- Safe abortion services and postabortion care must be

ensured by national policy

-  Social inequalities and discrimination on grounds of gender,
age and marital status, are to be removed.

Maternal Near Miss (MNM)

women who experienced and survived a severe health condition during
pregnancy, childbirth or postpartum are considered as maternal near miss or
severe acute maternal morbidity (SAMM) cases. Maternal near miss is defined
as :”A woman who nearly died but survived a complication that occurred during
pregnancy, childbirth or within 42 days of termination of pregnancy “(WHO).
MNM incidence ratio (MNMIR) refers to the number of maternal near miss
cases per 1000 live births (MNM IR=MNM/1000 LB).

MATERNAL MORBIDITY

Although considerable attention has been given to maternal mortality, very

littles concern has been expressed for maternal morbidity. It has been estimated
that for one maternal death at least 15 more quality of life as a result of short-
term or long-term disability.
Obstetric morbidity originates from any cause related pregnancy or its
management anytime during antepartum, intrapartum and postpartum period
usually up to 42 days after confinement. The parameters of maternal morbidity
are
- Fever more than 100.4*F or 38*C and continuing more than 24 hours
- Blood pressure more than 140/90mm of Hg
- Recurrent vaginal bleeding
- Hb % less than 10.5g irrespective of gestational period, and
- Asymptomatic bacteriuria of pregnancy.
Classification:
1. Direct-
Temporary- APH< PPH< eclampsia, obstructed labour, rupture
uterus, sepsis, ectopic pregnancy, molar pregnancy, etc.
Permanent (Chronic)- VVF, RVF, dyspareunia, CPT, prolapse,
secondary infertility, obstetric palsy, Sheehan’s syndrome, etc.
2. Indirect- these conditions are only expressions of aggravated previous
existing diseases like malaria, hepatitis, tuberculosis, anaemia, etc. by
the changes in the various systems during pregnancy.
Reproductive morbidity is used in a broader sense to include