Category Archives: Preterm Birth

7 Facts About Premature Births You Might Not Have Known

Photo: A premature baby is shown in the postnatal ward at Cama Hospital, a major hospital for women and children, in Mumbai, India. UN Photo/Mark Garten

Premature births are now the number one killer of babies globally. Of the 6.3 million children under five who died last year, 1.1 million of them died due to complications from premature births. Most of these deaths occured within the first month of life, according to new research published in The Lancet.

“This marks a turning of the tide, a transition from infections to neonatal conditions, especially those related to premature births, and this will require entirely different medical and public health approaches,” says Joy Lawn, M.D., Ph.D., of the London School of Hygiene & Tropical Medicine, a member of the research team and a long-term advisor to Save the Children. “The success we’ve seen in the ongoing fight against infectious diseases demonstrates that we can also be successful if we invest in prevention and care for preterm birth.”

Today is the the fourth World Prematurity Day, a global awareness campaign that focuses on the number of newborns that die every year and ways in which we can help those numbers decline. With heightened attention on premature births it is only a matter of time before global prematurity rates improve just as the overall child mortality statistics have improved steadily since 1990.

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Why Secondary Education for Girls Reduces Child Marriage, Early Pregnancies

UNESCO just released its report, Sustainable Development: Post 2015 Begins With Education, that takes a look at the critical importance of education on the post-2015 agenda. The core stance in the report portends that without greater access to education poverty eradication will become increasingly difficult to achieve by 2030. The betterment of women’s and girls’ lives across the globe, most specifically in sub-Saharan Africa and South and West Asia depends greatly on their equal access to quality education.

In the poorest countries, 2.9 million girls are married by 15. If girls in sub-Saharan Africa and South and West Asia simply have a secondary education child marriage would decrease by 69%. Secondary education also causes a delay in young girls having their first child. Young girls disproportionately die in childbirth. Education will, in turn, cause a reduction in not only maternal health, but also in newborn deaths. In fact, Brazil saw a a 70 percent reduction in its fertility rate because it became a country priority to improve schools and education.

Educated girls have children later and smaller families overall. They are less likely to die during pregnancy or birth, and their offspring are more likely to survive past the age of five and go on to thrive at school and in life. Women who attended school are better equipped to protect themselves and their children from malnutrition, deadly diseases, trafficking and sexual exploitation. – Erna Solberg, Prime Minister of Norway and Graça Machel, President, Foundation for Community Development & Founder, Graça Machel Trust.


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Photos from the Field: Expectant Mother Seeks Help in “Lie and Wait” House #Ethiopia

Women in Lie and Wait Home

Expectant woman, Ayelech Fikadu, and her mother, Zarge Badunga sit in a “lie and wait” house at Project Mercy outside of Butajira, Ethiopia. The house was recently renovated by USAID and Pathfinder.

Butajira is located in Ethiopia’s southern highlands where many live in the mountains. Women who live in the mountains have a difficult time delivering their babies at a hospital or health center due to a lack of facilities as well as the distance from them.

Ayelech came to this “lie and wait” house because she experienced birth complications. She will deliver her baby at the nearby hospital at Project Mercy that is literally up the street from the “lie and wait” house. Without these services women who experience pregnancy complications have a greater chance of dying during childbirth and their newborns have a decreased chance of survival.

Lie and Wait House



Photos: Jennifer James

How Ethiopia is Scaling Midwifery to Save More Mothers, Newborns

Addis Ababa- In Ethiopia there are 4.9 million pregnancies each year of which 84% take place in rural areas. Here in Ethiopia, where the vast majority of women deliver at home, only 32% of maternal, newborn and child health needs are being met by midwives according to the newly released State of Midwifery Report. That is troubling for a country that is making noticeable strides to save its women and children, including reaching Millennium Development Goal 4 last year. There is still scalable work to be done to save more Ethiopian mothers and their newborns.

