Intrapartum-related complications are responsible for approximately one-quarter of newborn deaths.
A similar number of deaths occur during labor but before birth, resulting in stillbirth. When complications arise and are not recognized or properly dealt with on a timely basis, the baby may emerge stillborn or be born alive but severely stressed and may not spontaneously begin to breathe. Unless stimulation and efforts to resuscitate are begun immediately, many of these babies quickly die of birth asphyxia.
estimated number of annual newborn deaths attributable to childbirth complications
percentage of women who give birth in a health facility
estimated number of newborns that do not breathe at birth
percentage of stillbirths that occur in low and middle income countries
What can be done?
Most outcomes associated with complications of childbirth are preventable. The proportion of term deliveries that end in death during or shortly after labor is a sensitive and responsive measure of the quality of labor and delivery care. It is important in and of itself, but it also reflects readiness for managing other important complications for the mother or newborn.
Pregnant women need a good assessment late in pregnancy to anticipate problems and ensure they receive any needed special care.Teaching expectant mothers about the importance of seeking healthcare can also prevent adverse birth outcomes. Giving birth in a center where assisted delivery or caesarian section can be provided quickly can also save a baby’s life. Good monitoring of the mother and fetus throughout labor ensures that prompt action can be take to prevent conditions from evolving to a life-threatening state.
Ending dangerous practices, like augmenting labor with oxytocin under unsafe conditions or applying pressure on the mother’s belly during labor, can prevent fetal deaths.
And for those cases in which the baby emerges in a very stressed state and is unable to start breathing, competent action taken within the “golden minute” can keep the baby alive until breathing begins. Finally, suitable equipment needs to be kept at the ready for all births, and provisions in place to ensure that health workers attending births are regularly practicing to maintain their resuscitation skills.
Helping Babies Breathe
Helping Babies Breathe (HBB) is a program to teach the essential skills of neonatal resuscitation to health workers in resource-limited areas. Developed by the American Academy of Pediatrics (AAP) and in keeping with the WHO recommendations, HBB takes a competency-based, pair-learning training approach to basic resuscitation skills. Since 2010 a public-private partnership has been working to improve resuscitation for asphyxiated babies by rolling out HBB globally. The partnership is not only training service providers but working with ministries of health and their partners to provide functional resuscitation equipment for all health facilities where babies are delivered.
Essential Newborn Care Course
The Essential Newborn Care Course (ENCC) is a WHO training program that works to ensure that health workers have the skills and knowledge to provide appropriate care at the most vulnerable period in a baby’s life. Health workers are taught how to use the WHO’s Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide for Essential Practice.
In particular, the course focuses on the sections concerned with newborn care, which provide up-to-date evidence-based information and management of babies with a range of needs in the initial newborn period. The course includes:
The course includes: