Maternal health

WHO estimates that about 295,000 maternal deaths occurred in 2017. The causes of these maternal deaths range from severe bleeding to obstructed labour, all of which have highly effective interventions. Further, indirect causes of maternal mortality include anemia and malaria. One third of the maternal deaths occur in India and Nigeria. The mother's death results in vulnerable families, and their infants, if they survive childbirth, are more likely to die before reaching their second birthday. Both maternal mortality (death) and severe maternal morbidity (illness) are "associated with a high rate of preventability." Also, when women attend clinics without charge and are issued free supplements, their health is maintained, and this reduces the monetary resources that the government invests in healthcare. In turn, the maternal morbidity rate, together with mortality rates, is lowered. Education on issues related to maternal health is essential to control and improve the healthcare of women. Women who have resources have a  low chance of their health status deteriorating, due to their knowledge. These women are informed to make decisions regarding family planning, the best time to give birth as far as their financial capabilities are concerned, and their nutrition, before, during, and after giving birth. Additionally, many approaches involve women, families, and local communities as active stakeholders in interventions and strategies to improve maternal health. Gannon (n.p) reports that the maternal rate of mortality dropped by 70% between 1946 and 1953, when women began receiving maternal education. The study recommended that the focus should be on communities that are marginalized and girls who are under the age of 18. When the government manages to reduce unwanted and unplanned pregnancies among these two groups of people, it becomes easier to reduce maternal health problems and the cost associated with them. ==Factors influencing maternal health==

Poverty and access to healthcare According to a UNFPA report, social and economic status, culture norms and values, and geographic remoteness all increase maternal mortality, and the risk for maternal death (during pregnancy or childbirth) in sub-Saharan Africa is 175 times higher than in developed countries, and risk for pregnancy-related illnesses and negative consequences after birth is even higher. Poverty, maternal health, and outcomes for the child are all interconnected. Women living in poverty-stricken areas are more likely to be obese and engage in unhealthy behaviors such as cigarette smoking and substance use, are less likely to engage in or even have access to legitimate prenatal care, and are at a significantly higher risk for adverse outcomes for both the mother and child. A study conducted in Kenya observed that common maternal health problems in poverty-stricken areas include hemorrhaging, anemia, hypertension, malaria, placenta retention, premature labor, prolonged/complicated labor, and pre-eclampsia. Prenatal care and decline (2021–2022); population growth rate takes birth, death, and migration rates into account. Future projections are based on the United Nations World Population Prospects (from 1950 until 2100). (2022–2023), referring to the average number of children that are born to a woman over her lifetime, according to the Population Reference Bureau. Generally, adequate prenatal care encompasses medical care and educational, social, and nutritional services during pregnancy. For example, prenatal care could include serum integrated screening tests for potential chromosomal abnormalities as well as blood pressure measurements, or uterus measurements to assess fetal growth. Although there are a variety of reasons women choose not to engage in proper prenatal care, 71% of low-income women in a US national study had difficulties getting access to prenatal care when they sought it out. Income is strongly correlated with quality of prenatal care. In addition to proximity being a predictor of prenatal care access, Materia and colleagues found similar results for proximity and antenatal care in rural Ethiopia. Also, inadequate and poor quality services contributes in increasing maternal morbidity and mortality. Pre-existing conditions Pregestational diabetes Pre-existing (pregestational) maternal Type 1 or Type 2 diabetes is a known factor that increases the risk of adverse outcomes, including pre-term birth, preeclampsia, and congenital birth defects. Studies from the United States and Australia indicate that the prevalence of pregestational diabetes is around 1% of pregnancies. Even healthy pregnancy causes a state of hyperglycemia. As a result, mothers with pregestational diabetes are at an increased risk for hyperglycemia. HIV/AIDS Maternal HIV rates vary around the world, ranging from 1% to 40%, with African and Asian countries having the highest rates. Whilst maternal HIV infection largely has health implications for the child, especially in countries where poverty is high and education levels are low, having HIV/AIDS while pregnant can also cause heightened health risks for the mother. A large concern for HIV-positive pregnant women is the risk of contracting tuberculosis (TB) and/or malaria, in developing countries. Increased rates of hypertension, diabetes, respiratory complications, and infections are prevalent in cases of maternal obesity and can have detrimental effects on pregnancy outcomes. Obesity is an extremely strong risk factor for gestational diabetes. Research has found that obese mothers who lose weight (at least 10 pounds or 4.5 kg) between pregnancies reduce the risk of gestational diabetes during their next pregnancy, whereas mothers who gain