The M of MCH
Everett, V.J.
Papua and new Guinea Medical Journal 30(2): 121-125
1987
ISSN/ISBN: 0031-1480 PMID: 3478915 Document Number: 289494
The ways in which better prenatal, intrapartum and postpartum care of mothers in Papua New Guinea could decrease perinatal mortality are discussed. Papua New Guinea has a fairly well developed system of rural health care, with teams visiting villages monthly. Emphasis on immunization and acute treatment of children, however, often consumes workers' time so that pregnant women are neglected. Tabulations of perinatal mortality in the Port Moresby General Hospital suggest that 14 to 49% of these deaths could have been prevented. 90% of babies born in the Central Province and National Capital District were delivered in this hospital. There were 132 stillbirths at the hospital in 1985, of which 10 were considered preventable. Prematurity is a common cause of neonatal mortality at the hospital, while infection, often associated with difficult labor, is more common in the rural highlands. There are 3 essential components of good antenatal care: selection of high-risk women for institutional delivery, prophylaxis for anemia, malaria and tetanus, and management of obstetric problems. Often good nutrition, rest from hard physical labor and cleanliness will make a significant impact. Cephalopelvic disproportion frequently complicates delivery, therefore sending all small primigravidae for institutional delivery would be ideal. The most important element of postpartum care is establishment of lactation. In Papua New Guinea, cultural mores regarding sexual abstinence after pregnancy are breaking down, necessitating the introduction of modern family planning.