Ensuring high quality care for mothers and newborns everywhere

One of the United Nations millennium development goals was to reduce the global number of maternal deaths by 75%. A new series from The Lancet shows that we fell far short of that target, with only a 44% drop by 2015. Gaps in maternal deaths have grown starker, with over a 100 greater chance of dying in childbirth in the bottom 10 versus top 10 countries. To address these gaps, a review co-authored by the UCSF Bixby Center's Dr. Suellen Miller recommends 78 evidence-based practices to care for women and newborns around the time of birth.

Recommended practices include:

  • Early detection and treatment of health conditions that can complicate pregnancy and birth, including mental health status.
  • Preventing infection during pregnancy by offering flu and tetanus vaccines.
  • Allow and encourage women to have a birth companion, and involve women in decisions about their care during birth.
  • Allow women to move and adopt whatever upright position they find comfortable in labor.
  • Prevent postpartum hemorrhage through active management of the third stage of labor.
  • Avoid separating the mother and newborn in the first hour after birth.
  • Allow mother and newborn to stay in the same room during any postpartum hospital stay.
  • Provide family planning counseling tailored to mothers' breastfeeding status.

Unfortunately, it's difficult to assess how widely these recommended practices are being used. For accurate data, many aspects of maternal and newborn care must be measured by health care providers or skilled birth attendants — and this information is not routinely collected in many countries. To measure our progress toward high quality care for mothers and infants, we will need to collect better data in all countries. To reach our global goal of ensuring that every woman, every newborn, everywhere has good quality care, we will have to link monitoring directly to quality improvement initiatives. 

The Lancet will launch the 2016 Maternal Health Series on Sunday during the United Nations General Assembly in New York City. Dr. Miller and other co-authors will discuss their findings and the pathways that can lead us to high-quality and respectful maternity care for all women.