weight actually increase their risk. Women who are pregnant should aim to exercise for at least 150 minutes per week, including muscle strengthening exercises. However, it is recommended that pregnant women discuss what exercise they can do safely with their OB/GYN in the early prenatal period. Vigorous Exercise The current guidelines for moderate intensity activity during pregnancy have been outlined by organizations such as the WHO and ACOG to be the same 150 minutes per week as regular physical activity guidelines. Certain modifications such as avoiding supine position after 20 weeks are also recommended. It has also been shown to have similar benefits to those who perform the same level of activity outside of pregnancy. If using vigorous exercise as a means of lowering maternal weight gain during pregnancy, it's important to note there is little evidence to suggest that higher intensity has more of an effect than moderate intensity activity on normal pregnancies; to monitor the growth and status of the fetus. Maternal health organizations suggest that at a minimum pregnant women should receive one ultrasound at week 24 to help predict any possible growth anomalies and prevent future gestational concerns. For pregnant women who are at an increased risk for Pre-eclampsia, one could take a dietary supplement of low dose aspirin as prophylaxis before 20 weeks gestation. Race and ethnicity Research has demonstrated that discrimination in maternal care occurs on an international level. In Canada, female patients claim to have experienced sterilization without their consent, while other female patients have experienced neglect while hospitalized that eventually led up to their death. In the United States and the United Kingdom, research has shown that black individuals are more prone to experiencing discrimination in when receiving medical attention. This discrimination leads to imbalances in the way they get treated and often results in death. Africa also faces issues with gender discrimination, which leads to maternal mortality. Statistics Analysis of the Pregnancy Mortality Surveillance System, conducted by the Center for Disease Control and Prevention (CDC), indicates significant racial and ethnic disparities in pregnancy-related deaths. The pregnancy-related mortality ratio (PRMR) represents the number of deaths per 100,000 live births resulting from pregnancy or pregnancy-related causes. A 2019 report from the CDC shows that the PRMRs of Black women and Indigenous women in the United States are 3-4 times higher than that of White women. White women had a PRMR of approximately 13 maternal deaths per 100,000 live births. While Black and Indigenous women had PRMRs of 41 and 30 maternal deaths per 100,000 live births, respectively. The majority of these deaths were due to preventable diseases associated with pregnancy, such as hypertension. While the fatality rate of these diseases was higher among Black and Indigenous women, the initial prevalence was generally the same across all races. The Maternal Vulnerability Index (MVI) tool, which measures risk factors on a county-by-county basis in the U.S., confirms the racial disparities in maternal health outcomes. Although lower than that of Black and Indigenous women, the PRMR for Asian and Pacific Islander women was still slightly higher than that of the White women at 13.5. Contributing factors The CDC cites multiple causes for the racial gap in maternal mortality. They say that most pregnancy-related deaths are the combined result of 3-4 contributing factors. Some of these factors include higher rates of chronic conditions in minority communities, lower rates of prenatal care, and lower rates of insurance coverage. Outside of provider-patient interactions, structural factors can contribute to the racial gap in maternal mortality. This includes the gap in access to primary and preventative care as well as other social determinants of health such as education and community support. The weathering hypothesis also states a higher rate of preterm birth among Black pregnant people in the United States, which is not only dangerous for the baby but also has effects on the birth parent. A Black birth parent of a preterm baby is more likely to experience high blood pressure following a preterm birth and subsequent higher rates of coronary artery calcification. Africa Research has demonstrated that Africa experiences discrimination in healthcare. Mothers experience gender-based discrimination, which affects the care a mom is receiving. Stereotypes such as them being prone to addiction, being irresponsible parents, or abuse the healthcare system frequently are held by workers in the healthcare industry. Joyce Echequan, an Indigenous woman, died as a result of the discrimination she experienced in a hospital in Quebec, Canada. A coroner claims if she were white, Echequan would be alive. Stereotypes and implicit biases, for of discrimination, affect the ability for women to speak up. Tinu Alikor, a mother of three, lost an abnormal amount of blood during the last three months of her pregnancy, which led to her seeking medical attention. Asians and black women are more prone to dying from childbirth than a white women. Alongside, white individuals have higher rates to receive pain treatment (epidurals) during labor, than a woman who is Black or Hispanic. It was harder for providers to acknowledge when a Black mother was in pain because it was harder to visualize it in their faces. The health care that they received from physicians did not provide information in respect to their religious or cultural practices and did little to provide cultural adjustments and emotional support. She cited that the cause of her guilt