2023 RN Maternal-Child Health FALL-SPRING
TERM (COMPLIED FROM REAL EXAM)
Maternal Death - ANSWER: the death of a woman while pregnant or within 42 days
after termination of pregnancy, irrespective of the duration and site of the
pregnancy, from any cause related to or aggravated by the pregnancy or its
management, but not from accidental or incidental causes.
Causes of Maternal Mortality (Direct) - ANSWER: Pregnancy and labor related
conditions
Delivery without trained birth attendant
Limited access to emergency treatment during labor
Causes of Maternal Mortality (Indirect) - ANSWER: Factors complicating the obstetric
situation or aggravated by pregnancy
-malaria
-anemia
-malnutrition
-diabetes
Direct causes - ANSWER: More than 75% of maternal deaths are due to direct
complications of pregnancy and childbirth, such as severe bleeding, infection, unsafe
abortion, hypertensive disorders (eclampsia), and obstructed labor.
Maternal Mortality Ratio - ANSWER: (MMR) Number of maternal deaths per 100,000
live births during a specified time period, usually 1 year
Maternal Mortality Rate - ANSWER: (MMRate) Number of maternal deaths per 100
000 women of reproductive age
Adult Lifetime Risk of Maternal Death - ANSWER: The probability of dying from a
maternal cause during a woman's reproductive lifespan
MDG 5 - ANSWER: Improve Maternal Health
MDG 5 Target 1 - ANSWER: Reduce by three quarters, between 1990 and 2015, the
maternal mortality ratio
Requires 5.5% annual decline
Global annual decrease from 1990 and 2008 was 2.3%
MDG 5 Target 2 - ANSWER: Achieve, by 2015, universal access to reproductive health
Increase contraceptive prevalence rate
Reduce adolescent birth rate
Increase antenatal care coverage
Reduce unmet need for family planning
,Global Number of Maternal Deaths - ANSWER: Sub-Saharan Africa and South Asia
account for 87% of maternal deaths
Global Number of Maternal Deaths - ANSWER: 11 countries account for 65% of all
these deaths
Afghanistan, Bangladesh, DRC, Ethiopia, India, Indonesia, Kenya, Nigeria, Pakistan,
Sudan and Tanzania
High Maternal Mortality Rate - ANSWER: 000 (45 countries)
Extremely High Maternal Mortality Rate - ANSWER: 000 (4 countries:
Afghanistan, Chad, Guinea-Bissau and Somalia)
Improvement of Maternal Health - ANSWER: Since 1990, some countries in Asia and
Northern Africa have more than halved maternal mortality.
There has also been progress in sub-Saharan Africa. But here, a woman's life time
risk of dying during pregnancy and childbirth is still very high at 1 in 39.
Barriers to Safe Motherhood and Neonatal Care - ANSWER: Lack of maternal health
care
No access to health care
High cost
Lack of information
Cultural preferences
Lack of decision making
Shortages of equipment and drugs
Neonatal care gap between maternal and child health programs
Neonatal care gap - ANSWER: Gap in care for neonates:
Maternal health focuses on the mother
child care starts at 1 month: gap for the neonates
High cost - ANSWER: Even though cities often have health centers that does not
necessarily mean that those living in the slums have access to it
financial reasons and also the care may not be good
Safe Motherhood - ANSWER: Care by skilled health personnel
Obstetrical emergency care
Prevention and management of complications of abortion
Family Planning for birth spacing
Reproductive education for women and their families
Skilled health personnel - ANSWER: Doctor
Nurse with OBGYN training
Professionally trained midwives
Community Health workers with additional training
NOT traditional birth attendants
,Obstetrical Emergency Care - ANSWER: C-sections
Blood transfusions
Prevention and management of complications of abortion - ANSWER: Big cause of
maternal mortality
Unsafe abortions are very common
Family planning for birth spacing - ANSWER: Increased risk with every pregnancy
If you get pregnant without wanting it, that's a totally unnecessary risk
If you can avoid getting women pregnant when they don't want to you can rule out
many risks of dying in childbirth
If you could provide more family planning for people who want it, you could reduce
maternal mortality by reducing the number of pregnancy
Maternal Mortality - ANSWER: An indicator of the health system and the quality of
maternity care
Access to care
Quality of care
Access to care - ANSWER: Prenatal visits
Accessibility of birthing center in obstetrical emergencies
Transportation
Quality of care - ANSWER: Skilled birth attendant at delivery
Standard of care received
Antenatal care objectives - ANSWER: Reduce maternal morbidity and mortality
Identification and management of high risk pregnancies
-need to come several times to determine if it is a high risk pregnancy
Opportunity to promote health and well-being of mother and infant including
neonatal care
- Can give vitamins and folic acid
- See if a woman's anemic
