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International standards of maternity care should be improved, says WHO



WHO has issued a new series of recommendations to improve quality of international antenatal care in order to reduce the risk of complications, stillbirths and negative pregnancy experiences.

WHO has issued a new series of recommendations to improve quality of international antenatal care in order to reduce the risk of complications, stillbirths and negative pregnancy experiences.

In 2015 an estimated 303,000 women died from pregnancy-related causes, 2.7 million babies died during the first 28 days of life and 2.6 million babies were stillborn.

Quality health care during pregnancy and childbirth can prevent many of these deaths but globally only 64% of women receive antenatal care four or more times throughout their pregnancy.

Antenatal care is critical for promoting a healthy lifestyle, including good nutrition; detecting and preventing diseases; providing family planning counselling and supporting women who may be experiencing domestic abuse.

Dr Ian Askew, Director of Reproductive Health and Research for WHO said: “Pregnancy should be a positive experience for all women and they should receive care that respects their dignity.”

WHO’s new antenatal care model increases the number of contacts a pregnant woman has with health providers throughout her pregnancy from four to eight.

It recommends pregnant women to have their first contact in the first 12 weeks’ gestation, with subsequent contacts taking place at 20, 26, 30, 34, 36, 38 and 40 weeks.

The new guidelines will bring global perinatal care more inline with NHS standards by providing pregnant women with counselling on healthy diet, physical activity, tobacco and substance use, malaria and HIV prevention, blood tests and tetanus vaccination, fetal measurements, and advice for dealing with common physiological symptoms such as nausea, back pain and constipation.

Daily oral iron and folic acid supplementation with 30 mg to 60 mg of elemental iron and 400 µg (0.4 mg) folic acid for pregnant women to prevent maternal anaemia, puerperal sepsis, low birth weight, and preterm birth.

Tetanus toxoid vaccination is also recommended for all pregnant women, depending on previous tetanus vaccination exposure.

The recommendations allow flexibility for countries to employ different options for the delivery of care based on their specific needs. This means, for example, care can be provided either through midwives or other trained health professionals and delivered at health facilities or through community outreach services.