was because of her Catholic upbringing. Other religious practices and traditions have shown to influence maternal health in a negative way. Practitioners of apostolicism in Zimbabwe have been associated with higher maternal mortality. Results of a study showed the dangerous associations that religion may have on maternal health. Spiritual interventions done by pastors in pregnancy included prayer, revelations, reversing negative dreams, laying of hands and anointing women. Religious artifacts used among the women during pregnancy and labor were anointing oil, blessed water, stickers, blessed white handkerchief, blessed sand, Bible and Rosary. The women made many connections to these practices and to their religion such as God having the capability to reduce labor pain and to provide a safe and successful delivery. The results concluded that spirituality is an integral part of the care of pregnant women in Ghana. In order to ensure the safety of these women, their religious practices should not be in secrecy. The presence of artifacts implies that women do not have the freedom to practice their religion at home. It was concluded that pastors should be sensitive to their role in the labor process and that revelations and spiritual interventions should not lead to pregnancy or labor complications. Future studies in religion and maternal health care will focus on the role of pastors, familiar support, and the views of midwives or health care professionals in different societies around the world. ==Effects on child health and development==

Prenatal health Prenatal care is an important part of basic maternal health care. It is recommended expectant mothers receive at least four antenatal healthcare visits, in which a health worker can check for signs of illness – such as underweight, anaemia or infection – and monitor the health and status of the fetus. During these visits, women are counselled on nutrition and hygiene to optimize their health prior to, and following, delivery. These visits can also include health maintenance of any pre-existing health conditions the woman may have had prior to becoming pregnant - such as diabetes, hypertension, or renal disease. In collaboration with her healthcare provider, the patient can develop a birth plan which outlines how to reach care and what to do in the event of an emergency. The model CenteringPregnancy (group prenatal care) is a relatively new addition to prenatal healthcare, and has shown to improve both birth outcomes and patient & provider satisfaction. Specifically, a randomized controlled trial indicated a 33 percent reduction in preterm birth (n=995), and the decrease was even more pronounced for Black/African American participants. CenteringPregnancy provides physical exams, education, and peer support to a group of pregnant women who all have a similar due date. Nonetheless, race concordant care has been proven to improve patient experience and patient & provider communication. Newborn-physician racial concordance was significantly associated with mortality improvements for black infants in 2020, but debunked in 2024. Poverty, malnutrition, and substance use may contribute to impaired cognitive, motor, and behavioral problems across childhood. In other words, if a mother is not in optimal health during the prenatal period (the time while she is pregnant) and/or the fetus is exposed to teratogen(s), the child is more likely to experience health or developmental difficulties, or death. The environment in which the mother provides for the embryo/fetus is critical to its wellbeing well after gestation and birth. A teratogen is "any agent that can potentially cause a birth defect or negatively alter cognitive and behavioral outcomes." Dose, genetic susceptibility, and time of exposure are all factors for the extent of the effect of a teratogen on an embryo or fetus. Prescription drugs taken during pregnancy such as streptomycin, tetracycline, some antidepressants, progestin, synthetic estrogen, and Accutane, as well as over-the-counter drugs such as diet pills, can result in teratogenic outcomes for the developing embryo/fetus. Additionally, high dosages of aspirin are known to lead to maternal and fetal bleeding, although low-dose aspirin is usually not harmful. Newborns whose mothers use heroin during the gestational period often exhibit withdrawal symptoms at birth and are more likely to have attention problems and health issues as they grow up. Use of stimulants like methamphetamine and cocaine during pregnancy are linked to a number of problems for the child such as low birth weight and small head circumference, motor and cognitive developmental delays, as well as behavioral problems across childhood. The American Academy of Child and Adolescent Psychiatry found that six-year-olds whose mothers had smoked during pregnancy scored lower on an intelligence test than children whose mothers had not. Cigarette smoking during pregnancy can have a multitude of detrimental effects on the health and development of the offspring. Common results of smoking during pregnancy include pre-term births, low birth weights, fetal and neonatal deaths, respiratory problems, and sudden infant death syndrome (SIDS), Also, in a study published in the International Journal of Cancer, children whose mothers smoked during pregnancy experienced a 22% risk increase for non-Hodgkin lymphoma. Although alcohol use in careful moderation (one to two servings a few days a week) during pregnancy are not generally known to cause fetal alcohol spectrum disorder (FASD), the US Surgeon General advises against the consumption of alcohol at all during pregnancy. Excessive alcohol use during pregnancy can cause FASD, which commonly consist