MADR-E-MEHARBAN COLLEGE OF NURSING

SCIENCES AND RESEARCH

ASSIGNMENT-1:ISSUES OF MATERNAL AND

CHILD HEALTH

10/20/2015

BY MISS SAIMA HABEEB

M.SC NSG IST YEAR (OBG NSG)

SUBMITTED TO: RESPECTED--

1. DR. MUNEERA Bashir (GUIDE)

2. MRS.KURSHIDA AKHTER (CO-GUIDE)

ISSUES OF MATERNAL AND CHILD HEALTH
INTRODUCTION

Safe motherhood begins before conception with good nutrition and a healthy lifestyle. It
continues with appropriate prenatal care and preventing problems if they arise. The ideal result is
a full-term pregnancy without unnecessary interventions, the delivery of a healthy baby, and a
healthy postpartum period in a positive environment that supports the physical and emotional
needs of the mother, baby, and family.

Pregnancy and childbirth have a huge impact on the physical, mental, emotional, and
socioeconomic health of women and their families. Pregnancy-related health outcomes are
influenced by a woman's health and other factors like race, ethnicity, age, and income. CDC's
Division of Reproductive Health conducts research and supports programs to improve women
health before, during, and after pregnancy to reduce both short- and long-term problems. CDC
collaborates with partners to reduce the higher rates of poor outcomes experienced by some racial
and ethnic groups, to improve the pregnancy and delivery experiences of all women. Our goal is
to help ensure that all women have a safe and healthy pregnancy.

MATERNAL AND CHILD HEALTH:

Maternal health now referred as reproductive health”. According to WHO, it is defined as a state
of complete physical, mental and social wellbeing and not merely the absence of disease or
infirmity in all matters relating to the reproductive system and its functions and processes. It
implies that people are able to have satisfying and safe sex life, are informed about to have access
to safe , effective , affordable and acceptable methods of family planning as well as other methods
of their choice for regulation of fertility which are not against the law, are able to have access to
appropriate health care services that will enable women to go safely through pregnancy and
childbirth.

Maternal health is the health of women during pregnancy, childbirth, and the postpartum period.
It encompasses the health care dimensions of family planning, preconception, prenatal, and
postnatal care in order to reduce maternal morbidity and mortality.
 Four elements are essential to maternal death prevention. First, prenatal care. It is recommended
that expectant mothers receive at least four antenatal visits to check and monitor the health of
mother and foetus. Second,skilled birth attendance with emergency backup such as doctors,
nurses and midwives who have the skills to manage normal deliveries and recognize the onset of
complications. Third, emergency obstetric care is to address the major causes of maternal death
which are hemorrhage, sepsis, unsafe abortion, hypertensive disorders and obstructed labour.
Lastly, postnatal care which is the six weeks following delivery. During this time bleeding, sepsis
and hypertensive disorders can occur and newborns are extremely vulnerable in the immediate
aftermath of birth. Therefore, a follow-up visit by a health worker is to assess the health of both
mother and child in the postnatal period is strongly recommended.

Maternal and child health (MCH) refers to a package of comprehensive health care services
which are developed to meet promotive, preventive, curative, rehabilitative health care of mothers
and children. It includes the sub areas of maternal health, child health, family planning, school
health and health aspects of the adolescents, handicapped children and care for children in special
settings.

OBJECTIVES OF MATERNAL AND CHILD HEALTH:

 To reduce maternal, infant, and childhood mortality and morbidity.

 To reduce perinatal and neonatal mortality and morbidity.
 Promote satisfying and safe sex life.
 Regulate fertility so as to have wanted and healthy children when desired.
 Provide basic maternal and child health care to all mothers and children.
 Promote and protect health of mothers.
 To promote reproductive health.
 To promote physical and psychological health of adolescents and infants in the family.
 Issues related to MCH:

