Wednesday, October 9, 2013

Emergency contraceptive methods are medications

Emergency contraceptive methods are medications (sometimes misleadingly referred to as "morning-after pills")[93] or devices used after unprotected sexual intercourse with the hope of preventing pregnancy.[94] They work primarily by preventing ovulation or fertilization.[6] A number of options exist, including high dose birth control pills, levonorgestrel, mifepristone, ulipristal and IUDs.[95] Sony VPCW1 Battery

Levonorgestrel pills, when used within 3 days, decrease the chance of pregnancy after a single episode of unprotected sex or condom failure by 70% (resulting in a pregnancy rate of 2.2%).[94] Ulipristal, when used within 5 days, decreases the chance of pregnancy by about 85% (pregnancy rate 1.4%) and might be a little more effective than levonorgestrel.[ Sony VPCW1E8R/BU Battery

Mifepristone is also more effective than levonorgestrel while copper IUDs are the most effective method.[95] IUDs can be inserted up to five days after intercourse and prevent about 99% of pregnancies after an episode of unprotected sex (pregnancy rate of 0.1 to 0.2%).[6][97] This makes them the most effective form of emergency contraceptive.[98]

Providing emergency contraceptive pills to women in advance does not affect rates of sexually transmitted infections, condom use, pregnancy rates, or sexual risk-taking behavior.[ Sony VPCY11AGJ Battery

All methods have minimal side effects.

Dual protection is the use of methods that prevent both sexually transmitted infections and pregnancy.[101] This can be with condoms either alone or along with another birth control method or by the avoidance of penetrative sex.[102][103] If pregnancy is a high concern using two methods at the same time is reasonable,[102] Sony VPCY11AHJ Battery

and two forms of birth control is recommended in those taking the anti-acne drug isotretinoin, due to the high risk of birth defects if taken during pregnancy.

Contraceptive use in developing countries is estimated to have decreased the number of maternal deaths by 40% (about 270,000 deaths prevented in 2008) and could prevent 70% of deaths if the full demand for birth control were met.[15][16] Sony VPCY11AVJ Battery

These benefits are achieved by reducing the number of unplanned pregnancies that subsequently result in unsafe abortions and by preventing pregnancies in those at high risk.[15]

Birth control also improves child survival in the developing world by lengthening the time between pregnancies.[15] In this population, outcomes are worse when a mother gets pregnant within eighteen months of a previous delivery.[15][106] Sony VPCY11M1E Battery

 Delaying another pregnancy after a miscarriage however does not appear to alter risk and women are advised to attempt pregnancy in this situation whenever they are ready.[106]

Teenage pregnancies, especially among younger teens, are at greater risk of adverse outcomes including early birth, low birth weight, and death of the infant.[10] Sony VPCY11S1E Battery

In the United States 82% of pregnancies in those between 15 and 19 are unplanned.[58] Comprehensive sex education and access to birth control are effective in decreasing pregnancy rates in this age group.

Maternal health refers to the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.[1] Sony VPCY11V9E Battery

Preconception care can include education, health promotion, screening and other interventions among women of reproductive age to reduce risk factors that might affect future pregnancies. The goal of prenatal care is to detect any potential complications of pregnancy early, to prevent them if possible, and to direct the woman to appropriate specialist medical services as appropriate. Sony VPCY11V9E/S Battery

Postnatal care issues include recovery from childbirth, concerns about newborn care, nutrition,breastfeeding, and family planning.

In many developing countries, complications of pregnancy and childbirth are the leading causes of death among women of reproductive age. A woman dies from complications from childbirth approximately every minute.[2] Sony VPCY219FJ/S Battery

According to the World Health Organization, in its World Health Report 2005, poor maternal conditions account for the fourth leading cause of death for women worldwide, after HIV/AIDS, malaria, and tuberculosis.[3] Most maternal deaths and injuries are caused by biological processes, not from disease, which can be prevented and have been largely eradicated in the developed world — such aspostpartum hemorrhaging, Sony VPCY21AFJ Battery

which causes 34% of maternal deaths in the developing world but only 13% of maternal deaths in developed countries.[4]

Although high-quality, accessible health care has made maternal death a rare event in developed countries, where only 1% of maternal deaths occur, Sony VPCY21AGJ Battery

these complications can often be fatal in the developing world because single most important intervention for safe motherhood is to make sure that a trained provider with midwifery skills is present at every birth, that transport is available to referral services, and that quality emergency obstetric care is available.[2] In 2008 342,900 women died while pregnant or from childbirth worldwide.[5] Sony VPCY21AHJ Battery

Although a high number, this was a significant drop from 1980, when 526,300 women died from the same causes. This improvement was caused by lower pregnancy rates in some countries; higher income, which improves nutrition and access to health care; more education for women; and the increasing availability of “skilled birth attendants” — people with training in basic and emergency obstetric care — to help women give birth. Sony VPCY21AVJ Battery

The situation was especially led by improvements in large countries like India and China, which helped to drive down the overall death rates. In India, the government started paying for prenatal and delivery care to ensure access, and saw successes in reducing maternal mortality, so much so that India is cited as the major reason for the decreasing global rates of maternal mortality.[6] Sony VPCY21S1E/L Battery

One specific disease that causes significant maternal health problems is HIV/AIDS. Mother to child transmission of HIV in the developing world is a large concern; approximately 45% of infected mothers transmit the disease to their children[2] and HIV is a major cause of maternal mortality, causing 60,000 maternal deaths in 2008. HIV rates are especially high in Sub-Saharan and Eastern Africa, where maternal mortality rates are on the rise.[6] Sony VPCY21S1E/P Battery

Maternal health problems also include complications from childbirth that do not result in death. For every woman that dies during childbirth, approximately 20 suffer from infection, injury, or disability[7]