of physical and cognitive abnormalities in the child such as facial deformities, defective limbs, face, and heart, learning problems, below average intelligence, and intellectual disability (ID). Although HIV/AIDS can be transmitted to offspring at different times, the most common time that mothers pass on the virus is during pregnancy. During the perinatal period, the embryo/fetus can contract the virus through the placenta. Additionally, children whose mothers had diabetes are more likely to develop Type II diabetes. Mothers who have gestational diabetes have a high chance of giving birth to very large infants (10 pounds (4.5 kg) or more). Because the embryo or fetus's nutrition is based on maternal protein, vitamin, mineral, and total caloric intake, infants born to malnourished mothers are more likely to exhibit malformations. Additionally, maternal stress can affect the fetus both directly and indirectly. When a mother is under stress, physiological changes occur in the body that could harm the developing fetus. Additionally, the mother is more likely to engage in behaviors that could negatively affect the fetus, such as tobacco smoking, substance use, and alcohol use. In pregnancies where the mother is infected with the virus, 25% of babies delivered through an infected birth canal become brain damaged, and 1/3 die. Postpartum period Globally, more than eight million of the 136 million women giving birth each year have excessive bleeding after childbirth. This condition—medically referred to as postpartum hemorrhage (PPH)—causes one out of every four maternal deaths that occur annually and accounts for more maternal deaths than any other individual cause. . During the postpartum period, many mothers breastfeed their infants. Transmission of HIV/AIDS through breastfeeding is a huge issue in developing countries, namely in African countries. despite that antiretroviral treatment (during pregnancy, delivery and during breastfeeding) reduces transmission risk by >90%. However, in healthy mothers, there are many benefits for infants who are breastfed. The World Health Organization recommends that mothers breastfeed their children for the first two years of life, whereas the American Academy of Pediatrics and the American Academy of Family Physicians recommend that mothers do so for at least the first six months, and continue as long as is mutually desired. Infants who are breastfed by healthy mothers (not infected with HIV/AIDS) are less prone to infections such as Haemophilus influenza, Streptococcus pneunoniae, Vibrio cholerae, Escherichia coli, Giardia lamblia, group B streptococci, Staphylococcus epidermidis, rotavirus, respiratory syncytial virus and herpes simplex virus-1, as well as gastrointestinal and lower respiratory tract infections and otitis media. Lower rates of infant mortality are observed in breastfed babies in addition to lower rates of sudden infant death syndrome (SIDS). Decreases in obesity and diseases such as childhood metabolic disease, asthma, atopic dermatitis, Type I diabetes, and childhood cancers are also seen in children who are breastfed. == Recommended maternal health practices ==

Maternal health care and care of the fetus starts with prenatal health. The World Health Organization suggests that the first step towards health is a balanced diet which includes a mix of vegetables, meat, fish, nuts, whole grains, fruits and beans. Additionally, iron supplements and folic acid are recommended to be taken by pregnant women daily. These supplements are recommended by the US Surgeon General to help prevent birth complications for mothers and babies such as low birth weight, anemia, hypertension and pre-term birth. Folic acid can aid neural tube formation in a fetus, which happens early in gestation and therefore should be recommended as soon as possible. Calcium and Vitamin A supplements are also recommended when those compounds are not available or only available in low doses in the natural diet but other supplements such as Vitamins D, E, C, and B6 are not recommended. Should possible side effects of a pregnancy occur, such as nausea, vomiting, heartburn, leg cramps, lower back pain, and constipation; low intensity exercise, balanced diet, or natural herb supplements are recommended by the WHO to mitigate the side effects. In the case of a healthy vaginal birth, mothers and babies typically are recommended to stay at the hospital for 24 hours before departing. This is suggested to allow time to assess the mother and child for any possible complications such as bleeding or additional contractions. The WHO recommends that babies should have checkups with a physician on day 3, day 7-14 and 6 weeks after birth. A 2021 systematic review of found that counseling interventions delivered by trained nonspecialist providers, such as nurses and midwives, were effective in reducing perinatal depression and anxiety symptoms, highlighting task-sharing and telemedicine to expand mental health care access for pregnant and postpartum women. At these check ins mothers also have the opportunity to seek consultation from a physician about starting the breastfeeding process. == Long-term effects for the mother ==

