Integrated Maternal and Newborn Care Basic Skills Course ...

DELAYS RESULTING IN MATERNAL AND NEWBORN DEATHS
The factors that often prevent women and newborns from getting the life-saving health care they
need include:
• distance from health services
• cost (direct fees as well as the cost of transportation, drugs, and supplies)
• multiple demands on women’s time
• women’s lack of decision-making power within the family
• poor quality services, including poor treatment by health providers and discourteous
behavior which makes women reluctant to use services
These have been described as the following delays:
• Delay in recognizing the problem: When a woman or newborn experiences a danger
sign, someone must recognize that there is a problem. If pregnant women, their
families, and women caring for them don’t know the danger signs that indicate the
woman or newborn is experiencing a complication, they will not know when they need to
seek care.
• Delay in deciding to seek care: When a problem arises, the woman and her family
have to decide to seek care. If the primary decision-maker is not present, it may mean
that the woman is not allowed to seek care, or take her newborn for care, or that seeking
care is delayed.
• Delay in arriving at the appropriate facility: Once a decision is made to seek care, the
woman and her family must find a means of transport and the necessary funds to go to
the appropriate facility. If there are no means of transport and/or the woman and her
family do not have the necessary funds, the woman or newborn will not get to the
appropriate health care facility in a timely fashion.
• Delay in receiving quality care: Once the woman or newborn has reached the
appropriate facility, care providers must provide quality services for whatever emergency
has transpired. If the care provided is not good quality or appropriate, then the woman
or newborn will have reached the appropriate facility in vain.
When delays occur in recognizing problems and referring women or newborns to appropriate
health care facilities, the result can lead to maternal and newborn deaths. One solution to
combat these problems is to work with the pregnant woman and her family to develop two
plans: a birth-preparedness plan and a complication-readiness plan.
BIRTH-PREPAREDNESS PLAN
Having a birth plan can reduce delayed decision-making and increase the probability of timely
care. A birth-preparedness plan is an action plan made by the woman, her family members, and
the health care provider. Often this plan is not a written document but an ongoing discussion
between all concerned parties to ensure that the woman receives the best care in a timely
manner. Each family should have the opportunity to make a plan for the birth. Health care
providers can help the woman and her family develop birth-preparedness plans and discuss
birth-related issues. Work with the woman to:
1. Make plans for the birth:
• Discuss the idea of a birth plan and what to include during the first visit.
• Inquire about the birth-preparedness plan during subsequent visits.
40
Integrated maternal and newborn care
Basic skills course