Global Health Mistakes: Prenatal Care

by Alanna Shaikh · 2009-02-25 16:02:00 UTC
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(photo credit: Meanest Indian)

After yesterday's post about unanswered questions in global health, a couple of people emailed me to ask for examples of global health mistakes we have made in the past. The example that came to mind first was prenatal care.

Global Health professionals spent a long time focused on providing lots of prenatal care in low-resource settings. Quantity was our goal. Women were asked to attend monthly - or more - frequent - visits to a health care provider to monitor pregnancy progress. Pregnant women were divided up into high-risk and low-risk groups, and high-risk women got extra provider attention and tests.

We were wrong. Multiple prenatal visits didn't improve pregnancy outcomes. Dividing women into risks groups actually seemed to make care worse. "High-risk" women were subjected to unnecessary testing and interventions, while "low-risk" women didn't get enough attention from providers. We sank time, effort, and money into prenatal care programs that had no or negative impact on the health of women and babies.

Now we focus on completely different things. Women are asked to attend 3-4 prenatal checkups while pregnant, and no more. All women receive the same attentive care. The focus is on prenatal care as a chance to educate the woman about self-care during pregnancy and prepare for childbirth. The focus is on good nutrition, healthy lifestyle choices, and giving birth with a trained attendant.

And now, we're improving infant and maternal mortality rates.

Alanna Shaikh
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