high-quality EmONC; drug procurement challenges and logistical problems in health facilities; personnel shortages and lack of equipment, particularly to deliver CEmONC; referral coordination from multiple sectors with competing interests, including health systems, infrastructure and public works, transportation, information and communication technologies; and, marginalized women’s health and rights through restrictive policies.

WHY US :

Early in your pregnancy is the time to choose your maternity care provider and birth setting. These major decisions can influence to choose us :

1.The care you receive and the effects of that care on you and your baby.
2.The quality of your relationship with your care provider(s).
3.All the basic and important information you get from us.
4.We provide the best choices and options you will have, particularly during labor and birth.
5.Your involvement with decisions about your care.

If you are a healthy childbearing woman, like most pregnant women in the United States, you can choose a midwife or a doctor as your maternity care provider. This section gives you information on why your choice of care provider is so important, the types of maternity care providers and things to keep in mind as you make this decision. It also provides some decision-making tools. You will learn that this decision goes hand-in-hand with the important decision about where you will give birth. And you will learn that it is important to ask whether these continue to be the right choices for you, as time goes on.

Remember: It may take some time and energy to find the right care provider, but making the right decision is well worth the effort.