UNIVERSITY OF HEALTH SCIENCE

FACULTY : MIDWIFERY

SEMESTER : SIX

PRESENTATION : THREE DELAYS MODEL THADDEUS AND

MAIN BEMONC AND CEMONC

GROUP : ONE
• The three delays model developed by Thaddeus and Maine is the
most common framework used to evaluate the circumstances
surrounding a maternal death [7]. These are
• 1) delay in deciding to seek care,
• 2) delay in reaching a healthcare facility
• 3) delay in receiving care at the healthcare facility.
1: Delay in decision to seek care due to;
• The low status of womenPoor understanding of
complications and risk factors in pregnancy and when
to seek medical helpPrevious poor experience of
health careAcceptance of maternal deathFinancial
implications
2Delay in reaching care due to;
• Distance to health centres and
hospitalsAvailability of and cost of
transportationPoor roads and
infrastructureGeography e.g. mountainous
terrain, rivers
3: Delay in receiving adequate health care due to
;Poor facilities and lack of medical
suppliesInadequately trained and poorly
motivated medical staffInadequate referral
systems
• An important part of any circuit delay model is
a means of estimating the various capacitances
of the circuit.
 DEFINITION OF BEMONC :

• Basic emergency obstetric and newborn care ( BEMONC) :

• is critical to reducing maternal and neonatal death. This care ,
which can be provided with skilled staff in health centre in
cludes :
• administering antibioics
• uterotonic drug ( oxytocin )
• anticonvulsants ( magnesium sulphate )
• manual removal of the placenta
• Removal of retained product following miscarriage or
abortion
• assisted vaginal delivery , preferably with vacuum
extractor
• basic neonatal resuscitation care
• administering antibiotics :
puerperal sepsis accounts
for 8% of global maternal deaths
• effectively managed with injectable antibiotics :
• IV Pencillin G every 6 hours
• plus gentamicing 5 mg/kg body weight IV every
24h
• plus metronidazole 500mg IV 8h
• Uterotonic drugs :
• postpartum hemorrhage accounts for 15% global maternal death
• effectively managed through active management of third stage of
labour ( AMTSL)
• IM oxytocin within 1 minute of delivery

administer parenteral anticonvulsant :

• effectively managed through use parenteral anticonvulsant :
• magnesium sulphate
Manually remove placenta :
• retained placenta : a major
Cause of postpartum
hemorrhage And puerperal sepsis both leading cause of
maternal mortality .
• Managed through Manual remove of the placenta
remove Retained product of conception :

• managed effectively through manual vacuum aspiration Or mediacal

evacuation using misoprostol

PERFORM ASSISTED VAGINAL DELIVERY :

• assisted vaginal delivery using forceps or vacuum extraction ,
when done appropriately , can avert unnecesarry hospital referral and
caesarian delivery.
• PERFORM BASIC NEONATAL RESUSCITATION:
• perinatal asphyxia is a leading cause of child mortality
• severe form are associated with serious long term
complications
• effective newborn resuscitation and mortality associated
with perinatal asphyxia
DEFINITION CEMONC

• Comprehensive emergency obstetric and

newborn care : are services comprise
caesarean section and blood transfusions ,
in addition to BEMONC functions .
PERFORM CAESAREAN DELIVERY :

• Caesereansection is a life saving procedure

required When
vaginal delivery places the life or health Of the or
baby at risk.
• PROVIDE BLOOD TRANSFUSION : IS life
saving procedure for women suffering from
postpartum hemorrhage the lead cause
maternal mortality