Almost 50% of the births in developing countries still take place without a medically skilled attendant to aid the mother, and the ratio is even higher in South Asia.[2] Sony VPCY21S1E/SI Battery

Women in Sub-Saharan Africa mainly rely on traditional birth attendants (TBAs), who have little or no formal health care training. In recognition of their role, some countries and non-governmental organizations are making efforts to train TBAs in maternal health topics, in order to improve the chances for better health outcomes among mothers and babies. Sony VPCCW1E8R/WU Battery

The World Bank estimated that a total of 3.00 US dollars per person a year can provide basic family planning, maternal and neonatal health care to women in developing countries.[9] Many non-profit organizations have programs educating the public and gaining access to emergency obstetric care for mothers in developing countries. Sony VPCCW1S1E Battery

The United Nations Population Fund (UNPFA) recently began its Campaign on Accelerated Reduction of Maternal Mortality in Africa (CARMMA), focusing on providing quality healthcare to mothers. One of the programs within CARMMA is Sierra Leone providing free healthcare to mothers and children. This initiative has widespread support from African leaders and was started in conjunction with the African Union Health Ministers.[10]Sony VAIO PCG-5S1M Battery

Improving maternal health is the 5th of the 8 United Nations' Millennium Development Goals, targeting a reduction in the number of women dying during pregnancy and childbirth by three quarters by 2015, notably by increasing the usage of skilled birth attendants, contraception and family planning.[11] The current decline of maternal deaths is only half of what is necessary to achieve this goal, Sony VAIO PCG-9Z1M Battery

and in several regions such as Sub-Saharan Africa the maternal mortality rate is actually increasing. Decreasing the rates of maternal mortality and morbidity in developing countries is important because poor maternal health is both an indicator and a cause of extreme poverty. According to Tamar Manuelyan Atinc, Vice President for Human Development at the World Bank:[12] Sony VAIO PCG-7171M Battery

"Maternal deaths are both caused by poverty and are a cause of it. The costs of childbirth can quickly exhaust a family’s income, bringing with it even more financial hardship."

Developed countries had rates of maternal mortality similar to those of developing countries until the early 20th century, therefore several lessons can be learned from the west. Sony VAIO PCG-7186M Battery

During the 19th century Sweden had high levels of maternal mortality, and there was a strong support within the country to reduce mortality rate to fewer than 300 per 100,000 live births. The Swedish government began public health initiatives to train enough midwives to attend all births. This approach was also later used by Norway, Denmark, and the Netherlands who also experienced similar successes.[13] Sony VAIO PCG-81112M Battery

Increasing contraceptive usage and family planning also improves maternal health through reduction in numbers of higher risk pregnancies. In Nepal a strong emphasis was placed on providing family planning to rural regions and it was shown to be effective.[14] Madagascar saw a dramatic increase in contraceptive use after instituting a nationwide family planning program, the rate of contraceptive use increased from 5.1% in 1992 to 29% in 2008. Sony VAIO PCG-31111M Battery

The U.S. Joint Commission on Accreditation of Healthcare Organizations calls maternal mortality a "sentinel event", and uses it to assess the quality of a health care system.

Maternal mortality data is said to be an important indicator of overall health system quality because pregnant women survive in sanitary, safe, well-staffed and stocked facilities. Sony VAIO PCG-31311M Battery

If new mothers are thriving, it indicates that the health care system is doing its job. If not, problems likely exist.[17]

According to Garret, increasing maternal survival, along with life expectancy, is an important goal for the world health community, as they show that other health issues are also improving. If these areas improve, disease-specific improvements are also better able to positively impact populations.[18] Sony VAIO PCG-8152M Battery

Worldwide, the Maternal Mortality Ratio (MMR) has decreased, with South-East Asia seeing the most dramatic decrease of 59% and Africa seeing a decline of 27%. There are no regions that are on track to meet the Millennium Development Goal of decreasing maternal mortality by 75% by the year 2015.

Maternal oral health has been shown to effect the well-being of both the mother and her unborn fetus. Sony VAIO PCG-61111M Battery

Oral health has long been considered an arena of its own, distinct from general health, but there has been a recent push to bring together these two fields. The 2000 Surgeon’s General Report stresses the interdependence of oral health on the overall health and well being of an individual.[20] Oral health is essential to overall health, especially during perinatal period and the future development of their children.[21] Sony PCG-71213M Battery

Proper management of oral health has benefits to both mother and child. Furthermore, lack of understanding or maintenance of good oral health for pregnant women may have adverse effects on them and their children. Hence, it is imperative to educate mothers regarding the significance of oral health. Moreover, collaboration and support among physicians across various fields, Sony PCG-71311M Battery

especially among family practitioners and obstetricians, is essential in addressing the concerns for maternal oral health.[22] In 2007, the Maternal Oral Health Project was developed to provide routine oral care to low-income pregnant women in Nassau County, NY. Since its inception, the program has treated more than 2,000 pregnant women, many of whom had significant gum and/or tooth problems. Sony PCG-71312M Battery

Oral health has numerous implications on overall general health and the quality of life of an individual. The Surgeon General’s Report lists that various systemic diseases and conditions have oral manifestations.[20] The oral cavity serves as both a site of and a gateway entry of disease for microbial infections, which can affect general health status. Sony PCG-71212M Battery

In addition, some studies have demonstrated a relationship between periodontal diseases and diabetes, cardiovascular disease, stroke, and adverse pregnancy outcomes. Furthermore, the report establishes a relationship between oral health and quality of life, including functional, psychosocial, and economic indicators. Diet, nutrition, sleep, psychological status, social interaction, school, and work all can be affected by poor oral health. Sony VAIO PCG-5J4M Battery

No comments:

Post a Comment