Disability-adjusted life year for maternal conditions per 100,000 inhabitants in 2004. Disability-adjusted life year for perinatal conditions per 100,000 inhabitants in 2004. Per figures retrieved in 2015, since 1990 there has been a 44 per cent decline in the maternal death rate. However, according to 2015 figures 830 women die every day from causes related to pregnancy or<unk>  and for every woman who dies, 20 or 30 encounter injuries, infections or disabilities. Most of these deaths and injuries are preventable. In 2008, noting that each year more than 100,000 women die of complications of pregnancy and<unk>  and at least seven million experience serious health problems while 50 million more have adverse health consequences after<unk> , the World Health Organization (WHO) has urged midwife training to strengthen maternal and newborn health services. To support the upgrading of midwifery skills the WHO established a midwife training program, Action for Safe Motherhood. The rising maternal death rate in the US is of concern. In 1990 the US ranked 12th of the 14 developed countries that were analysed. However, since that time the rates of every country have steadily continued to improve while the US rate has spiked dramatically. While every other developed nation of the 14 analysed in 1990 shows a 2017 death rate of less than 10 deaths per every 100,000 live births, the US rate has risen to 26.4. By comparison, the United Kingdom ranks second highest at 9.2 and Finland is the safest at 3.8. Furthermore, for every one of the 700 to 900 US woman who die each year during pregnancy or<unk> , 70 experience significant complications such as haemorrhage and organ failure, totalling more than one per cent of all births. Compared to other developed nations, the United States also has high infant mortality rates. The Trust for America's Health reports that as of 2011, about one-third of American births have some complications; many are directly related to the mother's health including increasing rates of obesity, type 2 diabetes, and physical inactivity. The U.S. Centers for Disease Control and Prevention (CDC) has led an initiative to improve woman's health previous to conception in an effort to improve both neonatal and maternal death rates. Labour and delivery complications Obstructed labour The second stage of labour may be delayed or lengthy due to poor or uncoordinated uterine action, an abnormal uterine position such as breech or shoulder dystocia, and cephalopelvic disproportion (a small pelvis or large infant). Prolonged labour may result in maternal exhaustion, fetal distress, and other complications including obstetric fistula. Eclampsia Eclampsia is the onset of seizures (convulsions) in a woman with pre-eclampsia. Pre-eclampsia is a disorder of pregnancy in which there is high blood pressure and either large amounts of protein in the urine or other organ dysfunction. Pre-eclampsia is routinely screened for during prenatal care. Onset may be before, during, or rarely, after delivery. Around one per cent of women with eclampsia die. Maternal complications A puerperal disorder or postpartum disorder is a complication which presents primarily during the puerperium, or postpartum period. The postpartum period can be divided into three distinct stages; the initial or acute phase, six to 12 hours after<unk> ; subacute postpartum period, which lasts two to six weeks, and the delayed postpartum period, which can last up to six months. In the subacute postpartum period, 87% to 94% of women report at least one health problem. Long-term health problems (persisting after the delayed postpartum period) are reported by 31 per cent of women. Postpartum bleeding Postpartum bleeding is the leading cause of death of birthing mothers in the world, especially in the developing world. Globally it occurs about 8.7 million times and results in 44,000 to 86,000 deaths per year. Uterine atony, the inability of the uterus to contract, is the most common cause of postpartum bleeding. Following delivery of the placenta, the uterus is left with a large area of open blood vessels which must be constricted to avoid blood loss. Retained placental tissue and infection may contribute to uterine atony. Heavy blood loss leads to hypovolemic shock, insufficient perfusion of vital organs and death if not rapidly treated. Postpartum infections Postpartum infections, also known as childbed fever and puerperal fever, are any bacterial infections of the reproductive tract following<unk>  or miscarriage. Signs and symptoms usually include a fever greater than 38.0 °C (100.4 °F), chills, lower abdominal pain, and possibly bad-smelling vaginal discharge. The infection usually occurs after the first 24 hours and within the first ten days following delivery. Infection