{"id":34568,"date":"2019-01-14T06:42:58","date_gmt":"2019-01-14T11:42:58","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=news-item&p=34568"},"modified":"2023-11-21T12:35:02","modified_gmt":"2023-11-21T17:35:02","slug":"we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation","status":"publish","type":"news-item","link":"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/","title":{"rendered":"‘We have a shower for pain relief’: can Haiti’s young midwives save a new generation?"},"content":{"rendered":"
\"\"
Newborn Sylvie Delice with her mother, Natalie. Photograph: Elena Heatherwick<\/figcaption><\/figure>\n

Sylvie Delice was born on a hot, slow March afternoon in a clinic in Marigot, a coastal town in south Haiti<\/a>. The labour was seven hours; her mother, Natalie, 24, a seamstress, was stoic throughout, helped by two midwives in pale pink scrubs. Sylvie arrived strong and healthy, and was named after her mother\u2019s cousin. Natalie recovered well and went home the next day. There was nothing unusual about Sylvie\u2019s birth \u2013 yet it was far from typical.<\/p>\n

Haiti has the highest maternal mortality rate in the Americas<\/a>; higher than much of Africa, including Sudan and Rwanda. According to the most recent figures available, Haitian women have a one in 280 chance of dying due to pregnancy or childbirth \u2013 a death rate, relative to the country\u2019s population, 40 times greater than the UK, 26 times more than the US and almost on a par with Afghanistan. And while the neonatal mortality rate has dropped from a high of 82.9 deaths per 1,000 births in 1967<\/a> to 28.3 in 2017, 3.1% of newborns die within a month, according to the Haitian ministry of health.<\/p>\n

Many of these deaths are caused by events that occur during, or shortly after, delivery. A mother may haemorrhage. She or her baby may suffer an infection. Some babies can\u2019t take their first breath without help; newborns, particularly those who are tiny, can quickly become cold, making them weak and less able to breastfeed. Simple, life-saving treatment has been available for decades in income-rich countries. But not in Haiti.<\/p>\n

Part of the problem is that, although Haiti has a relatively large number of hospitals (390 for a population of around 10 million) many are understaffed, underequipped and not open 24 hours a day. Haiti has 2.7 million women of childbearing age and only 600 obstetricians. About 36% of births occur in clinics or hospitals; the rest take place at home, often in remote villages with no running water or transport. Most Haitian women give birth with the help of \u201cmatrons\u201d, traditional birth attendants, a role passed from mother to daughter through the generations. Matrons charge around 500 gourdes (\u00a35.23) to deliver a girl and 800 (\u00a38.36) for a boy, because sons are more valued. But they may not have the equipment or know-how to identify high blood pressure (pre-eclampsia or eclampsia), conditions that are easily treatable in an equipped hospital, and that account for around 17% of maternal deaths in Haiti. There is also a lack of awareness about the importance of washing hands for vaginal examinations and delivery, and cutting the umbilical cord with a sterilised blade.<\/p>\n

\"\"
The capital, Port-au-Prince. Photograph: Elena Heatherwick<\/figcaption><\/figure>\n

But Haiti is working on a solution: the country is training a new generation of midwives, working in dedicated birth centres. This is radically transforming the prospects for mothers and babies even in the most hard-to-reach areas, and turning birth into an exhilarating rather than deadly experience.<\/p>\n

***<\/p>\n

Marigot\u2019s Centre de Sant\u00e9, where Sylvie Delice was delivered, is 60 miles south of the capital, Port-au-Prince. Set on the seafront, among hibiscuses and lime trees, the clinic serves a rural population of around 25,000 who live in the town and the surrounding lush forests and thatched hut villages. Women in labour arrive in tuk-tuks or sitting side-saddle on the back of motorbikes.<\/p>\n

\u201cThe midwives make you feel safe, because you have someone watching over you,\u201d Natalie says when we speak the morning after Sylvie\u2019s birth. She is married to a fisherman, and they live in Raymond les Bains, a village farther along the coast. \u201cI wasn\u2019t scared about the labour,\u201d she says. With her son, now two, she had an epic labour \u2013 five days \u2013 and was able to stay at the clinic throughout. \u201cThe midwives did not send me away,\u201d she says. \u201cThey were very patient.\u201d<\/p>\n

\"\"
Students at the midwifery school in Port-au-Prince; the city was devastated by an earthquake in 2010, and cholera a year later. Photograph: Elena Heatherwick<\/figcaption><\/figure>\n

Visitors can stay overnight, and Natalie was supported by her cousin and a neighbour. \u201cThey held the baby at night so I could sleep,\u201d Natalie says. \u201cThey brought me food: meat and plantain.\u201d<\/p>\n

The Marigot centre delivers around 800 babies a year. It has few of the amenities you would associate with a modern maternity clinic, such as ultrasound, or even a reliable supply of catheters. There is no pain relief, not even paracetamol. \u201cWe recommend a shower [warm water can help ease the pain of contractions],\u201d says Stephanie Roche, 30, the midwife who heads the clinic. Labouring women deliver alongside other women in a room with three beds; each has a detachable plastic cover and a bucket. While the clinic has basic plumbing and sanitation (fewer than a third of Haitians draw water from public or private taps; the rest comes from wells, bottled and bagged water, and cisterns filled by trucks); there is no air-conditioning, even though temperatures routinely reach 30C. It might not be obvious why women are better off delivering here rather than at home in a village, but the centre has not lost a mother or a baby since it opened in 2013. \u201cNot one,\u201d Roche says.<\/p>\n

