The importance of Prenatal Care and it's impact worldwide
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1 The importance of Prenatal Care and it's impact worldwide SARPOMA SEFA-BOAKYE M.D. SCRIPPS CHULA VISTA FAMILY MEDICINE 2 ND YEAR FAMILY MEDICINE RESIDENT GLOBAL MATERNAL AND CHILD HEALTH CARE ADVOCATE
2 Presentation Objectives Describe the basics of Pre-natal care and who has access to it? Describe who can provide Prenatal care and the latest trends in practice (i.e Centering group prenatal care ) Describe what pre-natal care looks like around the world especially where I studied Medicine in Cuba and in Ghana Describe how prenatal care can play a role in decreasing Maternal Mortality including the complications that can be detected, prevented and managed with care. Describe clinical indicators of when a cesarean section is medically necessary to save the life of both mother and child
3 Maternal and Child Health Statistics It s estimated that TWO women die everyday in the United States from pregnancy and child related conditions Women who do not receive prenatal care are 3-4 times more likely to die than women who do receive prenatal care. Babies of mothers who do not get prenatal care are 3 times more likely to have a low birth weight & 5 times more likely to die than those born to mothers who do get care.
4 Google Search: Prenatal Care
5 Google: What is Prenatal Care?
6 What is Prenatal Care and When does it begin? The care of a woman and her growing child in utero before and after the duration of her designated gestation period -Sarpoma Sefa-Boakye, MD Prenatal care is a type of preventive healthcare with the goal of providing regular check-ups that allow doctors or midwives to treat and prevent potential health problems throughout the course of the pregnancy while promoting healthy lifestyles that benefit both mother and child. -Wikipedia
7 Maternal Morality World Wide Malawi 1200deaths/100,000 Eritrea 1000 deaths/100,000 Zambia 650 deaths/100,000 India 540 deaths/100,000 Haiti 520 deaths/100,000 Bolivia 390 deaths/100,000 Ghana 380 deaths/100,00 Honduras 110 deaths/100,000 Trinidad and Tobago 75 deaths/100,000 Mexico 55 deaths/ 100,000 Cuba 33 deaths/100,000 United Kingdom 7 deaths/ United Arab Emirates/Grenada 1 death/100,000 USA African American women 33 deaths/100,000 Caucasian Women 9 deaths/ 100,000 **Unicef 2009
8 Ghana Country Profile Population: 23,350,927 million Live births annually 645,000 Maternal deaths per 100,000 live Births 540(remote) 214** (city) Neonatal mortality rate (per 1,000 live births)*43 Infant mortality rate (per 1,000 live births)* 64 * GSS, 2003 PRB, 2005 WHO, 2000 **MOH/GHS official figure
9 Who Provides Prenatal Care in Ghana? Traditional Birth Attendants Mothers and other Female family members Nurse Midwives 14 Midwife Training Institutions in Ghana Main Hospitals with limited access to OBGYN and FM Physicians for Emergencies
10 Prenatal care in the Maternity Centers
11 Pre-natal care in the Village communities
12 Cuba Country Profile Population: 11.2 million Maternal deaths per 100,000 live Births 80 Infant mortality rate (per 1,000 live births) 4.5 Fertility rate 1.5 Contraceptive Prevalence 72.6 Life Expectancy 81.2/77.2 *UNICEF
13 Prenatal Care in Cuba
14 Cuba s Focus on Women
15 Infant Mortality how we in SD compare
16 Infant Mortality Disparities by Race
17 Scripps Family Medicine Chula Vista Centering Pregnancy Multidisciplinary approach to prenatal care Increased education by Providers (FM residents and Attendings) 15minutes vs 2.5hr OB visits Enrollment of low risk pregnancy now including previous C-section who will be transferred out to OB s after 32wks
18 Our Centering Pregnancy Goals 85% will report initiating Breast feeding in the hospital 75% will report maintaining Breastfeeding at 6weeks Post partum 85% will achieve adequate weight gain within BMI
19 Obesity and Pregnancy Underweight (< 18.5) Goal lbs Normal ( ) Goal lbs Overweight ( ) Goal lbs Obese (>30) Goal lbs
20 Gestational Diabetes
21 Pre eclampsia
22 Absolute Clinical Indications for Cesarean Sections Total or Complete Placenta Previa
23 Placental Abruption
24 Uterine Rupture
25 Resources Care-for-Underserved-Women/The-Uninsured
26 Thank You!!!
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