C. Obstetric care

Ultrasonography follicular monitoring, obstetric ultrasounds.

Manual for dealing with obstetric emergencies.

Of the 146 maternal deaths recorded in 2002, 116 were due to obstetric causes and 30, to non obstetric causes.

There are 3 upper level obstetric centres.

62 138. Supporting efforts to end obstetric fistula

And the most devastating injury is obstetric fistula.

Table 11 Maternal mortality, by obstetric cause, 2002

Table 13 Non obstetric maternal mortality, 2001 2002

Most maternal deaths are directly due to obstetric complications.

There are obstetric and gynae wards in most major hospitals.

Fourteen of the deaths were attributed to indirect obstetric causes.

They are the general guidelines for the organization and standardization of emergency obstetric care (2000), the protocol for obstetric and paediatric care (2001) and the abortion care protocol (2002).

The following table shows the distribution of direct and indirect obstetric deaths.

The following table shows the primary causes of direct obstetric death in 2002

The number of obstetric wards (maternity hospitals) has remained unchanged (19 in total).

Deeply concerned that early childbearing and limited access to sexual and reproductive health care, including in the area of emergency obstetric care, causes high levels of obstetric fistula and maternal mortality and morbidity,

Obstetric wards of county hospitals and private hospitals are institutions of the secondary level.

One of the consequences of such traditional practices, particularly early marriage, is obstetric fistula.

By 31 December 2003, 93.2 of ward clinics have midwives and obstetric pediatric assistant doctors.

(u) Inter agency Group Meeting on Safe Motherhood, quot Essential Obstetric Care quot , June 1995

Apart from these measures, the Government has encouraged the establishment of Mother Friendly Hospitals and Mother Friendly Sub Districts that provide appropriate obstetric emergency care and monitor pregnant women for early detection of obstetric complications, referrals and emergency preparedness.

Emergency obstetric Care facilities through Women friendly hospitals in 20 districts of Pakistan under the Women Health Project.

(b) To strengthen the capacity of health systems to provide the essential services needed to prevent obstetric fistula and to treat those cases that do occur by providing the continuum of services, including family planning, prenatal care, skilled birth attendance, emergency obstetric care and post partum care, to young women and girls, including those living in poverty and in underserved rural areas where obstetric fistula is most common

For example, the provision of maternal health services, including emergency obstetric services, must be available to all young women.

In February 2004, a National Seminar on Obstetric and Neonatal care was held to establish the Pact's strategic actions.

(d) To develop a national strategy of prevention and treatment to effectively address the condition of obstetric fistula and to further develop a multisectoral, comprehensive and integrated approach to bring about lasting solutions and a meaningful response to the problem of obstetric fistula and related morbidities

(i) To develop means of transportation and financing that enable women and girls to access obstetric care and treatment, and provide incentives and other means to secure the presence in rural areas of qualified health professionals who are able to perform interventions to prevent obstetric fistula

In the health sector, the United Nations Population Fund (UNFPA) supported the improvement of emergency obstetric care in district hospitals.

12. Invites Member States to contribute to efforts to end obstetric fistula, including, in particular, the United Nations Population Fund global Campaign to End Fistula, with the goal of eliminating obstetric fistula by 2015, in line with the targets of the millennium development goal of improving maternal health

Examples of synergies are found in the IMCI and ACSD initiatives, in some obstetric care programmes and as described in paras.

Lastly, a survey had been conducted in 2003 with a view to measuring the availability and use of emergency obstetric services.

Among the main causes of maternal mortality, the most prevalent are obstetric haemorrhaging, severe forms of gestosis, and other complications of pregnancy.

A national plan is now being started to strengthen safe maternity services, including skilled care during delivery and emergency obstetric care (EmOC).

In the case of maternity the mother is provided with obstetric assistance and benefits in cash and kind during a set period.

219. In 1991, 333 maternal deaths were recorded, one third of which were due to miscarriages and two thirds to obstetric causes.

(g) To bring obstetric fistula to the attention of policymakers and communities, thereby reducing the stigma and discrimination associated with it and helping women and girls suffering from obstetric fistula so that they can overcome abandonment and social exclusion together with the psychosocial implications thereof, inter alia, through support of social reintegration projects

Delegations commended UNFPA work in the area of South South cooperation, its success with the obstetric fistula campaign, and the youth advisory programme.

The single most common direct cause of death accounting for a quarter of all maternal deaths is obstetric haemorrhage, generally occurring post partum.

With respect to the Goal on maternal health, all women should have access to skilled care during childbirth, as well as to emergency obstetric care.

To enhance the accessibility of medical care to women, work is under way in the Republic to restore medical obstetric facilities and open new ones.

In 61 Centers for Mother and Child Protection and Family Planning, there are 321 obstetric doctors, 60 pediatric doctors, 228 pediatric assistant doctors and 367 midwives.

UNICEF will also support pilot and other initiatives for Goal 5, including emergency obstetric care and training of skilled birth attendants, where warranted by country circumstances.

At the present time, the obstetric practices in the Syrian Arab Republic recommend delivery in hospital or natural childbirth centres if the pregnancy is high risk.

On 26 December, the prison medical warden, allegedly without obstetric experience, conducted a preliminary medical examination and declared Ae Soon Koh apos s condition as normal.