1. AGE: As maternal age advances, the result is increased rates of pregnancy loss and
birth of infants with chromosomal anomalies. Most women and women are aware
that advanced maternal age (older than 35 years) may affect a pregnancy adversely.
This awareness is the direct outcome of the adop tion of practice standards that
obligate obstetricians, gynecologists, and women’s health. Nurses appropriately
disseminate this information and the considerable media exposure about this issue
through public service campaigns, news programs, and storyline s in popular
entertainment. Conversely the general public health care providers are less aware of
that. Advanced paternal age (older than 45 years at conception) unfavorably affects
fetal growth and development. People of advanced reproductive age require
information about the possible outcomes for a child conceived with their genetic
gametes. The nurse should offer education and counseling using incidence tables for
chromosomal anomalies associated with advanced maternal age and review
characteristics of disorders that may occur through paternal transmission of
spontaneous new mutation as a result of advanced paternal age.

2. GENDER: In some societies there may be the discrimination between male and
female baby. If the mother is having a male baby the family will provide more care
and attention towards the mother and baby. And if the mother is having a female
baby, the family members will provide her less care and attention towards the
mother and baby. So the gender also influences the maternal and child health.

3. SEXUALITY: Both the client and her partner may express concerns about sexually
and intercourse during pregnancy. Although t here is no reason why the healthy
women need abstein from intercourse or orgasm during pregnancy, some sources
suggest that women should avoid coitus and orgasm in the last four weeks of
pregnancy. Regardless of suggestions studies have found that the freq uency of coitus
decreases as pregnancy progresses. Intercourse or orgasm is contraindicated in cases
 of known placenta previa, or ruptured membranes. Nipple stimulation, vaginal
penetration, or orgasm may cause uterine contractions secondary to the release of
prostaglandins and oxytocin. Therefore women who are predisposed to preterm
labour or threatened abortion may choose to avoid intercourse. Development of
sexuality is an important part of each person’s psychological identity, integrated
sense of self, reproductive capacity and ability to fulfill role functions in society.

4. PSYCHOLOGICAL: Virtually all culture emphasizes the importance of maintaining

a psychological and agreeable environment for pregnant women. An absence of
stress is important in ensuri ng a successful outcome for the mother and baby.
Harmony with other people must be fostered, and visits for extended family members
may be required to demonstrate pleasant and no controversial relationships. If
discord exists in a relationship, it is usually dealt with a culturally prescribed ways.
Certain environmental factors such as emotional stress, anxiety, fears, frustrations,
broken homes, poverty and many others can lead to mental illness. The psychosocial
environment at home or school is an essential factor for health. Children exposed to
happy and healthy homes make them physically and mentally healthy. Other factors
affecting the health status of children including community and social support
measures etc.
Pregnancy is the gestational process. Comprising the growth and develop ment with a
woman of a new individual for conception through the embryonic and fetal periods
to birthing environment. However, an increasing amount of social science and
midwifery research has explored the issue of social support for child bearing women
and the role that the maternity services might play in offering or facilitating rather
than undetermining such support to women. Support must be individualized and
tailored to the women’s changing needs during labour. Emotional support includes
physical presence and words of affirmation, reassurance, encouragement and praise.
Comfort measures are any hands on activity aim at decreasing the physical
discomfort (pain, hunger, and thirst) of labour. Information and advice ensure that
the women are aware of what is happening and of techniques that may help her to
cope.
5. SOCIOCULTURAL FACTOR: culture and family must be viewed simultaneously
for, regardless of the family type, it remains the basic unit of society and influences
human development or the life span. The older adults in these families often have
significant roles in health and childcare, household maintenance, and decision
making. Multiple caretakers are available to help with child rearing and discipline.
Socialization is an early but family functioning. Socialization includes all the
learning experiences of early life. Home remedies and folk care practices for
prevention of illness, maintenance of health, and curative purposes remain primary
sources for most families, regardless of ethnic and cultural backgrounds.
Communication patterns are influenced by a family’s culture.religous beliefs and
practices are part of cultural and familier heritage and influence health care
behaviors. Within the neighborhood and community, health families tend to
associate freely with community groups and institutions to identify resources and
receive services as needed by them. The ability of the healthy family to seek health
through contact with others appears related in part to the family’s perception of
itself as a part of a whole and to their successful dealings with the larger community
in meeting physical, psycho logic, and social requirements. The value of the children
varies greatly, depending on the meaning each society attaches to children. Health
values and beliefs are also important in understanding reactions and behavior. If a
culture views pregnancy as a sickness, certain behaviors can be accepted, whereas if
pregnancy is viewed as a natural occurrence, other behaviors may be accepted.
Prenatal care may not be a priority for women who view pregnancy as a natural
phenomenon. Many cultural variations in prenatal care exist. Some practices may
conflict with the beliefs and practices of a subculture group to which she belongs.
Because of these and other factors such as lack of transportation, and poor
communication on the part of health care providers, women from many such groups
don’t participate in the prenatal care system. Such be havior may be misinterpreted
lifestyle factors.

