Maternal Health, Both Foreign and Domestic

Nutrition is essential to our overall wellbeing and growth. What we put into our body not only nourishes our insides, but reflects as well on the outside. Proper nutrition throughout our lives can prevent chronic diseases when we are older. Nutrition and the well being of a person is extremely important when a woman is expecting a child. What she puts into her body not only affects her, but affects the growing child as well. The decisions she makes as to what she put into her body could positivity or negatively affect that child for the rest of their life.
Maternal health goes far beyond just prenatal care and delivery. An essential part of maternal care is making sure that mother consumes the proper nutrients for the child and maintains proper healthy habits that will help to avoid harm to the fetus. A safe delivery of the child is also important to the health of the mother and child. But mothers should be looking to healthcare professionals, even after birth to make sure they are taking the proper precautions and steps to lead a healthy life for themselves and their child. This includes staying away from the consumption of drugs and alcohol while pregnant. Consuming alcohol while expecting, can cause detrimental long term affects to the child. Obesity plays a big role in maternal health and health care professionals are aware of all of the issues that it can bring upon the mother and the fetus. These problems can occur during and after pregnancy. Obesity can cause a variety of physical, mental, emotional and psychological issues for the mother. Women who are overweight and obese have a higher risk at certain medical conditions that can be harmful to both them and their child. Women who are obese also have a higher risk at a child who will face obesity problems during their childhood. Obesity affects the process of breastfeeding in various ways. HIV/AIDS affects millions of people worldwide. It can be transmitted from unsafe sex, using dirty needles during drug injections and can be transmitted from mother to child. Mother to child transmission is a growing issue, especially in developing countries. There are immediate causes from the WHO to try and put an end to mother to child transmission of HIV.

Healthy growth and development for the fetus is essential during pregnancy. Expecting women must be aware of the proper nutrition they should be consuming, along with the essentials vitamins and minerals that are necessary for the fetus’ growth. Women should know not to consume drugs or alcohol during pregnancy and should be educated on the harmful effects that can be precipitated if consumed.
Healthcare professionals are hoping that women will look at maternal health as a part of their rights for their overall women’s health. They want women to look beyond when they deliver their child and look to healthcare professionals for counseling on nutrition, identification of chronic diseases, mental issues including depression, especially postpartum depression and even helping with identifying domestic violence(Requejo 2016). The importance of living and leading a healthy lifestyle and having access to healthcare is essential for maternal health as we move towards healthier lives in the future.

History of the Growth of Maternal Health Care

Harvard School of Medicine has taken an extensive look into maternal and child healthcare throughout the past century. According to Child and Maternal Health (2015), “Inspired by the idea that true preventative medicine begins with the child, in 1922 the School introduced the first teaching program in the nation devoted to promoting health in the well child.” Harvard conducted the first comprehensive study of normal childhood growth and development which in clouded 300 individuals. This study helped to give a baseline for helping healthy mothers have healthy babies.

The title V act was created because of the Great Depression and all of its cutbacks. President Franklin D. Roosevelt signed this legislation in hopes of improving maternal health. Title V is called the Social Security Act. This act remains the longest lasting public health legislation in our nation’s history.

Alcohol Consumption

Alcohol consumption in general has it’s risks and side effects. According to the Centers for Disease Control and Prevention, 10% of women will consume alcohol when they are pregnant. The consumption of alcohol during pregnancy have even far worse detrimental affects, especially on the fetus. This depends on the quantity, frequency and the time during the pregnancy that the alcohol was consumed. Along with a variety of defects that prenatal alcohol consumption can cause, it can also lead to premature birth and even miscarriages. Public health guidelines recommend that women not consume alcohol during pregnancy(O’Brien 2012). Exposure to alcohol while in utero can cause Fetal Alcohol Syndrome which is the most severe form of alcohol related fetal disorders. Among the disabilities that may result from prenatal exposure to alcohol are: facial anomalies, congenital abnormalities, growth retardation, impaired cognition, poor socio-emotional development, and behavioral difficulties(O

CCBY, Alcohol, https://flic.kr/p/UcdmDR

’Brien 2012). Cognitive growth in children with Fetal Alcohol Syndrome is often impaired and can cause learning difficulties, language acquisition problems, comprehension and expression, trouble forming and maintaining social relationships, impaired memory, poor consequential thinking and difficulty in planning ahead(Whitehurst 2011). The variety of issues that stem from Fetal Alcohol Syndrome vary in such numerous ways concluding that there are endless possibilities of symptoms. There is no safe amount of alcohol that a woman can consume during pregnancy. The mother’s choices during that 9 month period can have a lifetime of affects on her child.

