Emergency Obstetric Care in the

Prevention of Maternal Mortality

By Professor A. U. Oronsaye;
FWACS
Introduction : Definition &Scope
of the Subject

• The prevention of maternal deaths is

an area in which no amount of
primary health care or community
effort can make a significant impact
unless it is built around adequate
medial services. (Rosenfiled and
Maurine 1985)
 Introduction contd
• Once pregnant, probably 15-20%
will develop serious complication
such as obstructed labour,
placental abnormalities , pre-
clampsia, irrespective of medical
care received of social status
(Hibbard; 1978, Hartfield 1980)
 Concept of Emergency Obstetric
Care (EmOC)
• About two decades ago, WHO
concluded from several studies by
experts under its auspices that of all
health interventions, the single most
important factor in the prevention of
maternal mortality is the concept of
Emergency Obstetric Care (EmOC)
(WHO, 1986 page 10)
Suggestive options and strategies
1. Upgrade small Rural Hospital Health Centers
b. Have a resident physician with Basic
Surgical Obstetric skill
c. Provide facilities for carrying out simple
obstetrics surgical procedures such as
manual removal of placenta
d. Provide facilities for basic urine tests, packed
Cell Volume (PCV) etc.
e. Provide blood transfusion facilities
Suggestive options and strategies
contd.

2. Training /retraining of middle level health

providers

- Effective use of Non-Specialists to

manage complications at the Primary or
Rural Health Services
 Suggestion options and strategy
contd.
3. Provision of Drugs and Equipment for Emergency
Obstetric Care

• At the Primary or Basic Level provision and Obstetric

First-Aid box and essential drugs and supplies may be
all that is required at the primary Health Centres

• At the Secondary and Tertiary Levels, there is room for

Organisational improvement
- Effective 24 hours coverage
- Emergency obstetric care financing
- Abolition/Reduction of stage III delay. That i.e. delay in
receiving adequate care at the institution or facility.
 Conclusion
• Impact of effective and efficient Emergency
Obstetric Care (EmOC) as part and parcel of
the strategy of safe motherhood in reducing
maternal deaths in the practice can not be over
emphasized.

• Neglect of this aspect of the strategy is

continued escalation or at the best is a stats
and the prevention of maternal mortality.
Thank you All