What is important to note is those aforementioned numbers don’t tell the full story. Ethiopia’s Federal Ministry of Health has committed itself to providing more quality care and support for institutional births as well as prenatal and postnatal care by scaling the number of midwives in Ethiopia. Today there are nearly 7000 midwives in Ethiopia (2520 graduated in 2012), up from 1139 midwives in 2011; notable progress to be sure. Despite scaling up the number of midwives here, the increased rate of institutional deliveries is slow-going. Cultural customs prevent many women from delivering at a health center or hospital. These women opt to deliver at home and whether or not she is attended by a trained birth attendant is a toss-up, especially in the deepest rural parts of the country.

Hawassa Health Science College
Skills Lab Class at Hawassa Health Sciences College. Jhpiego is working with Ethiopia’s Federal Ministry of Health and the college to provide tools, materials, equipment, and quality education for midwives in training.

Increasingly, however, pregnant Ethiopian women (especially those in urban centers) are opting to deliver with trained health workers. In fact, health extension workers can deliver babies at mothers’ homes and in health posts. The Ethiopian Federal Ministry of Health has proven its commitment to saving the lives of more mothers and children by hiring and training 34,000 health extension workers in Ethiopia and paying their salaries each month. This committed cadre of women is the backbone of health care on the community level in Ethiopia. Midwives provide quality institutional deliveries in both health centers and hospitals.

Journalists in Ethiopia

As I  mentioned in my previous post, I am here in Ethiopia co-leading a group of journalists who are reporting on newborn health and its surrounding issues with the International Reporting Project. This week the journalists visited the Hawassa Health Sciences College in the Southern Nations, Nationalities, and People’s (SNNP) region where midwives are being trained to go out into mostly rural communities to assist with maternal, newborn and child health with a special focus on safe, clean deliveries. Jhpiego, an international health NGO, is working in tandem with the Federal Ministry of Health and the Hawassa Health Sciences College to provide materials, equipment, and quality training for the college’s midwifery students. Just announced this week,  Jhpiego was awarded the largest government funded project to save mothers and children throughout the world, of which Ethiopia is one of 24 priority countries.

Journalists Nicole Melancon, Heather Horn and Corine Milano interview midwives in training at the Hawassa Health Sciences College

Jhpiego is not only working in Hawassa, but throughout Ethiopia by replicating and scaling its programs to train more health workers with quality education as well as providing the tools and assistance that midwives in training need in order to save the lives of those who are most vulnerable.

Journalist, Elizabeth Atalay interviews a midwife in training
Journalist, Elizabeth Atalay, interviews a midwife in training

Project Mercy

In the highlands of the southern part of the country, a faith-based Ethiopian NGO, Project Mercy, is also working to train midwives with the help of Jhpiego. Armed with a $2 million grant from USAID’s Human Resources for Health program, Project Mercy is slated to train 480 midwives and 120 anesthesia nurses starting with its first class  in September 2014. Once graduated, the newly trained midwives will receive automatic job placement in southern Ethiopia by the regional SNNP government. The aim is to scale up the midwives in the region to actively prevent maternal and newborn deaths.

Currently, Project Mercy hospital staff are already being trained in midwifery skills by volunteer doctors from the United States.

Project Mercy

Awaiting the new students is a brand-new facility located near Butajira, Ethiopia. Project Mercy is currently recruiting nurses who want to learn new medical and practical skills as midwives to keep women and their newborns safe during pregnancy and delivery.

Project Mercy

While the number of midwives is still quite low in comparison to the population and the rate of births in Ethiopia, the government has recognized that educating more midwives is critical to saving the lives of mothers and newborns. Ethiopia has already proved that it understands how to scale health workers. Just look at the Health Extension Worker program. Now, it’s time to scale up midwives and that is what Ethiopia is doing.

Save the Children Releases New Report on Motherhood in Conflict

This article was originally published on the Bill and Melinda Gates Foundation’s Impatient Optimists.