remains a major cause of maternal deaths and morbidity in the developing world. The work of Ignaz Semmelweis was seminal in the pathophysiology and treatment of childbed fever and his work saved many lives. Psychological complications<unk>  can be an intense event and strong emotions, both positive and negative, can be brought to the surface. Abnormal and persistent fear of<unk>  is known as tokophobia. The prevalence of fear of<unk>  around the world ranges between 4–25%, with 3–7% of pregnant women having clinical fear of<unk> . Most new mothers may experience mild feelings of unhappiness and worry after giving birth. Babies require a lot of care, so it is normal for mothers to be worried about, or tired from, providing that care. The feelings, often termed the "baby blues", affect up to 80 per cent of mothers. They are somewhat mild, last a week or two, and usually go away on their own. Postpartum depression is different from the "baby blues". With postpartum depression, feelings of sadness and anxiety can be extreme and might interfere with a woman's ability to care for herself or her family. Because of the severity of the symptoms, postpartum depression usually requires treatment. The condition, which occurs in nearly 15 per cent of births, may begin shortly before or any time after<unk> , but commonly begins between a week and a month after delivery.<unk> -related posttraumatic stress disorder is a psychological disorder that can develop in women who have recently given birth. Causes include issues such as an emergency C-section, preterm labour, inadequate care during labour, lack of social support following<unk> , and others. Examples of symptoms include intrusive symptoms, flashbacks and nightmares, as well as symptoms of avoidance (including amnesia for the whole or parts of the event), problems in developing a mother-child attachment, and others similar to those commonly experienced in posttraumatic stress disorder (PTSD). Many women who are experiencing symptoms of PTSD after<unk>  are misdiagnosed with postpartum depression or adjustment disorders. These diagnoses can lead to inadequate treatment. Postpartum psychosis is a rare psychiatric emergency in which symptoms of high mood and racing thoughts (mania), depression, severe confusion, loss of inhibition, paranoia, hallucinations and delusions set in, beginning suddenly in the first two weeks after<unk> . The symptoms vary and can change quickly. It usually requires hospitalisation. The most severe symptoms last from two to 12 weeks, and recovery takes six months to a year. Fetal complications Mechanical fetal injury may be caused by improper rotation of the fetus. Five causes make up about 80 per cent of newborn deaths globally: prematurity, low-birth-weight, infections, lack of oxygen at birth, and trauma during birth. Stillbirth Stillbirth is typically defined as fetal death at or after 20 to 28 weeks of pregnancy. It results in a baby born without signs of life. Worldwide prevention of most stillbirths is possible with improved health systems. About half of stillbirths occur during<unk> , and stillbirth is more common in the developing than developed world. Otherwise depending on how far along the pregnancy is, medications may be used to start labour or a type of surgery known as dilation and evacuation may be carried out. Following a stillbirth, women are at higher risk of another one; however, most subsequent pregnancies do not have similar problems. Worldwide in 2015 there were about 2.6 million stillbirths that occurred after 28 weeks of pregnancy (about 1 for every 45 births). They occur most commonly in the developing world, particularly South Asia and Sub-Saharan Africa. In the United States for every 167 births there is one stillbirth. Stillbirth rates have declined, though more slowly since the 2000s. Preterm birth Preterm birth is the birth of an infant at fewer than 37 weeks gestational age. It is estimated that one in 10 babies are born prematurely. Premature birth is the leading cause of death in children under five years of age though many that survive experience disabilities including learning defects and visual and hearing problems. Causes for early birth may be unknown or may be related to certain chronic conditions such as diabetes, infections, and other known causes. The World Health Organization has developed guidelines with recommendations to improve the chances of survival and health outcomes for preterm infants. Neonatal infection Disability-adjusted life year for neonatal infections and other (perinatal) conditions per 100,000 inhabitants in 2004. Excludes prematurity and low birth weight, birth asphyxia and birth trauma which have their own maps/data. Newborns are prone to
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