\"\"Staffed by two midwives and an auxiliary nurse, and funded by the UNFPA (United Nations Population Fund<\/a>), it provides antenatal and maternity care, all free of charge. Most healthcare in Haiti is paid for, with the average cost of a first antenatal visit ranging from $6 to $25. The clinic also offers family-planning services and post-abortion care. Abortion is illegal in Haiti, and complications from unsafe terminations are another cause of maternal mortality.<\/p>\n

\u201cWomen are well taken care of, and that is very rare in this area,\u201d Roche says. The oldest of three children born to a single mother who worked in a shop, Roche started her career as a nurse, inspired by her grandmother who worked as a hospital assistant. \u201cShe gave me real equipment to play with,\u201d she says. \u201cI used to practise giving injections to the lizards on my bedroom wall. My sister and aunt are both nurses. I come from a family where all the women are nurses.\u201d After studying nursing in Port-au-Prince, she worked for 18 months in a hospital in Marchand-Dessalines, in the northern region of Artibonite.<\/p>\n

\"\"
Stephanie Roche, the midwife who heads the centre. Photograph: Elena Heatherwick<\/figcaption><\/figure>\n

She was at the hospital in 2010 when one of the deadliest earthquakes in history levelled Port-au-Prince and much of southern Haiti<\/a>, killing more than 220,000 people. As the shock waves surged through the country, the hospital started shaking, even though it was more than 130km from the epicentre. \u201cAt first, I thought it was a bulldozer or truck going by,\u201d Roche says. \u201cI only realised it was an earthquake when I saw one of the directors screaming, \u2018Get out!\u2019\u201d<\/p>\n

But, actually, she says, it was the catastrophe that befell Haiti barely a year later that really changed her: the cholera epidemic<\/a> that, to date, has killed around 10,000 people. It highlighted how ill-equipped Haiti was to deal with a public health emergency, and sharpened her resolve. \u201cIt was shocking,\u201d Roche says. \u201cIn other countries, this would not have occurred. It made me want to teach women how to keep themselves clean, and how to protect themselves from disease.\u201d<\/p>\n

This came at a time when Roche was becoming dissatisfied with nursing. \u201cAs a nurse, you have to run from gynaecology to cardiac to orthopaedic wards. As a midwife, you are doing a specific job with specific results.\u201d It\u2019s a job she describes as \u201cbeautiful, because you are really taking care of someone\u201d. In 2011, Roche enrolled at National Midwifery School in Port-au-Prince and then, after various internships, joined the clinic in Marigot in 2013. She has since delivered well over 1,000 babies.<\/p>\n

***<\/p>\n

Since 2013, the National Midwifery School has occupied a shiny new building, near Cit\u00e9 Soleil in Port-au-Prince. The previous building was devastated in the earthquake. Many student midwives would have been killed had lessons not finished less than an hour before it struck. When the rumbling started, some were at the nearby Lumi\u00e8re University, attending a lecture on obstetric care by Quettely Chevalier, then a teacher at the midwifery school and now its director. The students and Chevalier escaped unharmed.<\/p>\n

\"\"Chevalier\u2019s \u201cpersonal fight\u201d is to lower the maternal mortality rate so it\u2019s at least on a par with other countries in the Caribbean. \u201cWhy is it that so many women in my country have to die while giving life?\u201d she asks.<\/p>\n

Outside the midwifery school, a group of students are sitting on steps reciting the causes of sexually transmitted diseases (having an STD during pregnancy can create potential complications for both mother and baby). They are dressed in a smart, grey uniform (\u201cI want the midwives to stand out from other medical professionals,\u201d Chevalier says). The atmosphere is jovial, enthusiastic.<\/p>\n

\u201cI want to help women in difficulties,\u201d says Edeline Pierre, 19, who has moved with her mother to Port-au-Prince from Pilate, an eight-hour drive away, so she can train to be a midwife. \u201cI want to be informed, successful in life.\u201d The school has 38 students in the first year, including two boys. Oliver, a former law student, switched to medicine and then midwifery to \u201cdo my bit for Haiti\u201d.<\/p>\n

\"\"
Dionese Exil, 18, is having a long and difficult labour with her first baby. Photograph: Elena Heatherwick<\/figcaption><\/figure>\n

Before the earthquake, Haiti had around 350 midwives; by 2013, fatalities and emigration had reduced that number to 211. However, the intake has doubled in recent years, thanks to a change in structure that makes it easier to retrain nurses in midwifery. The college also offers a three-year direct-entry course for school leavers.<\/p>\n

A recent report by the WHO estimates that at least 2,200 midwives are needed to significantly lower maternal deaths in Haiti<\/a>. Chevalier remains hopeful that they will reach this target. \u201cThe plan is to open satellite midwifery schools to increase numbers,\u201d she explains. \u201cThere is a long way to go, but still, things are improving.\u201d<\/p>\n

***<\/p>\n

Back at the Marigot clinic, Roche\u2019s colleague, Pascal Darline, 30, also a former nurse, explains why she switched to midwifery five years ago. \u201cI like the idea of helping a woman give life.\u201d Darline grew up the second oldest of four in Grand Go\u00e2ve, near L\u00e9og\u00e2ne, in south-west Haiti, where her father is a soft drinks salesman and her mother a seamstress. She qualified as a midwife in 2013, working in a hospital in the Artibonite region. But the 90-minute commute from her home in Port-au-Prince was \u201ctoo far, so when a job came up here, I applied,\u201d she says. She has been here for a week. \u201cThe biggest challenge for me as a midwife is to watch a patient dying. It is very painful.\u201d She says in each case it was a home birth. \u201cIt\u2019s not that they don\u2019t want to come into hospital; it\u2019s because they can\u2019t afford it, or they can\u2019t get there.\u201d<\/p>\n

