Safe motherhood

Source-This post on Safe motherhood has been created based on the article “Spotlighting pre-eclampsia, ensuring safe motherhood” published in “The Hindu” on 21 May 2024.

UPSC Syllabus-GS Paper-2– Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources.

Context– The article highlights the significance of identifying and screening pre-eclampsia for ensuring safer motherhood. It states that prematurity, low birth weight, growth issues, and pre-eclampsia due to pregnancy-related hypertension are preventable problems that harm mothers and babies worldwide.

As per the National Family Health Survey (NFHS-5) perinatal mortality rates stand at 32 for 1,000 pregnancies, neonatal mortality rates at 25 for 1,000 live births, and hypertensive disorders in pregnancy remain a leading cause of maternal death. Safe motherhood

What is pre-eclampsia?

Description-It is a hypertensive disorder of pregnancy leading to multiorgan dysfunction in the mother.

Symptoms– Apart from having high blood pressure, which often starts after 20 weeks of pregnancy, these mothers may also show signs like swelling in the face, hands, and feet, severe headaches, vision changes, upper abdominal pain, and trouble breathing.

Implication– Studies show that pre-eclampsia significantly raises the risk of heart failure, coronary heart disease, stroke, and cardiovascular death in mothers.

What steps can be taken to ensure safe motherhood and birth, especially in dealing with pre-eclampsia?

1) Screening and Managing High-Risk Pregnancies Early -There is a need to carry out screening for conditions like pre-eclampsia and fetal growth restriction during the initial three months of pregnancy. Further, it’s important to handle pregnancies with elevated risks according to established guidelines.

2) Comprehensive Screening for Pre-eclampsia in High-Risk Pregnancies -Since pre-eclampsia is a systemic disorder, clinical criteria alone are inadequate to predict adverse outcomes. Thus, there is a need for a comprehensive screening approach involving factors like the mother’s medical background, demographics, specialized ultrasounds, blood pressure, placental indicators, and administering medicine promptly to high-risk pregnancies in the first trimester.

3) Comprehensive Monitoring for Pre-eclampsia– Monitoring for pre-eclampsia during the second and third trimesters helps observe, detect it early, and determine when to deliver the baby. Thus, there is a need to offer comprehensive care throughout all trimesters, with colour Doppler ultrasound as its cornerstone.

4) Samrakshan Programme-The Indian Radiological and Imaging Association started the “Samrakshan” program to spread safe motherhood efforts throughout India’s districts. The program promises to decrease pre-eclampsia from 8%-10% to 3% and fetal growth issues from 25%-30% to 10% by the end of the decade. This programme should be implemented effectively.

Community involvement and strong leadership are important for the success of programs supporting safe motherhood. This ensures that all women can give birth confidently and safely.

Question for practice

What is pre-eclampsia? What steps can be taken to ensure safe motherhood and birth, especially in dealing with pre-eclampsia?