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Nine months of immense value

· Maternal mortality still too high in the world ·

Even today in the world, 300,000 women die in a year (almost one per minute)from causes related to pregnancy and childbirth, and one million babies (two per minute) die in the first day of life. In addition, approximately30% of women give birth without assistance from qualified personnel.

The risk of dying from pregnancy-related causes varies according to region: in countries in the developing world, in 2013, the maternal mortality rate was 14 times higher than that of developed countries (230 opposed to16 per 100,000 live births). Even within developed countries there are discrepancies: in Europe, for example, maternal mortality in some countries was ten times higher than others. With the spread of a "culture of prevention" most of these deaths could be avoided.

For this reason the European Board and College of Obstetrics and Gynecology (EBCOG), which represents gynecologists and obstetricians in thirty European countries, recently presented to the European Parliament the standards of care for the health of women in Europe who - thanks to specific indicators - can be used as important tools for quality control of treatment centers. It also mobilized to raise awareness among all those who could help improve this situation, together with other major international scientific organizations of obstetrics and gynecology in the world, such as the International Federation of Gynecology and Obstetrics (FIGO), the American Congress of Obstetrics and Gynecology (ACOG), the Royal College of Obstetrics and Gynecology (RCOG) and the International Federation of Pediatric and Adolescent Gynecology (FIGIJ).

It is estimated that, by adequately informing prospective parents and providing access for all women to healthcare services that help to prepare for pregnancy and to deal with it safely, 70% of maternal deaths and 44 % of neonatal deaths could be prevented.

All women should be informed about preventive measures to safeguard the fertility and the successful outcome of pregnancy. When we talk about prevention, what we mean is adopting a healthy lifestyle - balanced nutrition, physical activity and appropriate moments of rest - to maintain optimal body weight and promote mental well-being, avoid smoking, drugs, excessive alcohol consumption, providing in a timely manner vaccinations against diseases that, if contracted during pregnancy could be harmful to the fetus (such as rubella and chickenpox). It also means protecting oneself against sexually transmitted diseases and, above all, remembering that the age group between twenty and thirty years is one in which pregnancy poses the least risk to both mother and fetus. In fact, in adolescents, pregnancy is the leading cause of death and the risk to infants is markedly greater. On the other hand, as one ages, fertility gradually decreases and the risk of serious complications during pregnancy increases. It is also appropriate to space pregnancies at least two years apart, to reduce the risk of neonatal mortality. Just as it is important that the pregnancy be checked periodically by qualified professionals, to prevent and treat the occurrence of any possibly disturbances.

Pregnancy involves a number of important modifications of the mother’s body, which requires specialized check-ups by qualified professionals and regular examinations aimed at assessing the state of health of the mother and fetus. In particular, if the woman is suffering from pre-existing conditions to pregnancy, she may need to replace or discontinue medical treatments that could have adverse effects on the fetus and/or considerbecoming pregnant in times of remission or optimal control of the illness, in order to reduce maternal and fetal risks. It is also advised to take folic acid, iron and any other micronutrients (vitamins and minerals) even before conception. In particular, the use pre-conception folic acid reduces by 50 percent the fetal neural tube defects (such as spina bifida).

But too many women in the world not only do not manage to comply with these conditions, but even cannot avoid heavy work and unsustainable hardship, violence and stress. It is obvious that,under these conditions, one finds mothers in countries where mortality is highest: it is up to the international organizations to take action to improve these situations, since it is only in this way that the health of women and babies as well can be truly protected. Motherhood should not become for many women a time of danger lived in fear; rather, it ought to be considered a value for all human beings, the object of care and protection, itought to be recognized as one of the central moments of human life in the world.

by Chiara Benedetto , President, European Board and College of Obstetrics and Gynecology

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