Safe motherhood is a comprehensive approach encompassing initiatives, practices, protocols, and service delivery guidelines designed to ensure that women receive high-quality gynecological, family planning, prenatal, delivery, and postpartum care. The goal is to achieve optimal health for the mother, fetus, and infant during pregnancy, childbirth, and the postpartum period.

Fundamentally, safe motherhood means preventing harm or death to women and children due to pregnancy or childbirth. It begins with ensuring the basic safety and well-being of girls and women in society.

Key Principles of Safe Motherhood:

• Choice and Family Planning: Freedom to choose when and whether to have children, with access to family planning for all couples.

• Active Participation: Encouragement of women’s active participation in their healthcare.

• Freedom from Discrimination: Elimination of all forms of discrimination in healthcare access and provision.

• Value of the Girl Child: Recognition and promotion of the value and well-being of girls.

• Accessible and Quality Care: Availability, acceptability, and easy access to healthcare for prenatal, childbirth, postpartum, family planning, and gynecological needs.

• Community and National Commitment: Involvement and commitment from communities and the nation to allocate resources fairly, promoting the health of all women and infants.

• Social Equity and PHC Integration: Social equity for women, integration of maternal healthcare within primary healthcare (PHC), and access to emergency obstetric and newborn care for managing complications.

In essence, safe motherhood is the concept that no woman, fetus, or baby should die or be harmed by pregnancy or childbirth.

This is achieved by providing timely, appropriate, and comprehensive quality obstetric care during:

• Preconception

• Pregnancy

• Childbirth

• Puerperium (Postpartum Period)

The Road Map to Safe Motherhood

The “Road Map” refers to the holistic approach to maintaining a woman’s health throughout her childbearing years, including pregnancy, labor, and the puerperium. The aim is to ensure the mother’s physical and mental well-being and prevent complications that could endanger her life.

Key Elements of the Road Map:

• Monitoring Maternal Health: Close monitoring during pregnancy to maintain good physical condition and ensure a healthy, well-nourished baby.

• Nutritious Diet for Girls: Ensuring girls receive good nutrition during childhood to promote healthy growth, adequate pelvic development, and reduce complications during future deliveries.

• Immunization: Full immunization of children against preventable diseases to support normal development and growth.

• Early Hospitalization: Prompt hospitalization of children when needed to avoid serious complications.

• Adolescent Sexual Health Education: Educating adolescent girls about safe sexuality before they become sexually active to prevent early, unplanned pregnancies and sexually transmitted infections.

• Maternal and Child Health Education: Providing information and education to young women about maternal and child health, as well as family planning, to empower them to make informed choices and avoid frequent pregnancies that can strain their health.

• Community and Family Support: Ensuring that women are valued and protected, both emotionally and physically. This includes preventing excessive workloads, especially during pregnancy, to avoid complications.

• Antenatal Care: Encouraging pregnant women to attend antenatal clinics early and regularly for monitoring, early detection and treatment of disorders, and referral for advanced management when needed.

• Training of TBAs: Educating traditional birth attendants (TBAs) and healers about safe motherhood practices, management of mothers during pregnancy, labor, and the puerperium, and timely identification and referral of high-risk cases.

• Community-Based Referral Systems: Establishing community-based referral systems for emergencies.

• Safe Delivery Management: Ensuring adequate management of delivery to prevent complications for both mother and baby.

• Postpartum Care: Providing proper postpartum care to detect and manage complications early.

History of Global Safe Motherhood Programs

The global safe motherhood movement began in 1987 with the launch of the global strategy for safe motherhood at the International Conference on Safe Motherhood in Nairobi, Kenya. This conference was co-sponsored by the WHO, the World Bank, the United Nations Population Fund (UNFPA), and the United Nations Development Programme (UNDP).

In 1994, the International Conference on Population and Development (ICPD) in Cairo, Egypt, further emphasized the importance of meeting the reproductive health needs of women and men as a critical requirement for human and social development. The conference affirmed that reproductive healthcare is an integral component of primary healthcare and should be provided within that context. The components of reproductive health significantly impact the course and outcome of pregnancy, and addressing them requires closely related health services.

This conference led to a consensus to adopt a strategy addressing all aspects of reproductive health and provided an opportunity to develop an integrated approach to safe delivery, leading to the WHO Mother-Baby Package.

After about five years, WHO and its partners recognized the need to further improve maternal health and reduce maternal mortality, leading to the “Making Pregnancy Safer” strategy.