Antenatal care isn't necessarily helpful in terms of actual problems during birth
- A lot of things that lead to maternal mortality just happen during birth
- Has a bigger effect on the wellbeing of the child in the long term
- Just antenatal care isn't going to reduce maternal mortality
Expanded Antenatal Care - ANSWER: Reduce risks to maternal health before
subsequent pregnancies and beyond the childbearing years
Promote parenting skills
Increase the child's well being
Reduce preterm birth and LBW
Reduce morbidities in the child
Address child abuse and neglect
Avoid unintended pregnancies
, Spacing babies - ANSWER: The longer a woman waits in between having children, the
less likely the child is to die
lowers the overall number of pregnancies in a woman's lifetime
spend more time with each child
Ways to reduce maternal mortality - ANSWER: Legalization of abortion
Availability of antibiotics
Responsible use of Oxytocin or Misoprostol during labor
Availability of blood transfusions (for PPH)
Improved management of hypertension (e.g. with magnesium sulfate)
Use of Oxytocin or Misoprostol - ANSWER: Oxytocin: induces labor → stronger
contractions
Avoids prolonged labor
Helps baby come out more quickly
Misoprostol is another drug
Both open the cervix
Also, used right after birth when the placenta is still in to deliver the placenta and
avoid hemorrhage
Uterotonic drug
Uterus needs to contract really quickly once the baby is out → oxytocin helps avoid
hemorrhage
Safe Childbirth interventions (essential) - ANSWER: Monitoring the progress of labor
using a partograph
Using aseptic practices
Supporting the birthing position of the mother's choice
Avoiding medical episiotomy unless specifically indicated
Preventing postpartum hemorrhage through active management of the third stage
of labor
Partograph - ANSWER: A simple and effective tool to reduce complications from
prolonged labor and can be used to assess and make correct decisions about
transfer, c-section or other life-saving interventions
Oftentimes women are going on and on in labor and the health personnel doesn't
take action
There are points where it becomes a risk for the mom or the baby
Midwives or nurses doing this
Aseptic practices - ANSWER: clean sheet to lie on sanitizer, clean gloves, etc.
Avoiding medical episiotomy - ANSWER: Episiotomy: vaginal incision
Risks: infection and hemorrhage
Prevention of postpartum hemorrhage by active management of the third stage of
labor - ANSWER: give uterotonic drug within 1 minute of birth
TERM (COMPLIED FROM REAL EXAM)
Maternal Death - ANSWER: the death of a woman while pregnant or within 42 days
after termination of pregnancy, irrespective of the duration and site of the
pregnancy, from any cause related to or aggravated by the pregnancy or its
management, but not from accidental or incidental causes.
Causes of Maternal Mortality (Direct) - ANSWER: Pregnancy and labor related
conditions
Delivery without trained birth attendant
Limited access to emergency treatment during labor
Causes of Maternal Mortality (Indirect) - ANSWER: Factors complicating the obstetric
situation or aggravated by pregnancy
-malaria
-anemia
-malnutrition
-diabetes
Direct causes - ANSWER: More than 75% of maternal deaths are due to direct
complications of pregnancy and childbirth, such as severe bleeding, infection, unsafe
abortion, hypertensive disorders (eclampsia), and obstructed labor.
Maternal Mortality Ratio - ANSWER: (MMR) Number of maternal deaths per 100,000
live births during a specified time period, usually 1 year
Maternal Mortality Rate - ANSWER: (MMRate) Number of maternal deaths per 100
000 women of reproductive age
Adult Lifetime Risk of Maternal Death - ANSWER: The probability of dying from a
maternal cause during a woman's reproductive lifespan
MDG 5 - ANSWER: Improve Maternal Health
MDG 5 Target 1 - ANSWER: Reduce by three quarters, between 1990 and 2015, the
maternal mortality ratio
Requires 5.5% annual decline
Global annual decrease from 1990 and 2008 was 2.3%
MDG 5 Target 2 - ANSWER: Achieve, by 2015, universal access to reproductive health
Increase contraceptive prevalence rate
Reduce adolescent birth rate
Increase antenatal care coverage
Reduce unmet need for family planning
,Global Number of Maternal Deaths - ANSWER: Sub-Saharan Africa and South Asia
account for 87% of maternal deaths
Global Number of Maternal Deaths - ANSWER: 11 countries account for 65% of all
these deaths
Afghanistan, Bangladesh, DRC, Ethiopia, India, Indonesia, Kenya, Nigeria, Pakistan,
Sudan and Tanzania
High Maternal Mortality Rate - ANSWER: 000 (45 countries)
Extremely High Maternal Mortality Rate - ANSWER: 000 (4 countries:
Afghanistan, Chad, Guinea-Bissau and Somalia)
Improvement of Maternal Health - ANSWER: Since 1990, some countries in Asia and
Northern Africa have more than halved maternal mortality.
