In addition to death occurring in pregnancy and childbirth, pregnancy can result in many non-fatal health problems including obstetrical fistulae, ectopic pregnancy, preterm labor, gestational diabetes, hyperemesis gravidarum, hypertensive states including preeclampsia, and anemia. Globally, complications of pregnancy vastly outway maternal deaths, with an estimated 9.5 million cases of pregnancy-related illness and 1.4 million near-misses (survival from severe life-threatening complications). Complications of pregnancy may be physical, mental, economic and social. It is estimated that 10–20 million women will develop physical or mental disability every year, resulting from complications of pregnancy or inadequate care. Consequently, international agencies have developed standards for obstetric care.
The ’90s turned toward a lot more talk about “fat-blasting” in the Snackwell’s/heroin chic era. But as the new millennium dawned, front cover messages started to sway from scolding to encouraging. Which makes sense: Why would someone want a magazine to yell at them? That’s why the current crop of women’s health magazine headlines stress taking time for yourself over how flat your abs might get. As Elizabeth Goodman, editor-in-chief of Shape magazine, explained via email: “As a women’s magazine, it’s our job to help women be their best selves—both inside and out. However, we don’t want to set the standard for normal or tell women what normal is; we want to encourage women to find and be proud of their normal… Our approach with our readers is not to judge or demand, just to inspire and support.”
Integrated health care, which integrates curative and preventive interventions, can improve nutrition outcomes for women across the life course through improved access to counseling, vaccinations, and screening and treatment of illnesses (103–107). Access to primary health care positively contributed to the prevention, diagnosis, and management of both communicable and noncommunicable disease (108). Distribution of insecticide-treated bed nets, condoms, screening and testing for disease, and delivery of medical treatments were often associated with integrated health initiatives and improved health and nutrition outcomes (13, 109). Access to health care was associated with the delivery of nutrition-specific interventions to manage pregnancy-induced hypertension, diabetes, pre-eclampsia, and hemorrhage (106, 107, 110). However, some studies showed that integrated services increased knowledge, but did not result in changes in health or nutrition outcomes (103). In addition, in many settings, quality of care was inadequate (107) and incorrect diagnoses and treatments were common (111).
Potdar RD, Sahariah SA, Gandhi M, Kehoe SH, Brown N, Sane H, Dayama M, Jha S, Lawande A, Coakley PJ et al. Improving women's diet quality preconceptionally and during gestation: effects on birth weight and prevalence of low birth weight—a randomized controlled efficacy trial in India (Mumbai Maternal Nutrition Project). Am J Clin Nutr 2014;100(5):1257–68.
Of near miss events, obstetrical fistulae (OF), including vesicovaginal and rectovaginal fistulae, remain one of the most serious and tragic. Although corrective surgery is possible it is often not available and OF is considered completely preventable. If repaired, subsequent pregnancies will require cesarian section. While unusual in developed countries, it is estimated that up to 100,000 cases occur every year in the world, and that about 2 million women are currently living with this condition, with the highest incidence occurring in Africa and parts of Asia. OF results from prolonged obstructed labor without intervention, when continued pressure from the fetus in the birth canal restricts blood supply to the surrounding tissues, with eventual fetal death, necrosis and expulsion. The damaged pelvic organs then develop a connection (fistula) allowing urine or feces, or both, to be discharged through the vagina with associated urinary and fecal incontinence, vaginal stenosis, nerve damage and infertility. Severe social and mental consequences are also likely to follow, with shunning of the women. Aprt from lack of access to care, causes include young age, and malnourishment. The UNFPA has made prevention of OF a priority and is the lead agency in the Campaign to End Fistula, which issues annual reports and the United Nations observes May 23 as the International Day to End Obstetric Fistula every year. Prevention includes discouraging teenage pregnancy and child marriage, adeaquate nutrition, and access to skilled care, including caesarian section.
Omega-3s: These essential fatty acids, EPA and DHA, play many roles in the body, including building healthy brain and nerve cells. Some studies show that omega-3s, especially DHA, can help prevent preterm births. Even women who don't plan to have children should be sure to get plenty of omega-3s. These healthy oils have been shown to reduce the risk of heart disease, the number one killer of women.