\"\"
Sylvie Delice at the Marigot; since the centre opened in 2013, it has not lost a mother or child. Photograph: Elena Heatherwick<\/figcaption><\/figure>\n

Haiti\u2019s terrain is marked by high mountains and deep troughs. On the northern side is the Massif du Nord; in the south-west, the Massif de la Hotte and Massif de la Selle. Over half of Haitians live in remote countryside. Chronic underfunding means there are few roads, little public transport and much of the country is inaccessible.<\/p>\n

\u201cMany of these women [who died] have seen their mothers give birth at home, so they follow their example, but they weren\u2019t as lucky as their mothers,\u201d Darline says. \u201cLack of education is a problem.\u201d<\/p>\n

Roche is single; Darline married. They board together at the clinic (Darline\u2019s husband lives in Port-au-Prince). Their official working day runs from 8am to 8pm, but the clinic is open 24 hours a day, and they help whenever required. They\u2019ve seen and learned to deal with countless complications: twins; babies whose umbilical cord is wrapped around their neck; stuck shoulders.<\/p>\n

More complex cases requiring blood transfusions, say, or caesareans, are transferred to Saint-Michel hospital, a 45-minute drive away in Jacmel, or to Port-au-Prince. The ambulance, a 4×4, is parked outside. Darline has just sent a women who is eight months pregnant to Jacmel. \u201cShe is severely anaemic. Even if we gave her iron tablets, she would still need a blood transfusion.\u201d Other patients include Marie Carline, 21, who is three months pregnant and suffering from severe morning sickness, and is lying in bed on a drip receiving much-needed fluids; and Dionese Exil, 18, who is having a long and difficult labour with her first baby. She kneels and rocks, her voice exploding through the air: \u201cWhoah, whoooah.\u201d With each contraction, she grows louder, \u201cO Lord! O Papa! Where are you!? The pain! God, I\u2019m dying!\u201d (Haitians subscribe to two religions: Catholicism and Voodoo.)<\/p>\n

Laurette, 36, a mother of two daughters, aged 18 and 14, is sitting in the outdoor waiting area in the clinic\u2019s courtyard with several neighbours to support Exil. Laurette knows firsthand how birth and death are interlinked. Her cousin died of a haemorrhage a few hours after giving birth in 2007. And her baby son died when he was one month old in 2004. \u201cHe fell ill with a fever.\u201d She says she would have gone to the hospital in Jacmel, but her only means of transport was her husband\u2019s boat \u2013 he\u2019s a fisherman \u2013 which had been seized by Dominican Republic authorities. \u201cThey said he was poaching.\u201d Lokun died in her arms.<\/p>\n

Laurette and her friends eat a packed lunch of fish and fried plantains. \u201cWe love babies,\u201d she says, sticking her head around the door of the labour room to cheer on Exil, who later gives birth to a boy in the hospital in Jacmel.<\/p>\n

***<\/p>\n

Motherhood may be a dangerous experience in Haiti, but it is highly valued, even revered. \u201cBeing a mother gives you a lot of status, you are seen as someone important in the community,\u201d says Moetsi Duchatellier, assistant representative, UNFPA, Haiti. \u201cIt\u2019s better to be married and divorce two or three weeks later than never to be married at all. The next level is to be married and have children. If you have a boy, you win it all.\u201d<\/p>\n

\u201cIf you don\u2019t have babies there is no possibility of change in your life,\u201d says Myrtha Magloire, 26, who lives among almond and mango trees in the lush hills above the village of Peredo, a 20-minute drive from Marigot. Married to a gardener and over eight months pregnant with her second child (her son is eight), her belly strains out of her dress; she is blooming. She chose the Centre de Sant\u00e9, even though it is at least an hour away, because her local clinic only offered antenatal appointments from seven months. The midwives in Marigot see women monthly during the first and second trimester, then twice a month. Magloire explains why some women die in childbirth. \u201cThis happens when you have extreme complications or some voodoo. It can be a spell someone has put on the woman. For example, someone might not like the man you\u2019re with, so it can be an act of jealousy.\u201d<\/p>\n

\u201cWe have to work with traditional beliefs,\u201d Darline says. \u201cIt\u2019s all about education.\u201d<\/p>\n

The midwives have created a safe sub-world in this poverty-stricken part of Haiti. But still, out of around 300 pregnant women currently registered, only 30 will deliver at the clinic. \u201cYou have to be really motivated, because getting here can be really difficult,\u201d Roche says. Women who live in the village of Guillermond find it particularly hard. \u201cThey are separated by a river. There is no bridge. It takes at least an hour to walk down the river. The only option is a boat.\u201d<\/p>\n

\"\"
Iloyese Belizaire, who moved in with her mother to be near the Marigot centre to give birth. Photograph: Elena Heatherwick<\/figcaption><\/figure>\n

Iloyese Belizaire, 18, is Haitian-born but lives in Dominican Republic (Haiti\u2019s neighbour to the east on the shared island of Hispaniola) with her husband, who makes metal doors. She moved in with her mother in a village deep in the forest outside Marigot when she was eight months pregnant, specifically to give birth at the clinic. \u201cI would have had to pay $7 and have a passport to deliver in Dominican Republic,\u201d she says.<\/p>\n

