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Maternal mortality--a neglected tragedy. Where is the M in MCH?

Rosenfield A; Maine D
Lancet. 1985 Jul 13; 326(8446):83-5.

Despite increasing attention to maternal and child health programs, most do little to reduce maternal mortality. In developing countries, maternal death rates of 100-300/100,000 births are common; rates are even higher in rural areas. Only 1 of the components of most maternal-child health programs (oral rehydration, growth monitoring, breastfeeding, family planning, and immunization) can reduce maternal mortality--family planning. Women who have many births or give birth at either extreme of the reproductive cycle are more likely to die of complications than other women. If all women who want to limit their families had access to efficient contraception, matenal mortality would be substantially reduced. Also needed is a major investment in a system of comprehensive maternity care. 75% of obstetric deaths are due to hemorrhage, infection, toxemia, and obstructed labor. Many of these complications occur among women with recognizable risk factors. It is recommended that the World Bank make maternity care 1 of its priorities. The Bank could initiate a program based on the construction of maternity centers in rural areas, the recruitment and training of staff for these centers, and the provision of supplies and drugs. Because women receiving maternity care can be offered family planning services as well, this proposal provides the World Bank with an opportunity to work toward its goal of reduced population growth rates.

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