The first day of life is also the most risky, both for the infant--and often for the mother. This year's report on the State of the World's Mothers came out last week. The focus of this report is on the first day of life. Save the Children, authors of the report, developed the first-ever "Birth Day Risk Index" to assess newborn odds of survival on that very first day that they are born.

Today there will be roughly 200,000 babies born into the world. To put that into perspective, that’s just shy of the entire population of Richmond, Virginia which boasts 205,000 or so residents. Progress towards meeting UN Millennium goals 4 & 5 are gaining more and more momentum, largely due in part towards the push to increase the presence of Front Line Health Workers in the most under-served countries.

September 17, 2012.
by A.E.Cote

Paolo Patruno is a gifted photographer. He has spent years raising awareness for maternal health, by taking some amazing photographs. Maternova recently had the rare opportunity to ask Paolo some questions about his important work. It is certainly worth taking the time to read.

M: Paolo, were you always a gifted photographer? Is it what you had planned for a career?

Maternova: Using Technology & Innovation to End Maternal Death
by Beth Pitts, Editor, August 31, 2012

A terrible fact: in the 21st century developing world, pregnancy remains a leading cause of death amongst women of childbearing age. One woman dies every 90 seconds in the context of trying to give life. In a country like Niger, this means 1 in 7 women will die 'a maternal death.'

Mission-driven for-profit Maternova, the first global portal for innovation in global maternal and neonatal health, is looking to change shocking statistics such as these. With a focus on tools and protocols, Maternova makes it easy for doctors, nurses and midwives to track innovation and to buy technologies and kits to use overseas.

Millennium Development Goal 5 sets out to “Improve Maternal Health” by 2015. To track progress on this target, researchers rely on maternal mortality ratios and rates of skilled birth attendance as indicators.

During humanitarian crises (such as armed conflicts, famine, epidemics and natural disasters), danger and uncertainty mean that access to quality reproductive health services is often severely limited. As a result, reproductive health issues become more pronounced and more urgent—including an increase in preventable maternal and child deaths due to lack of emergency obstetric care; sexual violence and trauma; unwanted pregnancies and unsafe abortions; and the spread of sexually transmitted diseases, including HIV.

A Free Clinical Textbook on Postpartum Hemorrhage

Imagine lifesaving clinical guidelines on maternal health could be made widely available at no cost to health workers across the world. The Global Library of Women’s Medicine (GLOWM) is a nonprofit initiative doing just this. Published by David and Paula Bloomer, GLOWM aims to advance women’s health by providing free access to a “vast and constantly updated, peer-reviewed resource of clinical information and guidance.”

Infection with group B streptococcus (GBS) is one of the leading causes of newborn morbidity and mortality worldwide—causing septicemia, pneumonia, meningitis, hearing loss, developmental disability and death. Unrelated to group A streptococcus (which causes strep throat), GBS is present in approximately 1 in 4 women and typically causes no symptoms in the mother. However, the bacteria can be transmitted to the infant during delivery unless women receive intravenous antibiotics during labor.

In 2005, India launched the largest conditional cash transfer program in the world with its Janani Suraksha Yojana (JSY) initiative. JSY, which roughly translates to “Safe Motherhood Scheme”, provides cash payments to pregnant women who deliver in public medical facilities, as well as the women health workers or ASHAs who accompany them. JSY was established in response to India’s persistently high rates of maternal and neonatal mortality, which account for approximately 20% and 31% of the worldwide totals.

The clinical steps around saving mothers' lives are a matter of swift-decision making and skill.  A lot of attention is being given to a simple process called the 'Active Management of the Third Stage of Labor' as a way to prevent postpartum hemorrhage. While clinicians who have been trained and who do hundreds of deliveries a month will remember the steps in AMTSL, newer clinicians will need reminders.  We saw an interesting rubber stamp that was created for a USAID project. It covered the steps of AMSTL and could be stamped directly into a paper medical record.