When her waters broke two weeks earlier, two neighbours carried her through the warren of dirt paths to the road. Then she spent an hour riding in a tuk-tuk and got to the clinic just in time for her daughter to be born. She passed out during the delivery. The midwives revived her with smelling salts, and gave her juice and crackers. \u201cMy blood sugar levels had dropped,\u201d she explains. \u201cI am so grateful to Miss Roche \u2013 and to God for giving me someone to care for.\u201d<\/p>\n","protected":false},"author":7211,"featured_media":34559,"template":"","acf":[],"yoast_head":"\nHealthy Newborn Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"'We have a shower for pain relief': can Haiti's young midwives save a new generation? - Healthy Newborn Network\" \/>\n<meta property=\"og:description\" content=\"Sylvie Delice was born on a hot, slow March afternoon in a clinic in Marigot, a coastal town in south Haiti. 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The labour was seven hours; her mother, Natalie, 24, a seamstress, was stoic throughout, helped by two midwives in pale pink scrubs. Sylvie arrived strong and healthy, and was named after her mother\u2019s cousin. … Continued","og_url":"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/","og_site_name":"Healthy Newborn Network","article_modified_time":"2023-11-21T17:35:02+00:00","og_image":[{"width":800,"height":480,"url":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/rsz_4770.jpg","type":"image\/jpeg"}],"twitter_card":"summary_large_image","twitter_misc":{"Est. reading time":"14 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/","url":"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/","name":"'We have a shower for pain relief': can Haiti's young midwives save a new generation? - Healthy Newborn Network","isPartOf":{"@id":"https:\/\/www.healthynewbornnetwork.org\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/#primaryimage"},"image":{"@id":"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/#primaryimage"},"thumbnailUrl":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/rsz_4770.jpg","datePublished":"2019-01-14T11:42:58+00:00","dateModified":"2023-11-21T17:35:02+00:00","breadcrumb":{"@id":"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/#primaryimage","url":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/rsz_4770.jpg","contentUrl":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/rsz_4770.jpg","width":800,"height":480,"caption":"Newborn Sylvie Delice with her mother, Natalie. Photograph: Elena Heatherwick"},{"@type":"BreadcrumbList","@id":"https:\/\/www.healthynewbornnetwork.org\/news-item\/we-have-a-shower-for-pain-relief-can-haitis-young-midwives-save-a-new-generation\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.healthynewbornnetwork.org\/"},{"@type":"ListItem","position":2,"name":"‘We have a shower for pain relief’: can Haiti’s young midwives save a new generation?"}]},{"@type":"WebSite","@id":"https:\/\/www.healthynewbornnetwork.org\/#website","url":"https:\/\/www.healthynewbornnetwork.org\/","name":"Healthy Newborn Network","description":"Addressing critical knowledge gaps in newborn health.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.healthynewbornnetwork.org\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"}]}},"featured_image":"<img width=\"768\" height=\"461\" src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/rsz_4770-768x461.jpg\" class=\"attachment-medium_large size-medium_large\" alt=\"\" decoding=\"async\" srcset=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/rsz_4770-768x461.jpg 768w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/rsz_4770-300x180.jpg 300w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/rsz_4770.jpg 800w\" sizes=\"(max-width: 768px) 100vw, 768px\" \/>","author_name":"HNN Team","author_image":"<img src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/themes\/hnn\/dist\/images\/member-default.jpg\" alt=\"\" class=\"avatar avatar-32 photo\" height=\"32\" width=\"32\"\/>","acf_custom_fields":{"featured_image":34559,"external_link":"https:\/\/www.theguardian.com\/society\/2018\/dec\/29\/haiti-midwives-save-new-generation","publication_date":"20181229","publication":"The Guardian","partners":[{"ID":21084,"post_author":"7211","post_date":"2017-10-02 14:54:45","post_date_gmt":"2017-10-02 18:54:45","post_content":"Our goal is to build a better, healthier future for people all over the world. Working through offices in more than 150 countries, WHO staff work side by side with governments and other partners to ensure the highest attainable level of health for all people.\r\n\r\nTogether we strive to combat diseases \u2013 infectious diseases like influenza and HIV and noncommunicable ones like cancer and heart disease. We help mothers and children survive and thrive so they can look forward to a healthy old age. We ensure the safety of the air people breathe, the food they eat, the water they drink \u2013 and the medicines and vaccines they need.","post_title":"World Health Organization","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"world-health-organization","to_ping":"","pinged":"","post_modified":"2017-10-02 14:54:45","post_modified_gmt":"2017-10-02 18:54:45","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=partner&p=21084","menu_order":0,"post_type":"partner","post_mime_type":"","comment_count":"0","filter":"raw"}],"issues":[{"ID":31084,"post_author":"7211","post_date":"2018-05-03 17:43:43","post_date_gmt":"2018-05-03 21:43:43","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Midwifery encompasses care of women during pregnancy, labor, and the postpartum period, as well as care of the newborn.<\/h2>\r\nMidwifery includes measures aimed at preventing health problems in pregnancy, the detection of abnormal conditions, the procurement of medical assistance when necessary, and the execution of emergency measures in the absence of medical help.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/4\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">2.2<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1666121600643{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\">maternal and newborn deaths, including stillbirths, that could be averted with <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/the-state-of-the-worlds-midwifery-2021-report-supplements\/\">serious investment in midwives<\/a> by 2035<\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/4\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">900<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"3\/4\"][vc_column_text css=\".vc_custom_1666121626966{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\">midwives needed to address <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/the-state-of-the-worlds-midwifery-2021-report-supplements\/\">global gaps<\/a><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"Specialized and Effective Care\" color=\"custom\" accent_color=\"#cccccc\"][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]Worldwide, approximately 295,000 women die every year due to pregnancy and childbirth related complications, 2.4 million newborns die in the first month of life and there are 2 million stillbirths*. Most of these largely preventable deaths occur in low-income countries and in poor and rural areas. Many maternal and newborn deaths can be prevented if competent midwives assist women before, during and after childbirth. Where referral services are in place, midwives are able to identify and refer women and newborns with complications to emergency obstetric or pediatric care when severe complications arise.