Every year Save the Children releases its annual State of the World’s Mothers report and each year a magnifying glass is held up to motherhood around the world and how mothers fare based solely on where they live. Now in its fifteenth year, Save the Children’s State of the World’s Mothers report puts into clear perspective the countries where motherhood is best and worst. This year Save the Children focuses its attention on motherhood in crisis.

Devastating crises have popped up across the globe, some of them ongoing and others that are fairly new, relatively speaking. No conflict, of course, is beneficial for the health and welfare of mothers and their children. In fact, women and children are precisely the ones who tend to suffer most during times of civil unrest, natural disasters, and all-out wars. Internal conflicts break families apart, cause families to flee to neighboring countries to then become refugees, or they become trapped inside of their home country and internally displaced. Basic services such as food assistance and health care then become scarce causing undue damage to the lives of children and the mothers who take care of them. The same is true for natural disasters that can irreparably ruin families’ lives and livelihoods.

This year over 60 million women and children are in need of humanitarian assistance according to the report and Save the Children has responded to nearly 120 humanitarian crises in 48 countries. Mothers and children, therefore, who are trapped in fragile countries are more susceptible to death and disease. We already know that 800 women die in childbirth and 18,000 children under the age of five die as a direct result of preventable disease every day. Did you know that half of these deaths for both women and children occur in countries that are fragile meaning there is a lack of good governance and political stability that leaves a country’s citizens open and vulnerable to a range of disasters whether man-made or natural.

During any crisis situation expectant mothers are in particular perilous situations. Obstetric services are often halted save for rudimentary services that many not be equipped to save a mother’s life in critical situations, that is if a pregnant woman is lucky. She may have to give birth alone in the bush or in the back of truck fleeing across the border to save her life and the life of her newborn.

The lives of newborns, of course, are also at increased risk when a mother gives birth in high-intensity, crises situations where mothers worry not only about giving birth to a healthy baby, but also simply staying alive.

As aforementioned, when countries experience crisis situations ordinary citizens suffer most. Health systems suffer. Frontline health workers – even the most dedicated of them – may have to flee along with citizens to save their own lives. And furthermore, hospitals and health centers can become targets of destruction in civil unrest in order to hurt those who need the services most.

Consider the conflict in the Central African Republic (CAR) where sectarian violence has left nearly 3000 dead and hundreds of thousands of people homeless and without access to the most basic needs such as food, clean water, and sanitation. And now that the rainy season is nearing the hardships in people’s lives will be greatly intensified. It is no wonder that the CAR ranks 173rd in the report rankings.

“Nothing will stop a mother from trying to keep her children safe and protected,” said Carolyn Miles, president and CEO of Save the Children, “But when disaster strikes, whether it’s a war in Syria, a tornado in Oklahoma or a typhoon in the Philippines, women and children are often at the greatest risk – up to 14 times more likely to die than men.  Fortunately, our evidence also shows we can save and dramatically improve the lives of mothers and children, even in the most challenging places to live, if we invest in the services they need.”

In Syria where the civil war has been raging on for four years 1.4 million children and nearly 700,000 women have fled the country, according to the report. There are now over 200,000 women and girls of reproductive age inside and outside of Syria according to the UNFPA meaning there will be an increased necessity for obstetric and newborn health care and family planning services. And, in the case of civil unrest, rape and torture of women and girls are often used as weapons of war exacerbating gender-based violence.

Even in the United States when a natural disaster such as Hurricane Sandy devastated the east coast, mothers and children with the least resources fared the worst amid the devastation and months of rebuilding. No matter the country or crises, women and children remain the most vulnerable communities to death, disease, abuse, and violence.

Through its report Save the Children is putting forth a reminder that in fragile countries the health of women and children remains a top priority and systems must be in placed to ensure they are not let down when they need help the most.

Read the full report at

Photo by Allessio Romenzi for Save the Children.