Maternal Healthcare Worldwide

Maternal healthcare throughout the world varies for numerous reasons. The healthcare system in first world countries is generally more advance and more obtainable to people than those living in developing countries. There are so many aspects to maternal healthcare. There is the nutrition aspect, prenatal, OBGYN, and neonatal. Women in developing countries who are expecting a child don’t have the resources that women do here in a first world country. This can cause health concerns not only for the mother but the child as well. Although programs have been implemented, according to Dettrick 2012, Development of suitable measurement tools is necessary to support the improvements in quality of care and improve populations health outcomes(Dettrick 2012). The risk of a woman in a developing country dying from a maternal-related case during her lifetime is 33 times higher compared to a woman living in a developed country who has more access to more advanced healthcare and healthcare professionals(Maternal and reproductive health 2017). According to Malin (2009), “Studies show that people of migrant origin have barriers to obtaining accessible and good quality care compared to people in the host society.” Social factors are often looked upon, especially in developing countries where health care isn’t as accessible. They need to educate and implement long lasting health plans for women of developing countries.

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Women in developing countries are at a higher risk of contracting certain diseases as well, such as the Zika virus. According to the World Health Organization, the Zika virus is transmitted by Aedes mosquitoes. Symptoms of this disease include skin rashes, conjunctivitis, joint pain,headaches and fevers. These typically last around 2-7 days. Scientists and medical specialist believe that the Zika virus can lead to microcephaly, which a a neurological condition that is rarely seen. Microcephaly is when an infant’s head is significantly smaller than a typical infant of that child’s age and sex. Access to healthcare for women affected by the Zika virus and for children affected by Microcephaly is scarce and they often do not have access to the proper medical specialist on these subjects.

HIV/AIDS

AIDS (Acquired Immune Deficiency Syndrome) and HIV (Human Immunodeficiency vVirus) are common growing concerns among the people of Africa. Out of the 34 million people that are HIV positive, there are about 23.8 million people affected in Africa. In 2010, with reports from the National AIDS Control Committee (NACC), in Cameroon alone, close to 7,300 babies were born HIV positive and without treatment half of the children will die(Sama 2). The World Health Organization takes an extreme interest in eliminating pediatric HIV. Pediatric HIV, also known as mother to child transmission, is when the mother is HIV positive and passes it on to her child during pregnancy, childbirth or while she is breastfeeding. Women will often not be aware the are HIV positive and transmit it to their baby. Research has shown that there is a strong correlation between HIV and poverty. People living in poverty do not have as much access to health care, and are not educated on the prevention and treatment of AIDS/HIV. Since the beginning of the HIV epidemic, women have remained more at risk than men.

CCBYNC, Thomas Hawk, https://flic.kr/p/hzRpNU

Men are looked upon in developing countries as more superior than women. Women are expected to treat their husbands with honor and respect, regardless of abuse. While this is expected of women, men often will seek sexual partners outside of their marriage. Most often they seek out prostitutes, who are commonly infected with HIV. The men then risk not only themselves, but their wives of becoming infected. Men also look to young girls. Younger girls are looked upon as “pure” and “untouched”. This then puts the younger girls at risk for becoming infected with HIV and with unwanted pregnancies. According to Women HIV and AIDS(2016), HIV is the leading cause of death among women of reproductive age, but the access to HIV testing and treatments remains low and access to it is difficult. Women have difficulties gaining access to healthcare services which offer Comprehensive HIV and sexual and reproductive health services which gives them a higher chance at contracting an HIV infection. According to Women HIV and AIDS(2016), in 2013, there were an estimated 380,000 new HIV infections among young women aged 15-24 every year, which account for 60% of all new HIV infections among young people.

HIV is not always looked upon as a top priority since is affects the majority of lower and middle socioeconomic classes in developing countries. HIV was once a short-lived, life threatening illness that has been turned into a life long chronic illness with the right medicine and support. What must be taken into great consideration is that the developing worlds cannot keep up with the treatment of HIV as it battles the rising numbers. The World Health Organization is taking extreme measures to put an end to mother to child transmission of HIV. This begins with mothers being aware of the risks of HIV, and to get tested continuously, even if they are pregnant since it can still be transmitted to them. Education, awareness and access to the right healthcare can help put an end to mother to child transmission.

