Prenatal Health

by

M. Anne George, Mary H. George

Introduction

Maternal and prenatal health covers a spectrum of topics, including nutrition, adequate health care, and risks caused by environmental exposures; alcohol, tobacco, and other drugs; maternal stress; maternal diseases; and many other health issues, such as maternal mental health. Both maternal and fetal death, including stillbirths, is an enormous burden. In some countries a strong emphasis is placed on policy and practice initiatives to reduce maternal and newborn mortality because complications of pregnancy and childbirth are the leading cause of death for both mother and child in developing countries. The World Health Organization (WHO) estimates that 1,500 women die daily due to complications in pregnancy or childbirth and that 10,000 babies are born dead or die in the first month of life. In these countries, malnutrition is a major contributor to women’s preventable morbidity and preventable mortality and has considerable outcomes for the developing fetus. Elsewhere in the world, where maternal and fetal death rates are lower, long-term consequences of maternal and fetal stressors, resulting from poor nutrition, teratogens, and maternal disease are the major concern. This has led to considerable research and development of best-practice guidelines that focus on maternal behaviors and conditions, prenatal environmental exposures, including prenatal alcohol and tobacco exposure, and treatment of preexisting conditions, such as depression. Some issues, such as HIV/AIDS and nutrition, affect maternal and prenatal health throughout the world, but to differing degrees.

General Overviews

Maternal health has been defined by the World Health Organization (WHO) across three periods: “Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive and fulfilling experience, for too many women it is associated with suffering, ill-health, and even death. The major direct causes of maternal morbidity and mortality include hemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labour” (Maternal Health). Few general introductory works include the topics of maternal health and fetal development and the risks to fetal health. Sigelman and Rider 2009 describes health and risks across the lifespan, including fetal development and risks from maternal behaviors and environmental exposures. Gilbert and Epel 2009 similarly describes the human in relation to its environment, with fetal development being a more predominant topic than maternal health.

• Gilbert, S. F., and D. Epel. 2009. Ecological developmental biology: Integrating epigenics, medicine, and evolution. Sunderland, MA: Sinauer.

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  Ecological development biology is the study of the interaction of the organism and its environment and includes the impact on the organism of pathological environments, including nutrition and teratogens. This book has chapters relevant to fetal health on teratogenic agents, endocrine disruptors, and fetal development of adult diseases.

• Sigelman, C. K., and E. A. Rider. 2009. Life-Span human development. 6th ed. Belmont, CA: Wadsworth.

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  Taking a life-span approach to health, this book explores development theories and has a well-documented section on prenatal development and birth. It includes summaries on human development theories, stages of fetal development, known teratogens, and perinatal environments.