Lack of interest in women’s health 6 weeks postpartum

Significant progress has been made in reducing maternal mortality over the past 30 years. However, levels remain unacceptably high in some areas. According to the World Health Organization, more than 800 women worldwide die every day from complications related to pregnancy and childbirth.

Article published in early December lancet Despite mixed outcomes in maternal health, the historical focus has been on reducing maternal mortality, while the relative impact of complications that occur or persist months or years after childbirth It emphasizes that this has been ignored.

This study is a comprehensive review of epidemiological data collected from 2000 to 2022 on the physical and psychological complications that occur in the medium to long term after childbirth. conclude that symptoms can appear in women months and even years after childbirth. childbirth. These conditions are ignored in global health agendas and national action plans, leading to the misconception that they are rare or unimportant. Historical limitations on postnatal care services up to six weeks after birth also contribute to the alarmingly high prevalence of problems faced by some mothers.

common health problems

The most common health problems at six weeks of age include dyspareunia (dyspareunia), anal incontinence, urinary incontinence, or both. postpartum depression, uterophobia (extreme fear of childbirth), and chronic postpartum pain such as pain in the lower back or perineum. According to this review, among the most common diseases of female morbidity related to childbirth and childbirth in the medium to long term, more than one-third of women record dyspareunia in 35% of cases. , lower than that. back pain (32%), urinary incontinence (8%-31%), anxiety (9%-24%), anal incontinence (19%), depression (11%-17%), local phobia (6%-15 %), perineal pain (11%), and secondary infertility (11%).

The authors noted that less common conditions resulting from childbirth and childbirth also have a serious impact on women’s health and well-being. These conditions include pelvic organ prolapse, post-traumatic stress disorder, thyroid dysfunction, mastitis, HIV seroconversion, psychotic episodes, i.v. thromboembolismand peripartum cardiomyopathy.

The study compiled information from sources such as the United Nations and national and international maternal and child registries such as Medline Plus, and used information to help minimize harm to mothers and babies during labor and birth. Although many interventions are available, they warn that their misuse or overuse can lead to dangerous conditions. Iatrogenic complications. For example, episiotomy: A common routine where an incision is made in the perineum to widen the entrance to the vagina during the last part of the labor phase, or during childbirth itself. Various studies have long reported that the restrictive use of episiotomy reduces posterior perineal trauma and reduces future complications. Although forceps delivery is a means of protecting the fetus, the damage to maternal tissue is significant, and the careless use of uterotonics to promote weak contractions during labor can lead to potentially fatal complications such as uterine rupture. It is a well-known risk factor for complications that can lead to devastating outcomes.Secondary infertility due to uterine wall repair, tubal ligation, partial or total hysterectomy, pelvic surgery, etc. sepsis. According to the data collected in lancetincluding justified pharmacological interventions such as the use of oxytocin or misoprostol to induce labor, and even surgical interventions such as episiotomy or incision. Caesarean section, can still impede a woman’s recovery. These complications can cause negative physical, social, or psychological effects and can persist or appear long after birth.

As the authors of this study cautioned, most data on the prevalence of these postpartum conditions come from high-income countries with well-resourced health systems. With the exception of the mental health sector, there is little population-level data for low- and middle-income countries. Therefore, the authors suggested that the situation for new mothers in these regions may have harsher consequences. According to a study reviewed in lancet, women in low- and middle-income countries have a higher prevalence of postpartum depression than women in high-income countries. The rate reaches 17% in the former and 11% in the latter.

Based on approximately 100 clinical guidelines consulted for the prevention, recognition, and treatment of medium- to long-term diseases caused by labor and childbirth, the authors conclude that there are high-quality guidelines for some of these diseases. However, they concluded that most of them were not appropriate. It was developed and adapted for the context of high-income countries. These measures consistently emphasize the importance of quality care during childbirth, systematic clinical assessment, postnatal screening to identify those at risk, and prompt treatment.

Comprehensive healthcare services

To comprehensively address these symptoms, researchers emphasize the need for broader and more comprehensive health services beyond 6 weeks postpartum, including multidisciplinary care models. Furthermore, awareness is needed to prevent and manage the medium and long-term impacts of labor and childbirth, which affect millions of women around the world and are not included in the global agenda or population health. We call for improvement, better measurement, collective action, and funding. Action plans for many countries. Finally, the authors advocated for increased investment in epidemiological, intervention, and implementation research. As they conclude, timely, women-centered, evidence-based care is the most effective preventive and remedial strategy for all the complications mentioned.

This article has been translated from spanish universitypart of the Medscape Professional Network.