February 28, 2014
Article by Global Pre-Meds
Hospital doctor shadowing & global health experience programs.
However, while in developed countries all pregnant women take this standard of care as a given, this is not so in the third world. In fact in several countries around the world, many women are lucky to have just one prenatal visit.
The average British woman will have on average about 15 prenatal visits during a normal 40-week pregnancy. In much of the developing world, however, getting one prenatal visit is a relief and up to five visits are considered a bonus.
According to a report by the World Health Organization, 81% of women in developing countries have one prenatal visit and only 36% have the recommended minimum of four visits.
Another big difference between prenatal visits between the developed and developing world is that in third world countries, the visits may be fewer, but they are longer. In the developing world, which includes countries in Africa, South Asia, Latin America and the Caribbean, health care providers try to cram a lot of information into what might be the sole visit a woman has during her pregnancy.
A study showed that in Tanzania, first prenatal visits last an average of 46 minutes and follow-up visits if any last more than 30 minutes. These visits are not your routine visits. They are focused mostly on educating women about pregnancy-related complications and warning signs, which are all too common. During these visits, healthcare providers focus on treatment of infections, tetanus vaccination and screening for high blood pressure. Most of these women do not realise the importance of high blood pressure in pregnancy, which can be a precursor of preeclampsia and eclampsia, which are major maternal issues.
In the third world, the planning process is not about what clothes and toiletries to pack. It involves helping a woman decide whether she will deliver at a hospital or at home and what she should do if there’s an emergency. In most of these countries, dialling 911 does not exist.
If a woman decides to have a hospital birth, she must decide in advance how she would get there. Transportation is a huge deciding factor.
Moreover, in most of these places, there is no health insurance. Pregnant women are advised to set aside money to pay for the birth and any unexpected emergencies.
There are some scary birth scenarios that can be completely avoided. According to the World Health Organisation, an estimated 25% of maternal deaths in Africa occur during pregnancy and childbirth. As many as half of those deaths are due to haemorrhage and hypertension, conditions that could have been treated with proper education and prenatal care.
With adequate prenatal care and education, third-world mothers-to-be are more likely to be vaccinated for tetanus, receive iron and folic acid to treat anaemia, take precautions against malaria and be treated for sexually transmitted diseases such as syphilis that can lead to stillbirth and infant death.