iv Chapter 3 Great expectations:making pregnancy safer 41 Realizing the potential of antenatal care Meeting expectations in pregnancy 42 Pregnancy-a time with its own dangers 44 Seizing the opportunities 46 Critical directions for the future 47 Not every pregnancy is welcome 48 Planning pregnancies before they even happen 48 Unsafe abortion:a major public health problem 50 Dealing with the complications of abortion 51 Valuing pregnancy:a matter of legal protection 52 Chapter 4 Attending to 136 million births,every year 61 Risking death to give life 61 Skilled professional care:at birth and afterwards 65 Successes and reversals:a matter of building health systems 65 Skilled care:rethinking the division of labour 68 Care that is close to women-and safe 69 A back-up in case of complications 72 Rolling out services simultaneously 73 Postpartum care is just as important 73 Chapter 5 Newborns:no longer going unnoticed 79 The greatest risks to life are in its beginning 79 Progress and some reversals 82 No longer falling between the cracks 85 Care during pregnancy 86 Professional care at birth 86 Caring for the baby at home 88 Ensuring continuity of care 89 Planning for universal access 90 Benchmarks for supply-side needs 90 Room for optimism,reasons for caution 91 Closing the human resource and infrastructure gap 93 Scenarios for scaling up 93 Costing the scale up 98 Chapter 6 Redesigning child care: survival,growth and development 103 Improving the chances of survival 103 The ambitions of the primary health care movement 103 The successes of vertical programmes 103 Time for a change of strategy 105 Combining a wider range of interventions 105 Dealing with children,not just with diseases 107 Organizing integrated child care 108iv Chapter 3 Great expectations: making pregnancy safer 41 Realizing the potential of antenatal care 42 Meeting expectations in pregnancy 42 Pregnancy – a time with its own dangers 44 Seizing the opportunities 46 Critical directions for the future 47 Not every pregnancy is welcome 48 Planning pregnancies before they even happen 48 Unsafe abortion: a major public health problem 50 Dealing with the complications of abortion 51 Valuing pregnancy: a matter of legal protection 52 Chapter 4 Attending to 136 million births, every year 61 Risking death to give life 61 Skilled professional care: at birth and afterwards 65 Successes and reversals: a matter of building health systems 65 Skilled care: rethinking the division of labour 68 Care that is close to women – and safe 69 A back-up in case of complications 72 Rolling out services simultaneously 73 Postpartum care is just as important 73 Chapter 5 Newborns: no longer going unnoticed 79 The greatest risks to life are in its beginning 79 Progress and some reversals 82 No longer falling between the cracks 85 Care during pregnancy 86 Professional care at birth 86 Caring for the baby at home 88 Ensuring continuity of care 89 Planning for universal access 90 Benchmarks for supply-side needs 90 Room for optimism, reasons for caution 91 Closing the human resource and infrastructure gap 93 Scenarios for scaling up 93 Costing the scale up 98 Chapter 6 Redesigning child care: survival, growth and development 103 Improving the chances of survival 103 The ambitions of the primary health care movement 103 The successes of vertical programmes 103 Time for a change of strategy 105 Combining a wider range of interventions 105 Dealing with children, not just with diseases 107 Organizing integrated child care 108 The World Health Report 2005