Delay in safe motherhood

PhD ceremony: Mr. L.R.C.W. van Lonkhuijzen, 16.15 uur, Academiegebouw, Broerstraat 5, Groningen

Title: Delay in safe motherhood

Promotor(s): prof. P.P. van den Berg, prof. J. van Roosmalen, prof. A.J.J.A. Scherpbier

Faculty: Medical Sciences

More than 350.000 women worldwide die every year due to pregnancy and labour. The majority of these women live in developing countries. The most important causes include unsafe abortion, infections, hypertension, bleeding and obstructed labour. In this thesis several interventions to reduce delay in the treatment of these problems are evaluated. The ‘maternity waiting home’ is a place close to the hospital where women can stay awaiting labour. Potentially these homes can reduce delay in treatment when complications occur. In practice, however, various barriers that prevent women to use the waiting homes need to be addressed. In Malawi, the introduction of a protocol for the treatment of eclampsia, supported by a treatment and observation checklist, improved the quality of care. A literature review showed that in low resource countries the training of health care workers was appreciated and improved their knowledge, but it is unknown whether it leads to behavioural changes and improved outcomes. In The Netherlands, the use of a video in the labour room potentially can improve the quality of care. Research showed that health care providers and patients were positive about such developments.