Maternal health problems include complications from childbirth that do not result in death. For every woman that dies during childbirth, approximately 20 develop infection, injury, or disability. Around 75% of women who die in childbirth would be alive today if they had access to pregnancy prevention and healthcare interventions. Black women are more likely to experience pregnancy-related deaths as well as to receive less effective medical care during pregnancy. Women who have chronic hypertension before their pregnancy are at increased risk of complications such as premature birth, low birthweight or stillbirth. Women who have high blood pressure and had complications in their pregnancy have three times the risk of developing cardiovascular disease compared to women with normal blood pressure who had no complications in pregnancy. Monitoring pregnant women's blood pressure can help prevent both complications and future cardiovascular diseases. Almost 50% of the births in developing countries still take place without a medically skilled attendant to aid the mother, and the ratio is even higher in South Asia. Women in Sub-Saharan Africa mainly rely on traditional birth attendants (TBAs), who have little or no formal health care training. In recognition of their role, some countries and non-governmental organizations are making efforts to train TBAs in maternal health topics, in order to improve the chances for better health outcomes among mothers and babies. Breastfeeding provides women with several long-term benefits. Women who breastfeed experience better glucose levels, lipid metabolism, and blood pressure, and lose pregnancy weight faster than those who do not. Additionally, women who breastfeed experience lower rates of breast cancer, ovarian cancer, and type 2 diabetes. However, it is important to keep in mind that breastfeeding provides substantial benefits to women who are not infected with HIV. In countries where HIV/AIDS rates are high, such as South Africa and Kenya, the virus is a leading cause of maternal mortality, especially in mothers who breastfeed. A complication is that many HIV-infected mothers cannot afford formula, and thus have no way of preventing transmission to the child through breast milk or avoiding health risks for themselves. In cases like this, mothers have no choice but to breastfeed their infants regardless of their knowledge of the harmful effects. ==Maternal Mortality Rate==

worldwide, as defined by the number of maternal deaths per 100,000 live births from any cause related to or aggravated by pregnancy or its management, excluding accidental or incidental causes. Worldwide, the Maternal Mortality Ratio (MMR), which is defined as deaths per 100,000 live births per time-period, has decreased, with South-East Asia seeing the most dramatic decrease of 59% and Africa seeing a decline of 27%. There are no regions that are on track to meet the Millennium Development Goal of decreasing maternal mortality by 75% by the year 2015. Maternal mortality—a sentinel event In a September 2016 ACOG/SMFM consensus, published concurrently in the journal Obstetrics & Gynecology and by the American College of Obstetricians and Gynecologists (ACOG), they noted that while they did not yet have a "single, comprehensive definition of severe maternal morbidity" (SMM), the rate of SMM is increasing in the United States as is maternal mortality. Both are "associated with a high rate of preventability." The U.S. Joint Commission on Accreditation of Healthcare Organizations calls maternal mortality a "sentinel event", and uses it to assess the quality of a health care system. Maternal mortality data is said to be an important indicator of overall health system quality because pregnant women survive in sanitary, safe, well-staffed and stocked facilities. If new mothers are thriving, it indicates that the health care system is doing its job. If not, problems likely exist. According to Garret, increasing maternal survival, along with life expectancy, is an important goal for the world health community, as they show that other health issues are also improving. If these areas improve, disease-specific improvements are also better able to positively impact populations. MMR in low and lower-middle income countries Statistics Maternal mortality rates are extremely high worldwide. However, most women who die during or after pregnancy live in low and lower-middle income countries. Specifically, in 2017, 94% of all maternal deaths occurred in low and lower-middle income countries. The MMR in low-income countries was 462 in 2017 signifying that 462 mothers died during childbirth for every 100,000 live births. In many low and lower-middle income countries complications of pregnancy and childbirth are the leading causes of death among women of reproductive age. According to the World Health Organization, in its World Health Report 2005, poor maternal conditions account for the fourth leading cause of death for women worldwide, after HIV/AIDS, malaria, and tuberculosis. In low-income countries, most maternal deaths and injuries during pregnancy and labor are due to preventative issues that have been largely eradicated in higher income countries including postpartum hemorrhaging, hypertensive disease, and maternal infections. For example, postpartum hemorrhaging is the leading cause of maternal death globally; however, 99% of postpartum hemorrhages occur in low and lower-middle income countries. Decline in MMR over time The MMR is extremely high in low-income countries; however, it is necessary to acknowledge the reduction in MMR that has occurred over the past two decades. The MMR has drastically declined in low-income countries since 2010. In low and lower-middle income countries, the average decline rate of the MMR is about 2.9% since 2000. This improvement was caused by lower pregnancy rates in some countries; higher income, which improves nutrition and access to health care; more education for women; and the increasing availability of "skilled birth attendants"—people with training in basic and emergency obstetric care—to help women give birth. Despite this immense progress, there is still lots of work that must be done in order for low-income countries to meet the goal of the