Care of the newborn

Abstract

The present high levels of perinatal mortality (100 per 1000 births) and maternal deaths (10 per 1000 births) in the Third World, might be improved - not by introducing advanced medical technology, but by implementing simple common sense measures. These stem from an assessment of the factors that contribute to high risks of mortality for the mother and her infant: obstetric and medical complications, social and cultural factors, and biological determinants such as age, parity, birth interval, and nutritional state. No one factor can be taken in isolation, and because of this modern methods of obstetrics and neonatal intensive care cannot produce the appreciable and lasting benefits that accrue from a general improvement in the nutrition and health of the whole community. Improved hygiene and prenatal care, the identification of mothers at risk, and monitoring to ensure that fetal growth is adequate are essential. At present four fifths of all births in the developing world are conducted by traditional birth attendants and there is much scope for upgrading their skills through appropriate training. In the Sudan a training programme was first established in 1921 and many nations have now developed similar programmes.