The majority of maternal and newborn deaths and stillbirths occur around the time of birth. However, there are many opportunities during pregnancy to reduce these risks.
While traditional antenatal care (ANC) is understood mainly to focus on obstetrical issues, contacts with pregnant women also provide important opportunities to deliver other preventive clinical interventions as well as counseling and health education on birth preparedness, danger signs and appropriate response, key practices at household level during and after pregnancy, and family planning.
percentage reduction in newborn mortality that could be achieved with various antenatal care interventions
percentage reduction in stillbirths possible with various antenatal care interventions
Opportunities for ANC
The prioritization of specific ANC interventions should vary by setting. For example, in areas of high malaria risk, intermittent presumptive treatment and use of insecticide-treated mosquito nets are very important. How we reach pregnant women with services and messages must also vary by setting. There are certainly advantages to having fully-qualified health professionals like nurses or nurse-midwives provide services; however many aspects of the needed services could be provided by cadres of health auxiliaries with less training. In some settings, greater reach is achieved by providing services on an outreach basis. Over the past 15 years, the standard model for ANC has been “focused ANC,” a four-visit schedule. The World Health Organization is currently reviewing this model and is expected to issue new recommendations in late 2016.