Antenatal and Postnatal Care

Mother and baby, India

Antenatal Care (ANC)
Antenatal care is the routine health control of presumed healthy pregnant women without symptoms (screening), in order to diagnose diseases or complicating obstetric conditions without symptoms, and to provide information about lifestyle, pregnancy and delivery (WHO, 2016).

Antenatal care is a major success story. Demand has increased and continues to do so in most parts of the world. Globally between 2007 and 2014, 83% of women attended for antenatal care on at least one occasion during pregnancy and 64% attend four times or more. In reality, in many cases this constitutes a series of ‘missed opportunities’. Many of the antecedents or conditions associated with the direct causes of maternal mortality can be recognised and management instituted during pregnancy to prevent adverse outcome for both the mother and her unborn baby. 

Of the 50 essential interventions for reproductive, maternal, newborn and child health for which there is evidence of effectiveness and which can be expected to have a significant impact on maternal, newborn and child survival; 16 (including the specific components of the antenatal care package) are expected to be implemented as part of antenatal care. These are meant to be implemented as a continuum of care during and after pregnancy. Antenatal care should be integrated i.e. inclusive of the recognition and management of malaria, HIV/AIDS and tuberculosis and the provision of ‘routine’ obstetric care, and differentiated i.e meeting the specific health needs of mothers and their unborn babies.

During antenatal care, conditions that may lead to complications of childbirth, maternal mortality, stillbirth and neonatal death can be prevented, identified and managed. Good care during and after pregnancy is important for the health of both the mother and the baby. Antenatal care links the woman and her family with the formal health system, has the potential to improve health during pregnancy for both the mother and her unborn baby, and increase the probability of the mother receiving skilled birth attendance, essential newborn care and postnatal care. 

 

Postnatal Care
The term ‘postnatal’ is used for all issues pertaining to the mother and the baby after birth. The postnatal period begins immediately after the birth of the baby and extends up to six weeks (42 days) after birth. (WHO 2010)

The majority of maternal and neonatal deaths occur in the first week after birth. Currently only 48% of women and babies globally receive postnatal care. Care in the period following birth is critical not only for survival but also for the future health and development of both the mother and her baby. Of the 50 essential interventions for reproductive, maternal, newborn and child health for which there is evidence of effectiveness and which can be expected to have a significant impact on maternal, newborn and child survival, 12 are intended to be provided as part of postnatal care. An important challenge in the postpartum period is providing support for family planning to address a largely unmet need for contraception that can prevent millions of unintended, untimely and unwanted pregnancies.

 

CMNH has developed a new competency-based workshop package for healthcare providers working in low and middle-income countries, to address the identified health needs of mothers and babies during and after pregnancy with integration of care across three main diseases – HIV/AIDS, TB and malaria. Read more here.