From Pregnancy to the Postpartum Period: Integrating Health Care for Mothers and Babies

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By: Annie Kearns, Project Manager, Maternal Health Task Force, Women and Health Initiative

Maternal health care has historically been viewed in distinct stages: antenatal care, care during labor and delivery, and postpartum care. More recently, the importance of care between pregnancies has also been recognized. After birth, the child’s health care—vaccinations, growth monitoring, and nutrition—has also been viewed separately from the mother’s postpartum care, and has often received far more attention in global health programs. However, in recent years, maternal and child health programs have increasingly sought to develop approaches that extend across the “1000 days” period that extends from pregnancy through a child’s second birthday.

Recent research has highlighted the close links between the health of mothers and the health of their children. For instance, research conducted in Matlab, Bangladesh found that children whose mothers died had a cumulative probability of survival to age ten of just 24 percent, while infants between two and five months of age were particularly vulnerable: infants whose mothers died were 25 times more likely to die than their peers whose mothers survived. Similarly, in rural Tanzania, researchers found that maternal orphans faced greater challenges to receiving adequate health care and nutrition than their peers whose mothers remained alive; educational performance decreased, and early marriage was common among both boy and girl orphans. Further, the link between maternal nutrition and newborn health is widely recognized: as a 2007 analysis by UNICEF found, under-nourished mothers are more likely to give birth to underweight babies, who in turn are more likely to die than their healthy-weight counterparts.

With the link between mothers’ and children’s health in mind, some interventions have been designed which influence both maternal and child health outcomes. For example, one intervention in  Nepal that established community-based women’s groups contributed to increases in women’s use of  services such as antenatal care, facility delivery and other health-seeking behaviors, and, in turn, helped improve the odds of survival among both women and newborn. Elsewhere, programs are delivering care for maternal and newborn health in tandem. For instance, in Nigeria, JSI works with local health authorities to distribute two life-saving drugs: misoprostol to prevent and treat maternal postpartum hemorrhage, and chlorhexidine to prevent newborn cord infection

While several interventions rooted in an integrated approach to maternal and child health hold promise, maternal and child health programs still require expanded  evidence base on integrated care in order to identify effective approaches for implementing  integrated services.

Recognizing the need to strengthen the evidence base  to guide the integration of care during  the 1000 days period   the theme for Year 3 of the MHTF and PLOS Medicine Collection focuses on integrated health care to meet the needs of both mother and child. In addition, the Women & Health Initiative is working on a project called Adding Content to Contact, which is documenting innovative methods of delivering antenatal and postnatal care for pregnant women, new mothers, and infants.

To learn more about how to submit articles for consideration under the Year 3 of the MHTF-PLOS Medicine collection, visit the call for articles.