FOREWORD In modern times,improvements in knowledge and technological advances have greatly improved the It is against this background that we are proud to present the document Pregnancy,Childbirth. health of mother and children.However,the past decade was marked by limited progress in reducing Postpartum and Newbor Care:A guide for essential practice,as new additions to the Integrated matemal mortality and a slow-down in the steady decline of childhood mortality observed since the Management of Pregnancy and Childbirth tool kit.The guide provides a full range of updated, mid 1950s in many countries,the latter being largely due to a failure to reduce neonatal mortality. evidence-based norms and standards that will enable health care providers to give high quality care during pregnancy.delivery and in the postpartum period,considering the needs of the mother and her Every year,over four million babies less than one month of age die,most of them during the critical newborn baby. first week of life:and for every newborn who dies,another is stillborn.Most of these deaths are a consequence of the poor health and nutritional status of the mother coupled with inadequate care We hope that the guide will be helpful for decision-makers,programme managers and health care before,during.and after delivery.Unfortunately,the problem remains unrecognized or-worse-accepted providers in charting out their roadmap towards meeting the health needs of all mothers and children. as inevitable in many societies,in large part because it is so common. We have the knowledge,our major challenge now is to translate this into action and to reach those women and children who are most in need. Recognizing the large burden of matemnal and neonatal ill-health on the development capacity of individuals.communities and societies,world leaders reaffirmed their commitment to invest in mothers and children by adopting specific goals and targets to reduce matemal and childhood-infant mortality as part of the Millennium Declaration. There is a widely shared but mistaken idea that improvements in newbom health require sophisticated and expensive technologies and highly specialized staff.The reality is that many conditions that result in perinatal death can be prevented or treated without sophisticated and expensive technology.What is required is essential care during pregnancy,the assistance of a person with midwifery skills during Dr.Tomris Turmen childbirth and the immediate postpartum period,and a few critical interventions for the newbom Executive director during the first days of life. Family and Community Health(FCH) QHOM3HO ForewordForeword FOREWORD In modern times, improvements in knowledge and technological advances have greatly improved the health of mother and children. However, the past decade was marked by limited progress in reducing maternal mortality and a slow-down in the steady decline of childhood mortality observed since the mid 1950s in many countries, the latter being largely due to a failure to reduce neonatal mortality. Every year, over four million babies less than one month of age die, most of them during the critical first week of life; and for every newborn who dies, another is stillborn. Most of these deaths are a consequence of the poor health and nutritional status of the mother coupled with inadequate care before, during, and after delivery. Unfortunately, the problem remains unrecognized or- worse- accepted as inevitable in many societies, in large part because it is so common. Recognizing the large burden of maternal and neonatal ill-health on the development capacity of individuals, communities and societies, world leaders reaffirmed their commitment to invest in mothers and children by adopting specific goals and targets to reduce maternal and childhood-infant mortality as part of the Millennium Declaration. There is a widely shared but mistaken idea that improvements in newborn health require sophisticated and expensive technologies and highly specialized staff. The reality is that many conditions that result in perinatal death can be prevented or treated without sophisticated and expensive technology. What is required is essential care during pregnancy, the assistance of a person with midwifery skills during childbirth and the immediate postpartum period, and a few critical interventions for the newborn during the first days of life. It is against this background that we are proud to present the document Pregnancy, Childbirth, Postpartum and Newborn Care: A guide for essential practice, as new additions to the Integrated Management of Pregnancy and Childbirth tool kit. The guide provides a full range of updated, evidence-based norms and standards that will enable health care providers to give high quality care during pregnancy, delivery and in the postpartum period, considering the needs of the mother and her newborn baby. We hope that the guide will be helpful for decision-makers, programme managers and health care providers in charting out their roadmap towards meeting the health needs of all mothers and children. We have the knowledge, our major challenge now is to translate this into action and to reach those women and children who are most in need. Dr. Tomris Türmen Executive director Family and Community Health (FCH) FOREWORD