title: Preventing deaths from complications of labour and delivery.
abstract: The process of labour and delivery remains an unnecessary and preventable cause of death of women and babies around the world. Although the rates of maternal and perinatal death are declining, there are large disparities between rich and poor countries, and sub-Saharan Africa has not seen the scale of decline as seen elsewhere. In many areas, maternity services remain sparse and under-equipped, with insufficient and poorly trained staff. Priorities for reducing the mortality burden are provision of safe caesarean section, prevention of sepsis and appropriate care of women in labour in line with the current best practices, appropriately and affordably delivered. A concern is that large-scale recourse to caesarean delivery has its own dangers and may present new dominant causes for maternal mortality. An area of current neglect is newborn care. However, innovative training methods and appropriate technologies offer opportunities for affordable and effective newborn resuscitation and follow-up management in low-income settings.
authors.affiliation: Department of Obstetrics and Gynaecology, Chris Hani Baragwanath Academic Hospital, PO Bertsham 2013, Johannesburg, South Africa. Electronic address: eckhart.buchmann@wits.ac.za.
authors.forename: Eckhart J
authors.initials: EJ
authors.lastname: Buchmann
authors.affiliation: School of Medicine, University of St Andrews and College of Medicine, University of Malawi, Fife KY16 9JT, UK. Electronic address: rws6@st-andrews.ac.uk.
authors.forename: William
authors.initials: W
authors.lastname: Stones
authors.affiliation: Department of Neonatology, Christian Medical College, Vellore 632004, India. Electronic address: niranjan@cmcvellore.ac.in.
authors.forename: Niranjan
authors.initials: N
authors.lastname: Thomas
mesh_terms: D001720:Birth Injuries / Q000150:complications / Q000517:prevention & control* / Q000628:therapy; D002585:Cesarean Section; D036861:Delivery, Obstetric; D004420:Dystocia / Q000628:therapy; D004630:Emergencies; D005260:Female; D005311:Fetal Hypoxia / Q000150:complications / Q000517:prevention & control* / Q000628:therapy; D006297:Health Services Accessibility; D006801:Humans; D007224:Infant Care; D007231:Infant, Newborn; D007318:Inservice Training; D007743:Labor, Obstetric; D063130:Maternal Death / Q000209:etiology / Q000517:prevention & control*; D007744:Obstetric Labor Complications / Q000628:therapy*; D066087:Perinatal Death / Q000209:etiology / Q000517:prevention & control*; D006473:Postpartum Hemorrhage / Q000628:therapy*; D011247:Pregnancy; D018805:Sepsis / Q000150:complications / Q000628:therapy*; D000066908:Simulation Training; D014592:Uterine Hemorrhage / Q000150:complications / Q000628:therapy
keywords: Intrapartum care: Neonatal care; Low-resource settings; Maternal mortality; Perinatal mortality