6. LIFESTYLE PATTERN: Individual has a direct relationship to the lifestyle. It is

nothing but just a way of living. A person who has healthy practices of day to day
living will remain healthy. Those people who follow the healthy life styles are much
healthier than those who follow injurious lifestyles. The way of life of people in a
community and their individual’s life style also has a significant impact on life.
Health is deeply related to lifestyle which includes ways of living, personal hygiene,
habits and behavior. A healthy lifestyle helps to promote health and poor lifestyle
has ill effects on health. Lifestyles are the most critical modifiable factor
influencing the health today. Lifestyle refers to a person’s general way of living,
including living conditions and individual patterns of behavior that are influenced by
sociocultural factors and personal characteristics. Life style choices may have
positive or negative effects on health. Practices that have potentially negative effects
on health are often referred as risk factors. E.g. Overeating, getting insufficient
exercise, overweight are closely related to incidence of heart diseases, diabetes and
hypertension. Excessive use of tobacco is clearly implicated in lung cancer,
emphysema and cardiovascular diseases. These lifestyle risk factors have gained
increased attention because it is known that many of the leading causes of death.
This also presents a huge imp act on the economics of the health care system.
Therefore it is important to understand the impact of lifestyle behaviors on health
status. Nurses can educate their clients and the public on wellness - promoting
lifestyle behavior.

Emerging Issues in Maternal and Child Health:

Recent efforts to address persistent disparities in maternal and child health have employed a
“life course” perspective to health promotion and disease prevention. At the start of the decade,
fewer than half of all pregnancies are planned. Unintended pregnancy is associated with a host of
public health concerns. In response, preconception health initiatives have been aimed at
improving the health of a woman before she becomes pregnant through a variety of evidence-
based interventions.
The life course perspective also supports the examination of quality of life, including the
challenges of male and female fertility. An estimated 7.3 million American women ages 15 to 44
have received infertility services (including counseling and diagnosis) in their lifetime. Infertility
is an area where health disparities are large, particularly among African American women and
may only continue to increase as childbearing practices change over time
 BIBLIOGRAPHY
1. Dutta,D.C, Textbook of obstetrics, 7 th edn. New central Book Agency, Kolkata,
2004.

2. Park k. park’s textbook of social and preventive medicine, 19 th edition. Jabalpur:

M/S Banarsidas Bhanot Publishers, 2005.

3. Jacob Annamma. Comprehensive textbook of midwifery and gynecological nursing,

4 th edition. Jaypee medical publishers, page no; 571 - 574

4. CC Wang, Maternal and Child Health Journal,2004

5. Salhan Sudha, Textbook of Obstetrics, 1 st edn. Jaypee brothers Medical Publishers

ltd, New Dehli, 2007

6. Gulani k.k, Principles and Practices of Community Health Nursing, 4 th edn. Jaypee
Brothers Medical Pblishers, New Dehli.

7. www. Scribd.com/doc/…/ Maternal and Child Health Problems.

INDEX

S.NO CONTENT PAGE NO

1. Introduction 03

2. Concept and of Maternal health(MCH) 03

3. Definition of MCH 04

4. Objectives of MCH 04

5. Issues of MCH 05

o AGE 05

o GENDER 05

o SEXUALITY 06

o PSYCHOLOGICAL FACTOR 06

o SOCIOCULTURAL FACTOR 07

o LIFESTYLE PATTERN 08

6. Emerging issues in MCH 08

7. Bibliography 09