\r\n\r\nMidwives are a special nexus between maternal and newborn care, providing supportive and respective care for women and infants. Balanced between labor and delivery expertise, prevention and management of complications and skilled emergency care, midwives enhance efficient use of resources and promote cost-effective, affordable and sustainable care while improving outcomes for women and babies.\r\n<h6>*All data on this page represents the most recent data available. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> page and download the Excel spreadsheet to explore the data further.<\/h6>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]When midwifery is successfully integrated into a healthcare system, it allows for provision of more effective care for women and infants, as described in The Lancet Midwifery Supplement. Strategic scale up of midwifery services and contributions within existing health facilities can increase not only coverage, but also sustainability, quality of care, and access to life saving interventions.\r\n\r\nThe International Day of the Midwife occurs each year on May 5th.\r\n\r\n<strong>Key resources:<\/strong>\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/the-state-of-the-worlds-midwifery-2021-report-supplements\/\">State of the World\u2019s Midwifery 2021<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/the-lancet-midwifery-series\/\">The Lancet: Midwifery Series<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/state-worlds-midwifery-analysis-sexual-reproductive-maternal-newborn-adolescent-health-workforce-east-southern-africa\/\">The State of the World\u2019s Midwifery: Analysis of the Sexual, Reproductive, Maternal, Newborn and Adolescent Health Workforce in East & Southern Africa<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]","post_title":"Midwifery","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"midwifery","to_ping":"","pinged":"","post_modified":"2022-10-18 15:33:12","post_modified_gmt":"2022-10-18 19:33:12","post_content_filtered":"","post_parent":0,"guid":"https:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=31084","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":116,"post_author":"7211","post_date":"2015-10-21 15:17:32","post_date_gmt":"2015-10-21 15:17:32","post_content":"<p>[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]<\/p>\n<h2>Intrapartum-related complications are responsible for approximately one-quarter of newborn deaths and half of stillbirths.<\/h2>\n<p>When complications arise during childbirth 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.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">570<\/span>k<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456246957513{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">estimated number of annual newborn deaths attributable to childbirth complications<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">1.3<\/span>m<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690478685637{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">estimated number of intrapartum stillbirths (2015)<br \/>\n<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">80<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690476768268{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of women who give birth in a health facility globally from 2015 - 2021<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-green\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">10<\/span>m<\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456247366820{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">estimated number of newborns that do not breathe at birth<\/span><\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"What can be done?\" color=\"custom\" accent_color=\"#cccccc\"][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]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.<\/p>\n<p>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\u2019s 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.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]Ending dangerous practices, like augmenting labor with oxytocin under unsafe conditions or applying pressure on the mother\u2019s belly during labor, can prevent fetal deaths.<\/p>\n<p>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 \u201cgolden minute\u201d 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.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_text_separator title=\"Key Resources\"][vc_column_text]<\/p>\n<ul>\n<li><a href=\"https:\/\/www.who.int\/tools\/essential-newborn-care-training-course\">Essential Newborn Care Course (WHO)<\/a> - interim version of the second edition (2022)<\/li>\n<li><a href=\"https:\/\/www.aap.org\/en\/aap-global\/helping-babies-survive\/enc-now\/\" target=\"_blank\" rel=\"noopener\">ENC Now! (American Academy of Pediatrics (AAP) and Laerdal Global Health)<\/a> \u2013 a digital version of the new WHO Essential Newborn Care 1 Basic Course (ENC) (formerly Helping Babies Breathe).<\/li>\n<li><a href=\"https:\/\/shop.laerdalglobalhealth.com\/product\/neonatalie-live\/\" target=\"_blank\" rel=\"noopener\">Neonathalie Live<\/a> \u2013 Newborn Ventilation Trainer<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/MCPC-2nd-ed.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">WHO guidelines Managing complications in pregnancy and childbirth: A guide for midwives and doctors <\/a>(2017)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/every-newborn-action-plan\/\">Every Newborn Action Plan<\/a><\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452735746534{padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>Helping Babies Survive<\/h4>\n<p><img class=\"alignnone size-full wp-image-352\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/small-helpingbabiesbreathe.jpg\" alt=\"small-helpingbabiesbreathe\" width=\"570\" height=\"252\" \/><\/p>\n<p><a href=\"https:\/\/www.aap.org\/en\/aap-global\/helping-babies-survive\/\">Helping Babies Survive<\/a> is a package of evidence-based training programs designed to teach the necessary skills to reduce neonatal mortality in resource-limited environments. The first program Helping Babies Breathe (HBB) was developed in 2010 by the American Academy of Pediatrics (AAP) in keeping with WHO recommendations. Studies have shown that it can reduce neonatal mortality by up to 47%; saving thousands of asphyxiated newborns. The success of HBB led to a global request for additional programs (such as Essential Care for Every Baby, Essential Care for Small Babies, and Improving Care of Mothers and Babies) addressing other leading causes of newborn death by equipping providers with the necessary skills and competencies to deliver high quality care to newborns during and after birth.\u200b<\/p>\n<p>The partnership is not only providing competency-based, hands-on training to service providers but working with ministries of health and their partners to provide functional resuscitation equipment for all health facilities where babies are born.