Maternal and newborn health
In 2004, the World Health Assembly adopted a strategy for reproductive health to accelerate progress towards the attainment of international goals and targets, such as the Millennium Development Goals (MDGs). All 53 Member States in the WHO European Region approved the strategy, of which improving maternal and newborn health is 1 of 5 core aspects.
Maternal, perinatal and newborn health matters to every person, society and country. The achievement of MDG 5 (for improved maternal health) is essential to that of MDG 4 (for reduced child mortality).
Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Perinatal health refers to health from 22 completed weeks of gestation until 7 completed days after birth. Newborn health refers to babies’ first month of life. A healthy start during the perinatal period influences infancy, childhood and adulthood.
Health before pregnancy
Parents’ overall health and lifestyle choices before pregnancy can affect fertility, maternal health and infants’ probability of developing chronic conditions later in life. Such choices include: maintaining a healthy diet, being physically active and avoiding unhealthy behaviour (such as smoking, illicit drug use, alcohol consumption and unsafe sexual behaviour).
People contemplating pregnancy should be screened for health problems; these need to be diagnosed and managed for optimal maternal and newborn health.
During pregnancy, the dynamics of work and home life, as well as physiological and psychological needs, change in preparation for parenthood. A healthy environment and healthy lifestyle during the 40 weeks of pregnancy are important to optimize health in a woman’s changing body.
In the 53 Member States in the WHO European Region, particular groups of women have a higher risk of adverse outcomes of pregnancy and birth, including: adolescents, migrants, Roma and women with low socioeconomic status or education level. (Poverty is strongly associated with poor reproductive health.) These groups often do not seek antenatal care, and experience violence during pregnancy. In 2008, Millennium Development Goal (MDG) target 5B – “Achieve, by 2015, universal access to reproductive health” – was added to decrease inequality in the social determinants of sexual and reproductive health and reduce maternal mortality.
High-quality antenatal care (professional health care throughout pregnancy) is essential to monitor maternal, perinatal and newborn health, along with providing education and basic, easily understood information on health care to expectant parents. While most pregnancies are uneventful, high-quality antenatal care is needed to detect and manage the minority that has complications. Evidence shows that timely prevention, intervention and management reduce maternal, perinatal and newborn morbidity and mortality.
Delivery complications may require immediate professional care. That is why high-quality, evidenced-based emergency obstetric and neonatal care is one of WHO’s highest priorities to reduce illness and death in mothers and their newborn babies.
Monitoring maternal and newborn health during the postpartum period is critical. The risk of death is highest for newborn babies: 75% of all neonatal deaths occur during the first week of life. Timely detection and management of symptoms have been shown to reduce mortality and complications.
Breastfeeding is optimal for both maternal and child health, and crucial for a healthy start in life. Exclusive breastfeeding for six months provides just the nutrients that newborn babies need and promotes bonding with their mothers. For women, the benefits include a reduced risk of ovarian and breast cancer, and a quicker return to pre-pregnancy weight than with formula feeding.
Women who remain healthy during pregnancy and after birth are more likely to stay healthy later in life. The continuum of newborn, infant, child, adolescent, reproductive, maternal and perinatal health is part of a woman’s life-course. All these stages are interrelated