 

Maternal Mortality

Maternal mortality is a commonly known issue in the developing world, but is also still prevalent in the United States of America. According to Agrawal (2015), between 1990 and 2013, the maternal mortality ratio for the USA more than doubled from an estimated 12 to 28 maternal feathers per 100,000 births and the country has now a higher ratio than those reported for most high-income countries and the Islamic Republican of Iran, Libya and Turkey. Complications can often occur during pregnancy, and when women are giving birth can result in death for the mother. Maternal deaths only account for a small percent of deaths among reproductive age women in low and middle income countries, reporting roughing in

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between 6-40%(Requejo 2016). According to the article of maternal and reproductive health(2017), in 2015, 830 women died every day dye to complications of pregnancy and child birth. The majority of these deaths happened in low-resource settings and most of them could have probably been prevented. There are multiple reasons why women die from maternal complications such as, haemorrhage, hypertension, infections, and often pre-existing medical conditions(Maternal and reproductive health 2017). Many fatalities can be prevented. According to Priya (2015), “With increased awareness of maternal mortality and life-threatening events – and concrete actions to ensure that pregnant women get the quality care they need – many fatal and near- fatal complications could be prevented.” Reducing maternal deaths is a major goal for international focus for health and with the proper health care and prevention systems, the number of maternal deaths can be prevented and reduced.

Nutrition

Nutrition is essential for the proper growth of a fetus during gestation. It is taken upon the mother to be responsible and consume the applicable vitamins and minerals that will help produce a healthy baby and for lactation once the baby is born. The mother is not only consuming the foods necessary for her own health during this time period but the fetus’ as well. Taking a prenatal vitamin can help ensure that both the mother and the fetus is receiving the correct amount of vitamins and minerals. A well rounded diet should be consumed along with prenatal vitamins.

CCBYNC, Marcia O’Connor, https://flic.kr/p/fgZrs2

Folic acid, also known as folate, is essential to the health of the fetus. Folic acid helps prevent major birth defects of the baby’s brain and spine, which is called neural tube defects. Before, and during pregnancy women should be consuming 400 micrograms of folic acid(Women’s Health Care Physicians 2015). Another important mineral during pregnancy is iron. Iron is used to support red blood cells that carry oxygen to the organs and tissues. While pregnant women need double the iron compared to when they are not pregnant to accommodate the extra blood that supplies oxygen to the baby. The recommended dose of iron is 27mg, which can often be consumed in a prenatal vitamin. Women can help support their iron intake by consuming iron-rich foods which are lean red meat, poultry, fish, dried beans and peas, and prune juice(Women’s Health Care Physicians 2015). Some important key nutrients to consume during pregnancy is folate, iron, calcium and vitamin D(Lucas 2014).Vitamin D is important because it helps the body use calcium and phosphorus. It also promotes strong bones and teeth. This can be found in milk, fatty fish and by getting outside and getting some sunshine. Calcium is another important essential mineral. It helps to build the baby’s bones and teeth. Pregnant women should be intaking 1,000 mg of calcium. They can get this nutrient by consuming cheese and yogurt, broccoli, dark and leafy greens, sardines or by taking a calcium supplement(Women’s Health Care Physician 2015). Long-chain n-3 fatty acids are required for fetal brain and nervous system development so pregnant women should try and consume two portions of fish per week, one that should be oil-rich(Williamson 2006). Expecting mothers should avoid foods such as mould-ripened and blue-veined cheeses to reduced exposure to potentially harmful food pathogens, such as listeria and salmonella. They should also avoid foods high in retinol, which are liver and liver products since excessive intakes are toxic to the developing fetus. (Williamson 2006). An expecting mother can control both her health and the health of the baby to an extent with what she puts into her body. Consuming a healthy diet full of whole foods filled with nutrients and maintaining healthy lifestyle habits will positively affect a woman and her child during pregnancy and while she is breastfeeding.

Maternal Obesity

We all have heard and been educated on the dangers of being overweight, which can lead to obesity. Being obese is rough on the body, and can eventually lead to an array of chronic conditions that can lead to long term issues and death. Women who are obese and pregnant come across even more issues than someone who is just simply obese.