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<\/p>\n<h4>Essential Newborn Care Course<\/h4>\n<p><img class=\"wp-image-1614 size-full alignnone\" src=\"\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/small-essentialnewborncare2.jpg\" alt=\"\" width=\"570\" height=\"230\" \/><\/p>\n<p><em>Please note this section will be updated in 2022. See <a href=\"https:\/\/www.who.int\/tools\/essential-newborn-care-training-course\" target=\"_blank\" rel=\"noopener\">interim version of the second edition of the Essential Newborn Care Course (ENCC)<\/a> for more information.\u00a0<\/em><\/p>\n<p>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 <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241549356?msclkid=05ffb757d06d11ec8a219bb5009124b0\" target=\"_blank\" rel=\"noopener\">WHO's Pregnancy, Childbirth, Postpartum and Newborn Care: A Guide for Essential Practice.<\/a><\/p>\n<p>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:[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]<\/p>\n","post_title":"Complications during childbirth","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"complications-during-childbirth","to_ping":"","pinged":"","post_modified":"2023-07-27 13:25:43","post_modified_gmt":"2023-07-27 17:25:43","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=116","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":126,"post_author":"7211","post_date":"2015-10-21 15:19:14","post_date_gmt":"2015-10-21 15:19:14","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Severe newborn infections\u2014including sepsis, meningitis, and <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/pneumonia\/\">pneumonia<\/a>\u2014are a major cause of morbidity and mortality among newborns in low- and middle-income countries.<\/h2>\r\nRecent analyses estimate that globally, approximately 400,000 newborns die each year as a result of severe infections, over one-sixth of the total burden of newborn deaths. Most of these deaths could be averted through:\r\n<ol>\r\n \t<li>preventive measures, such as improving hygiene practices, and<\/li>\r\n \t<li>timely and appropriate care for sick newborns.<\/li>\r\n<\/ol>\r\n[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">17<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456252549558{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of neonatal deaths caused by severe bacterial infections<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">400<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1456252596727{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of newborns who die each year as a result of severe infections<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><b><span class=\"ticker\">8<\/span><\/b><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1653422219529{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\">percentage of neonatal deaths caused by pneumonia<\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1453407008439{padding-top: 0px !important;padding-bottom: 0px !important;background-color: #f6f6f6 !important;}\"][vc_column][vc_text_separator title=\"Prevention\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]Preventive measures during the antenatal and intrapartum periods can reduce the risk of congenital and newborn infections while protecting the health of the mother. Before and during pregnancy, women can be screened and treated for syphilis and vaccinated against diseases like tetanus. In addition to preventing subsequent infection in the newborn, treating maternal infections during pregnancy \u2013 such as antibiotics for prolonged, preterm rupture of membranes or chorioamnionitis -- can also greatly reduce the risk for preterm birth, a leading cause of newborn mortality as well as prevent serious newborn infection.\r\n\r\nClean birth practices reduce the rate of newborn infections at home and implementation of consistent, high-quality infection control practices reduces newborn infections in facility settings. Hygienic umbilical cord care, including using a sterile instrument to cut the cord and, when appropriate and per national guidelines, <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/chlorhexidine-for-umbilical-cord-care\/\">applying chlorhexidine to the newborn cord stump<\/a>, can also reduce infection and preventable death. <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/breastfeeding-and-feeding-of-small-and-sick-newborns\/\">Early and exclusive breastfeeding<\/a> also reduces the likelihood of newborn infections in several ways, including providing critical support to boost immune system development and avoiding the introduction of potentially harmful substances to the immature gut.\r\n\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1453407008439{padding-top: 0px !important;padding-bottom: 0px !important;background-color: #f6f6f6 !important;}\"][vc_column][vc_text_separator title=\"Management\"][vc_row_inner equal_height=\"yes\"][vc_column_inner][vc_column_text]WHO recommends that newborns and young infants should be hospitalized when they have signs of possible <a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/treatment-of-possible-severe-bacterial-infection\/\">serious bacterial infection, and treated<\/a> with 7 days of a combination of injectable antibiotics \u2013 gentaminin and ampicillin (or penicillin). In many or most low and middle-income countries (LMICs), such hospital-based treatment is not routinely feasible for many families for a number of cultural, geographic, and financial barriers. In these circumstances, recent evidence has led WHO to recommend outpatient antibiotics to such newborns and young infants to successfully treat the illness. The recommended antibiotic course is a combination of injectable and oral antibiotics: 2 days of once-daily gentamicin combined with 7 days of twice-daily oral amoxicillin. A follow up visit at 4 days of treatment is recommended to ensure adherence to the antibiotics and to ensure improvement in the newborn\u2019s condition. When referral from outpatient facility to hospital is accepted by families, the health center provider should ensure that the newborn or young infant is first given a dose of gentamicin and amoxicillin since even short delays in initiation of treatment can mean the difference between life and death.\r\n\r\nSaving newborn lives from life-threatening infections is now indeed feasible, acceptable, and effective in reducing preventable newborn and young infant deaths, and should be a top public health priority.\r\n\r\n<strong>Key Resources:\u00a0<\/strong>\r\n<ul>\r\n \t<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25274969\/\">Respiratory Distress in the Newborn <\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/SafeOxygen_english_7.6.17.pdf\">Safe and effective oxygen use for inpatient care of newborns<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/InfectionPrevention_english_7.6.17.pdf\">Safe and effective infection prevention for inpatient newborn care<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/07\/DNH_TechBrief_MgmtNewbornInfection_7.15.19.pdf\">Management of newborn infections during inpatient care<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.nature.com\/articles\/pr2013207\">Neonatal severe bacterial infection impairment estimates in South Asia, sub-Saharan Africa, and Latin America for 2010<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row]","post_title":"Severe infections","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"severe-infections","to_ping":"","pinged":"","post_modified":"2022-10-18 14:43:52","post_modified_gmt":"2022-10-18 18:43:52","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=126","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":114,"post_author":"7211","post_date":"2015-10-21 00:24:21","post_date_gmt":"2015-10-21 00:24:21","post_content":"<p>[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]<\/p>\n<h2>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.