Obstetrics

Each year, over half a million women die as a result of complications of pregnancy, childbirth and abortion. The vast majority of these deaths are preventable and occur in developing countries in contexts where women lack access to good quality, skilled and timely health care.

Obstetrics is the surgical specialty involved with the care of women during pregnancy, childbirth, and the puerperium (the period shortly after birth). Most [Page 1270]obstetricians are also gynecologists and look after women's other health issues such as fertility problems, reproductive organ cancers, and termination of unwanted pregnancy in some settings. Obstetrics differs from other branches of medicine in that it deals with patients who are generally in good health. After all, pregnancy is not a pathological condition, but rather a natural process that most women will go through at some point in their lives. The majority of pregnancies proceed without complications and result in the safe delivery of a healthy infant. However, every woman has the potential to develop a life-threatening complication during pregnancy or childbirth that may require skilled care and, occasionally, surgical intervention. The role of the health professional during pregnancy and labor is therefore to prevent, recognize, and manage complications that might otherwise result in catastrophic outcomes for the woman and her baby.

In many countries, both in the developed and developing world, the care of women during pregnancy and childbirth is shared among different health professionals and is not exclusively the domain of medically trained doctors. Midwives and specialist nurses are key providers of care to pregnant women in developed countries, while in many parts of the developing world, women deliver with the assistance of traditional birth attendants and family members.

Maternal health reflects the overall quality of healthcare systems within a community: the facilities available, women's ability to access these facilities, the status and role of women in society, and the background incidence of chronic disease and malnutrition. Maternal mortality is, however, difficult to measure and quantify, particularly where health infrastructures are weak and causes of deaths are poorly registered. Thus, global estimates of maternal mortality are often subject to wide margins of error and are broadly considered to underestimate the magnitude of the problem in developing countries.