Maternal obesity is a growing concern among health officials in the medical field. Weight gain is a given during pregnancy, but the amount of weight a women gains depends on her weigh before she got pregnant. The amount of weight a woman gains during pregnancy is based on the women’s pre-pregnancy body mass index(Women’s Health Care Physician 2015). Overweight and obese women carry extra risks during pregnancy. The extra weight can cause a variety of complications for both the mother and the fetus, during and after giving birth. These problems include gestational diabetes, high blood pressure, preeclampsia, preterm birth and can lead to a cesarean section delivery(Women’s Health Care Physicians 2015). Maternal obesity can cause complications as serious as stillbirth, miscarriage and fetal death. Obese mothers often lead to their children having a higher risk of obesity as well. Women who suffer from obesity and give birth via caesarian section have a greater chance of a surgical site infection than women of normal weight(Marchi 2015). Obesity can cause a higher risk of antenatal and postnatal depression. Obesity can make breastfeeding difficult as well. According to Marchi 2015, studies show that women with obesity breastfed for a shorter time period than women of normal weight. Women with obesity have a hard time with breastfeeding for various reasons. Whether they are physiological, behavioral, socio-cultural, psychological, medical, or a combination of these, women face difficulty completing this task. According to Marchi 2015, obese women also may have issues relating to not being breastfed themselves, smoking, low self-esteem, poor mental health or because they may be self conscious to breastfeed in public. A biological issue may also be the reason obese women have trouble breast feeding. Women with obesity may have elevated progesterone levels that may prevent the usual fall in progesterone following birth that leads to lactogenesis (Marchi 2015), which is the production of milk. Women should talk with their healthcare professionals about the risk of their weight during pregnancy. Being educated and aware can help prevent some of the side effects that come with obesity and pregnancy.

Works Cited

Agrawal, P. (2015). Maternal mortality and morbidity in the United States of America. Bulletin of the World Health Organization.

Child and Maternal Health. (2015). from https://www.hsph.harvard.edu/history-of-the-school/research/child-and-maternal-health/
Dettrick, Z., Gouda, H. N., Hodge, A., & Jimenez-Soto, E. (2016). Measuring Quality of Maternal and Newborn Care in Developing Countries Using Demographic and Health Surveys. Plus One, 11(6).
Lucas, C. (2014). Nutrition Advice During Pregnancy: Do Women Receive it and Can Health
Professionals Provide it? Maternal & Child Health Journal. Retrieved April 19, 2014.
Lukhele, B. W., Techasrivichien, T., Suguimoto, S.P., Musumari, P. M., El-Saaidi, C., Haumba, S., … Kihara, M. (2016). Structural and Behavioral Correlates of HIV infection among Pregnancy Women in a Country with a Highly Generalized HIV Epidemic: A Cross- Sectional Study with a Probability Sample of Antenatal Care Facilities in Swaziland. Plos One, 11(12).
Malin, M. (2009). Maternal care and birth outcome among clinic minority women in Finland. BMC Public Health.


Marchi, J., Berg, M., Dencker, A., Olander, E. K., & Begley, C. (2015). Risks associated with obesity in pregnancy, for the mother and baby: a systemic review of reviews. Obesity Reviews, 16(8), 621-638.
Maternal and reproductive health. (2017). http://www.who.int/gho/maternal_health/en/
O’Brien, P. L. (2012). Ego-Dystonic Pregnancy and Prenatal Consumption of Alcohol Among First-Time Mothers. Maternal & Child Health Journal.
Requejo, J. H., & Bustreo, F. (2016). Putting Maternal Health in Perspective with a Life Course Approach to Women’s Health. Journal of Women’s Health, 25(3), 211-212.

Sama, Carlson. “Prevalence of maternal HIV infection and knowledge on mother-to-child transmissionn of HIV and its prevention among antenatal care attendees in rural area in northwest Cameroon.” PLoS ONE (2017).
Stringer, E.M., Sinkala, M., Stringer, J. S., Mzyece, E., Makuka, L., Goldenberg, R. L, … Vermund, S. H. (2003). Prevention of mother-to-child transmission of HIV in Africa: successes and challenges in scaling-up a nevirapine-based program in Lusaka, Zambia. Aids, 17(9).
Whitehurst, T. (2011). Raising a child with foetal alcohol syndrome: Hearing the parent voice. British Journal of Learning Disabilities, 40(3), 187-193.
Willamson, C. S. (2006). Nutrition in pregnancy. British Nutrition Foundation.
Women’s Health Care Physicians. (2015, April). http://www.acog.org/Patients/FAQs/Nutrition- During-Pregnancy
Women HIV and AIDS. (2016). https://www.avert.org/professionals/hiv-social-issues/key- affected-populations/women

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One Reply to “Maternal Health, Both Foreign and Domestic”

  1. The images here really contribute to the post being engaging, and I like how this research dovetails with your applied project, and really demonstrate an emerging commitment to and expertise in the field of women’s health. This research seems solid, and gave me a good introduction to the basics. I wish you had added more of a synthesis and conclusion, since I am curious about how you assess the state of maternal care in the US and globally, and what you think are the needed interventions at a policy and medical level at this point. Overall, I enjoyed your work on this topic very much!

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