<\/h2>\n<p>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.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">88<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690993922335{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percent of women age 15-49 who received at lease one ANC visit during pregnancy globally (2016-2021)<\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]<\/p>\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">65<\/span><\/strong><\/h1>\n<p>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1690993939923{padding-top: 10px !important;padding-bottom: 10px !important;}\"]<\/p>\n<h3 style=\"text-align: center;\">percent of women age 15-49 who received four or more ANC visits during pregnancy globally (2016-2021)<\/h3>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_column_text]<\/p>\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a>\u00a0page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\n<p>[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row][vc_column][vc_text_separator title=\"Opportunities for ANC\"][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]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 \u201cfocused ANC,\u201d a four-visit schedule. In 2016 the World Health Organization reviewed this model and issued new recommendations.[\/vc_column_text][vc_text_separator title=\"Key Resources\"][vc_column_text]<\/p>\n<ul>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/news-item\/updated-who-recommendations-for-malaria-chemoprevention-among-children-and-pregnant-women-who\/\" target=\"_blank\" rel=\"noopener\">Updated WHO recommendations for malaria chemoprevention among children and pregnant women<\/a> (2022)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/ending-preventable-maternal-mortality-epmm-a-renewed-focus-for-improving-maternal-and-newborn-health-and-wellbeing\/\" target=\"_blank\" rel=\"noopener\">Ending Preventable Maternal Mortality (EPMM): A Renewed Focus for Improving Maternal and Newborn Health and Wellbeing<\/a> (2021)<\/li>\n<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/recommendations-antenatal-care-positive-pregnancy-experience\/\">WHO recommendations on antenatal care for a positive pregnancy experience<\/a> (2016) + Executive Summary<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n","post_title":"Antenatal care","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"antenatal-care","to_ping":"","pinged":"","post_modified":"2023-08-02 12:32:20","post_modified_gmt":"2023-08-02 16:32:20","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=114","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"},{"ID":136,"post_author":"7211","post_date":"2015-10-21 15:21:03","post_date_gmt":"2015-10-21 15:21:03","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Integrating postpartum family planning services and counseling into childbirth care is vital to newborn and maternal health and survival.<\/h2>\r\nOffering contraceptive counselling and a wide range of modern methods along the continuum of childbirth care has shown to increase contraception use, which enables women to choose when and if to have a baby. Family planning use is considered postpartum if the woman initiates and uses a method in the first twelve months after childbirth. Postpartum reproductive health and family planning also includes services initiated after miscarriage or abortion. Pregnancies that are spaced by at least two years after a live birth and six months after a miscarriage or induced abortion can reduce the risk of complications and adverse newborn outcomes. Maternal survival is also impacted as women who practice healthy timing and spacing of pregnancies are less likely to die in childbirth or from pregnancy complications. Integrating contraception counseling and services into quality antenatal, postnatal, and newborn care is a <a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/immediate-postpartum-family-planning\/\">proven intervention<\/a> and should be included in both facility and community based services.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">163<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666117399105{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of women with <a href=\"https:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(22)00936-9\/fulltext\">unmet need for modern contraception services in 2019<\/a><\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">1.7<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1667922548234{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of fewer newborn deaths annually if <a href=\"https:\/\/www.guttmacher.org\/fact-sheet\/investing-sexual-and-reproductive-health-low-and-middle-income-countries\">unmet contraceptive need is met <\/a>in LMICs<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">700<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1667922954092{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of stillbirths that could be averted annually if <a href=\"https:\/\/www.guttmacher.org\/report\/adding-it-up-investing-in-sexual-reproductive-health-2019\">unmet contraceptive need is met<\/a> in LMICS<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner content_placement=\"middle\"][vc_column_inner][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"More on Family Planning\" color=\"custom\" accent_color=\"#cccccc\"][vc_row_inner equal_height=\"yes\"][vc_column_inner width=\"1\/2\"][vc_column_text]<strong>Family planning methods:<\/strong> There are <a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/family-planning-contraception\">many methods available<\/a>, under many different brand names. Modern methods include oral contraception pills, implants, injectable, intrauterine devices (IUDs), emergency contraception, male and female condoms, male and female sterilization, and lactational amenorrhea method (LAM). Additional methods include withdrawal, the calendar or rhythm method, and other fertility based methods. Some are more effective than others, and many rely on proper use to ensure effectiveness. Most of these contraceptives can be <a href=\"https:\/\/postpartumfp.srhr.org\/\">safely used immediately postpartum<\/a>; the rest can be initiated shortly after delivery, within a few weeks to six months.\r\n\r\nThe lactational amenorrhea method (LAM) is <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9678098\/\">98% effective<\/a> for the first six months postpartum. LAM prevents pregnancy while the mother is exclusively breastfeeding. It becomes less effective when other foods and liquids, like formula, are included, so women who are unable to exclusively breastfeed should consider other methods.