Maternal death in the context of "Maternal health"

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⭐ Core Definition: Maternal death

Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pregnancy, underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while she is pregnant or within six weeks of resolution of the pregnancy. The CDC definition of pregnancy-related deaths extends the period of consideration to include one year from the resolution of the pregnancy. Pregnancy associated death, as defined by the American College of Obstetricians and Gynecologists (ACOG), are all deaths occurring within one year of a pregnancy resolution. Identification of pregnancy associated deaths is important for deciding whether or not the pregnancy was a direct or indirect contributing cause of the death.

There are two main measures used when talking about the rates of maternal mortality in a community or country. These are the maternal mortality ratio and maternal mortality rate, both abbreviated as "MMR". By 2017, the world maternal mortality rate had declined 44% since 1990; however, every day 808 women die from pregnancy or childbirth related causes. According to the United Nations Population Fund (UNFPA) 2017 report, about every 2 minutes a woman dies because of complications due to child birth or pregnancy. For every woman who dies, there are about 20 to 30 women who experience injury, infection, or other birth or pregnancy related complication.

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👉 Maternal death in the context of Maternal health

Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. In most cases, maternal health encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to ensure a positive and fulfilling experience. In other cases, maternal health can reduce maternal morbidity and mortality. Maternal health revolves around the health and wellness of pregnant individuals, particularly when they are pregnant, at the time they give birth, and during child-raising. WHO has indicated that even though motherhood has been considered as a fulfilling natural experience that is emotional to the mother, a high percentage of women develop health problems, sometimes resulting in death. Because of this, there is a need to invest in the health of women. The investment can be achieved in different ways, among the main ones being subsidizing the healthcare cost, education on maternal health, encouraging effective family planning, and checking up on the health of individuals who have given birth. Maternal morbidity and mortality particularly affects women of color and women living in low and lower-middle income countries.

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Maternal death in the context of Abortion

Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. The unmodified word abortion generally refers to induced abortion, or deliberate actions to end a pregnancy. Abortion occurring without intervention is known as spontaneous abortion or "miscarriage", and occurs in roughly 30–40% of all pregnancies. Common reasons for inducing an abortion are birth-timing and limiting family size. Other reasons include maternal health, an inability to afford a child, domestic violence, lack of support, feelings of being too young, wishing to complete an education or advance a career, and not being able, or willing, to raise a child conceived as a result of rape or incest.

When done legally in industrialized societies, induced abortion is one of the safest procedures in medicine. Modern methods use medication or surgery for abortions. The drug mifepristone (aka RU-486) in combination with prostaglandin appears to be as safe and effective as surgery during the first and second trimesters of pregnancy. Self-managed medication abortion is highly effective and safe throughout the first trimester. The most common surgical technique involves dilating the cervix and using a suction device. Birth control, such as the pill or intrauterine devices, can be used immediately following an abortion. When performed legally and safely on a woman who desires it, an induced abortion does not increase the risk of long-term mental or physical problems. In contrast, unsafe abortions performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities cause between 22,000 and 44,000 deaths and 6.9 million hospital admissions each year — responsible for between 5% and 13% of maternal deaths, especially in low-income countries. The World Health Organization states that "access to legal, safe and comprehensive abortion care, including post-abortion care, is essential for the attainment of the highest possible level of sexual and reproductive health". Public health data show that making safe abortion legal and accessible reduces maternal deaths.

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Maternal death in the context of Self-managed abortion

A self-induced abortion (also called a self-managed abortion, or sometimes a self-induced miscarriage) is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women in the case that they are incorrectly used.

Self-induced (or self-managed) abortion is often attempted during the beginning of pregnancy (the first eight weeks from the last menstrual period). In recent years, significant reductions in maternal death and injury resulting from self-induced abortions have been attributed to the increasing availability of misoprostol (known commercially as "Cytotec"). This medication is a synthetic prostaglandin E1 that is inexpensive, widely available, and has multiple uses, including the treatment of post-partum hemorrhage, stomach ulcers, cervical preparation and induction of labor. The World Health Organization (WHO) has endorsed two regimens for abortion up to 12 weeks of pregnancy using misoprostol: a standardized regimen of mifepristone and misoprostol and a regimen of misoprostol alone. The regimen with misoprostol alone has been shown to be up to 83% effective in terminating a pregnancy but is more effective combined with mifepristone.

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Maternal death in the context of Prenatal care

Prenatal care, also known as antenatal care, is a type of preventive healthcare for pregnant individuals. It is provided in the form of medical checkups and healthy lifestyle recommendations for the pregnant person. Antenatal care also consists of educating the pregnant individual about maternal physiological and biological changes in pregnancy, along with prenatal nutrition; all of which prevent potential health problems throughout the pregnancy and promote good health for the parent and the fetus. The availability of routine prenatal care, including prenatal screening and diagnosis, has played a part in reducing the frequency of maternal death, miscarriages, birth defects, low birth weight, neonatal infections, and other preventable health problems.

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Maternal death in the context of Postpartum bleeding

Postpartum bleeding or postpartum hemorrhage (PPH) is significant blood loss following childbirth. It is the most common cause of maternal death worldwide, disproportionately affecting developing countries. Definitions and criteria for diagnosis are highly variable. PPH is defined by the World Health Organization as "blood loss of 500 ml or more within 24 hours after birth", though signs of shock (insufficient blood flow) have also been used as a definition. Some bleeding after childbirth is normal and is called lochia. It is difficult to distinguish lochia from delayed PPH.

Signs and symptoms of PPH may initially include: an increased heart rate, feeling faint upon standing, and an increased breathing rate. As more blood is lost, the patient may feel cold, blood pressure may drop, and they may become restless or unconscious. In severe cases circulatory collapse, disseminated intravascular coagulation and death can occur. The condition can occur up to twelve weeks following delivery.

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Maternal death in the context of Zorka Karađorđević

Princess Zorka Karađorđević (Serbian Cyrillic: Кнегиња црногорска Зорка; 23 December [O.S. 11 December] 1864 – 16 March [O.S. 4 March] 1890), born Princess Ljubica of Montenegro, was the eldest child of Prince Nicholas I and Princess Milena of Montenegro, who later became the country's king and queen consort. In 1883, Ljubica married Prince Peter Karađorđević and she changed her name to Zorka (and her surname to Karađorđević). She died in childbirth while giving birth to Prince Andrija on 16 March 1890. Prince Andrija died shortly thereafter. Zorka's husband later became king of Serbia as Peter I.

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