Lecture 1- Maternal and infant public health Flashcards Preview

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Flashcards in Lecture 1- Maternal and infant public health Deck (36)
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broad overview of the three domains of public health

Health protection

Ensuring that the risks to health from communicable diseases and/or environmental hazards are minimised.

Health improvement

Preventing ill health and promoting wellbeing by commissioning and providing services that fit with the needs of our population

Healthcare public health

Making sure we have the right health services in place for the population and that these are effective and accessible to all those who need them


the birth experience 


Maternal health is the

health of women during pregnancy, childbirth and the postpartum period. It encompasses the health care dimensions of

  • family planning,
  • pre-conception,
  • prenatal and
  • postnatal care

in order to ensure a positive and fulfilling experience in most cases and reduce maternal morbidity and mortality in other cases. (WHO, Maternal Health)


UNFPA definition‘Good sexual and reproductive health is a state of complete

physical, mental and social well-being in all matters relating to the reproductive system. It implies that people are able to have a satisfying and safe sex life, the capability to reproduce, and the freedom to decide if, when, and how often to do so.’


having a baby is an excellent health promotion opportunity

  • Many opportunities to screen for health conditions


How do we measure maternal health?

  • maternal mortality ratio
  • proportion of births attebnded by skilled health personnel
  • contraceptive prevalence rate
  • adolescent birth rat
  • antenatal care coverage
  • unmet need for family planning


how long does pregnnacy last

  • Pregnancy 280 days/40 weeks (term +- 2 weeks)


trimesters of pregnancy

  • 3 trimesters
    • First (12 weeks)
    • Second (12)
    • Third (12)


First trimester


  • Pregnancy starts at fertilisation when sperm meets egg
  • Embryo implants in the uterus
  • Starting of formation of embryo and placenta
  • V vulnerable to teratogens at this time


Second trimester


Foetus is growing with a placenta


Third trimester


Baby ready to be born


Labour and birth


  • Labour can be spontaneous or induced
  • Delivery can be vaginal (normal delivery) or Caesarean section


Postnatal period


6 weeks after delivery


Maternal mortality ratio (MMR) calculated by


maternal mortality ratio (MMR) represents

Represents the risk associated with each pregnancy (i.e. the risk of dying once pregnancy

  • Worse in lower income countries


Maternal mortality ratio (MMR) pros

  • good indicator of general population health plus status of women, health services etc
  • advocacy purposes
  • there are methods to get around missing data


Maternal mortality ratio (MMR) cons

  • does not include all pregnancies in the denominator
  • dificult to get data required
  • does not detail causes of mortality


International Classification of Diseases (ICD)  definition of maternal death

  • death of a woman while pregnant or within 42 days of the end of the pregnancy (excluding accidental or incidental causes)
    • direct
    • indirect


late maternal deaths

indirect or direct causes >42 days but <1 year post pregnancy


leading cause of maternal death

  • Thrombosis/thromboembolism remain leading cause of direct death
  • Maternal suicide is third largest cause of direct maternal death (most important cause of late maternal death)


inequalities in maternal mortality factors

  • ethnic groups
  • age
  • living in more deprived area


Inequalities in maternal health and care have far reaching consequences

  • Even before birth inequalities transmit to diff outcomes throughout life



Health protection in maternal and child health: some examples

  1. Good infection control: sanitation and hygiene during delivery to prevent infections (in mothers and infants)
  2. Controlling communicable diseases: prevention of vertical transmission of blood-borne diseases e.g. HIV
  3. Control of environmental hazards, such as ionising radiation, heavy metals, which can be harmful in pregnancy...


Health improvement in maternal and child health: some examples

  • Family planning and contraception
  • Screening for foetal abnormalities, e.g. ultrasound scans
  • Folic acid for the prevention of neural tube defects
  • Behaviour and lifestyle changes: e.g. stopping smoking,
  • alcohol and substance misuse, improving physical exercise
  • Some measures discussed in childhood:
    • Weight management programmes
    • Oral health promotion (brush4life)
    • Free school meals


Healthcare public health in maternal and child health: some examples

“Preventing diseases or improving health-related outcomes through access and utilisation of effective healthcare interventions or treatment”

  • Health needs assessment to improve access to mental health care in vulnerable young people at risk of offending


what can be done about maternal mortality 


timely managemnt and treatment can 

make the difference between lfie and death for mother and baby


Morbidity examples


  • Birth injury e.g. fistula can lead to disability and stigmatisation
    • Caused by obstruction of babbies head causing necrosis of tissue


  • Psychological morbidity


Neonatal mortality rate =

number of deaths in first 28 days of life per 1000 live births (no 100,000 like MMR)