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/2\"][vc_column_text]<strong>Spacing of pregnancy:<\/strong>\u00a0Use of family planning helps achieve healthy spacing of pregnancies, which is critical to a healthy pregnancy and delivery and to newborn survival. When pregnancies are too close together (less than 24 months between the last live birth and the next pregnancy), the risk of low birth weight, preterm birth, and newborn death increases; when pregnancy begins within six months of the last live birth, these complications are even more likely. Furthermore, when a mother who is still nursing an infant of any age becomes pregnant again, it is difficult to meet the nutritional needs of the mother, nursing baby, and fetus.\r\n\r\n<strong>Timing of pregnancy:<\/strong>\u00a0Studies have shown that both newborns and mothers have the healthiest outcomes when pregnancies occur after age 18. When mothers are <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4562289\/\">younger than 18<\/a>, they and their infants face increased risk of birth\u00a0<a href=\"https:\/\/www.healthynewbornnetwork.org\/issue\/complications-during-childbirth\/\">complications<\/a>, including stillbirth, low birth weight, and preterm birth. When possible, it is recommended to time pregnancies appropriately, especially by delaying first pregnancy until at least age 18. Adolescents, regardless of marital status, should have access to contraceptive methods to delay pregnancy.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_single_image image=\"56227\" add_caption=\"yes\"][vc_text_separator title=\"Key resources\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/training-resource-package-for-family-planning\/\">Training Resource Package for Family Planning\u00a0<\/a><\/li>\r\n \t<li><a href=\"https:\/\/fphandbook.org\/\">Family Planning Global Handbook for Providers<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/immediate-postpartum-family-planning\/\">High Impact Practices for Family Planning \u2013 Immediate Postpartum Family Planning<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/negative-effects-of-short-birth-interval-on-child-mortality-in-low-and-middle-income-countries-a-systematic-review-and-meta-analysis\/\">Negative effects of short birth interval on child mortality in low and middle income countries: a systematic review and meta analysis<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/family-planning-contraception\">WHO Family planning\/contraception methods<\/a><\/li>\r\n \t<li><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9678098\/\">Postpartum contraception: the lactational amenorrhea method<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Reproductive health & family planning","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"reproductive-health-family-planning","to_ping":"","pinged":"","post_modified":"2023-02-07 16:00:38","post_modified_gmt":"2023-02-07 21:00:38","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=136","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[{"ID":250,"post_author":"7211","post_date":"2015-10-21 22:10:30","post_date_gmt":"2015-10-21 22:10:30","post_content":"","post_title":"Latin America and Caribbean","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"latin-america-and-caribbean","to_ping":"","pinged":"","post_modified":"2016-02-11 21:52:01","post_modified_gmt":"2016-02-11 21:52:01","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&p=250","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":182,"post_author":"7211","post_date":"2015-10-21 21:58:06","post_date_gmt":"2015-10-21 21:58:06","post_content":"[vc_row][vc_column css=\".vc_custom_1453305596740{padding-top: 30px !important;padding-bottom: 30px !important;}\"][vc_text_separator title=\"Leading causes of neonatal deaths in Haiti (2020)\" el_class=\"transform:upperclass\"][vc_row_inner][vc_column_inner][vc_round_chart type=\"doughnut\" stroke_width=\"1\" stroke_color=\"custom\" values=\"%5B%7B%22title%22%3A%221%25%20Diarrhoea%22%2C%22value%22%3A%221%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%220%25%20Tetanus%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%23f79468%22%7D%2C%7B%22title%22%3A%2210%25%20Pneumonia%22%2C%22value%22%3A%2210%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2238%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2238%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2224%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2224%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%226%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%226%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%227%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%227%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2213%25%20Other%20conditions%22%2C%22value%22%3A%2213%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686158484703{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&source=gmail&ust=1551964625737000&usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158394800{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">24.3<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Newborn mortality rate (deaths per 1,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158381420{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">1<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Annual reduction in newborn mortality rate 2000-2021 (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158428153{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">42<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Proportion of under-5 child deaths that are newborn (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158410520{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">17.7<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Stillbirth rate (deaths per 1,000 births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158465817{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">41.6<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Skilled birth attendance (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1651153170344{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><b>47<\/b><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698696281601{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">8.9<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births <37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158441756{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">350<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Maternal mortality ratio (deaths per 100,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text css=\".vc_custom_1453307990481{margin-top: 20px !important;}\"]\r\n<h5 style=\"text-align: center;\"><span style=\"color: #ffffff;\">Visit our<\/span> <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> <span style=\"color: #ffffff;\">page to explore the most recent data further<\/span><\/h5>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Haiti","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"haiti","to_ping":"","pinged":"","post_modified":"2023-10-30 16:03:17","post_modified_gmt":"2023-10-30 20:03:17","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&p=182","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}]},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/34568"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/news-item"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/news-item\/34568\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/34559"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=34568"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}