WHO organization of an MMR of less than 130 by 2030. Looking forward, the MMR in low and lower-income countries must continue to decline through improving access to skilled birth attendants to perform cesarean sections and other necessary procedures, increased access to family planning, and increased access to hospital facilities. The U.S. has the "highest rate of maternal mortality in the industrialized world." It was found that Black women were experiencing higher rates of maternal mortality from cardiomyopathy, complications from hypertension, and hemorrhage. Black women were also found to be at an increased risk for experiencing preeclampsia, abrupt placentae, placenta prevue, and postpartum hemorrhage when compared to white women. According to the United States Centers for Disease Control and Prevention (CDC), c. 4 million women who give birth in the US annually, over 50,000 a year, experience "dangerous and even life-threatening complications." This is of even greater concern for pregnant women that have chronic conditions prior to pregnancy, such as hypertension or diabetes, that need to have their pregnancies closely monitored. == The Sustainable Development Goals and maternal mortality ==

In SDG 3, countries set a target to accelerate the decline of maternal mortality by 2030, specifically to: reduce "the global MMR to less than 70 per 100 000 births, with no country having a maternal mortality rate of more than twice the global average". ==Proposed improvements==

The WHO estimates that the cost to provide basic family planning for both maternal and neonatal health care to women in developing countries is US$8 per person a year. Many non-profit organizations have programs educating the public and gaining access to emergency obstetric care for mothers in developing countries. The United Nations Population Fund (UNPFA) recently began its Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA), focusing on providing quality healthcare to mothers. One of the programs within CARMMA is Sierra Leone providing free healthcare to mothers and children. This initiative has widespread support from African leaders and was started in conjunction with the African Union Health Ministers. Improving maternal health was the fifth of the United Nations' eight Millennium Development Goals (MDGs), targeting a reduction in the number of women dying during pregnancy and childbirth by three quarters by 2015, notably by increasing the usage of skilled birth attendants, contraception and family planning. The current decline of maternal deaths is only half of what is necessary to achieve this goal, and in several regions such as Sub-Saharan Africa the maternal mortality rate is actually increasing. However, one country that may meet their MDG 5 is Nepal, which has it appears reduced its maternal mortality by more than 50% since the early 1990s. As the 2015 deadline for the MDG's approaches, an understanding of the policy developments leading to the inclusion of maternal health within the MDG's is essential for future advocacy efforts. According to the UNFPA, maternal deaths would be reduced by about two-thirds, from 287,000 to 105,000, if needs for modern family planning and maternal and new-born health care were met. Increasing contraceptive usage and family planning also improves maternal health through reduction in numbers of higher risk pregnancies and by lowering the inter-pregnancy interval. In Nepal a strong emphasis was placed on providing family planning to rural regions and it was shown to be effective. Madagascar saw a dramatic increase in contraceptive use after instituting a nationwide family planning program, the rate of contraceptive use increased from 5.1% in 1992 to 29% in 2008. Family planning has been reported to be a significant factor in maternal health. Governments should invest in their national healthcare to ensure that all women are aware of birth control methods. The government, through the ministry of health, should liaise with the private healthcare as well as the public healthcare division to ensure that women are educated and encouraged to use the right family planning method. The government should invest in this operation as when the rate of underage, as well as unplanned pregnancies, are reduced the healthcare cost stand a chance to drop by up to 8%. Healthcare will, therefore, be in a position to handle the other women who give birth. This will result in an improvement in maternal health. 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 fetus. 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 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 new-borns are extremely vulnerable in the immediate aftermath of birth. Therefore, follow-up visits by a health worker is assess the health of both mother and child in the postnatal period is strongly recommended. Digital health technologies are increasingly being used to support maternal care worldwide. Online pregnancy communities and telehealth programs have been shown to improve access to information and reduce feelings of isolation among expectant mothers. These digital tools can also help healthcare providers monitor pregnancies remotely, improving continuity of care for women in underserved or rural regions. According to the World Health Organization, “Digital health, or the use of digital technologies for health, has become a salient field of practice for employing routine and innovative forms of information and communications technology (ICT) to address health needs.” A 2023 review found that digital technology-enabled health interventions, such as mobile applications and virtual education programs, improve engagement and health outcomes for expectant mothers. == See also ==