There has also been progress in sub-Saharan Africa. But here, a woman's life time
risk of dying during pregnancy and childbirth is still very high at 1 in 39.
Barriers to Safe Motherhood and Neonatal Care - ANSWER: Lack of maternal health
care
No access to health care
High cost
Lack of information
Cultural preferences
Lack of decision making
Shortages of equipment and drugs
Neonatal care gap between maternal and child health programs
Neonatal care gap - ANSWER: Gap in care for neonates:
Maternal health focuses on the mother
child care starts at 1 month: gap for the neonates
High cost - ANSWER: Even though cities often have health centers that does not
necessarily mean that those living in the slums have access to it
financial reasons and also the care may not be good
Safe Motherhood - ANSWER: Care by skilled health personnel
Obstetrical emergency care
Prevention and management of complications of abortion
Family Planning for birth spacing
Reproductive education for women and their families
Skilled health personnel - ANSWER: Doctor
Nurse with OBGYN training
Professionally trained midwives
Community Health workers with additional training
NOT traditional birth attendants
,Obstetrical Emergency Care - ANSWER: C-sections
Blood transfusions
Prevention and management of complications of abortion - ANSWER: Big cause of
maternal mortality
Unsafe abortions are very common
Family planning for birth spacing - ANSWER: Increased risk with every pregnancy
If you get pregnant without wanting it, that's a totally unnecessary risk
If you can avoid getting women pregnant when they don't want to you can rule out
many risks of dying in childbirth
If you could provide more family planning for people who want it, you could reduce
maternal mortality by reducing the number of pregnancy
Maternal Mortality - ANSWER: An indicator of the health system and the quality of
maternity care
Access to care
Quality of care
Access to care - ANSWER: Prenatal visits
Accessibility of birthing center in obstetrical emergencies
Transportation
Quality of care - ANSWER: Skilled birth attendant at delivery
Standard of care received
Antenatal care objectives - ANSWER: Reduce maternal morbidity and mortality
Identification and management of high risk pregnancies
-need to come several times to determine if it is a high risk pregnancy
Opportunity to promote health and well-being of mother and infant including
neonatal care
- Can give vitamins and folic acid
- See if a woman's anemic
Antenatal care isn't necessarily helpful in terms of actual problems during birth
- A lot of things that lead to maternal mortality just happen during birth
- Has a bigger effect on the wellbeing of the child in the long term
- Just antenatal care isn't going to reduce maternal mortality
Expanded Antenatal Care - ANSWER: Reduce risks to maternal health before
subsequent pregnancies and beyond the childbearing years
Promote parenting skills
Increase the child's well being
Reduce preterm birth and LBW
Reduce morbidities in the child
Address child abuse and neglect
Avoid unintended pregnancies
, Spacing babies - ANSWER: The longer a woman waits in between having children, the
less likely the child is to die
lowers the overall number of pregnancies in a woman's lifetime
spend more time with each child
Ways to reduce maternal mortality - ANSWER: Legalization of abortion
Availability of antibiotics
Responsible use of Oxytocin or Misoprostol during labor
Availability of blood transfusions (for PPH)
Improved management of hypertension (e.g. with magnesium sulfate)
Use of Oxytocin or Misoprostol - ANSWER: Oxytocin: induces labor → stronger
contractions
Avoids prolonged labor
Helps baby come out more quickly
Misoprostol is another drug
Both open the cervix
Also, used right after birth when the placenta is still in to deliver the placenta and
avoid hemorrhage
Uterotonic drug
Uterus needs to contract really quickly once the baby is out → oxytocin helps avoid
hemorrhage
Safe Childbirth interventions (essential) - ANSWER: Monitoring the progress of labor
using a partograph
Using aseptic practices
Supporting the birthing position of the mother's choice
Avoiding medical episiotomy unless specifically indicated
Preventing postpartum hemorrhage through active management of the third stage
of labor
Partograph - ANSWER: A simple and effective tool to reduce complications from
prolonged labor and can be used to assess and make correct decisions about
transfer, c-section or other life-saving interventions
Oftentimes women are going on and on in labor and the health personnel doesn't
take action
There are points where it becomes a risk for the mom or the baby
Midwives or nurses doing this
Aseptic practices - ANSWER: clean sheet to lie on sanitizer, clean gloves, etc.
Avoiding medical episiotomy - ANSWER: Episiotomy: vaginal incision
Risks: infection and hemorrhage
Prevention of postpartum hemorrhage by active management of the third stage of
labor - ANSWER: give uterotonic drug within 1 minute of birth
