Safe Passage to Motherhood, saving mothers and babies in the developing world

Highlights

Safe Passage to Motherhood is committed to increasing the numbers of mothers and children who survive pregnancy and go on to lead lives that contribute to the wellbeing of their communities.

We believe that the health of a society is reflected in the well being of its mothers and children. Working for the survival of mothers is a human rights imperative.

The Safe Motherhood Initiative is a worldwide effort, launched in 1987, that aims to reduce the number of deaths and illnesses associated with pregnancy and childbirth.

Despite international Safe Motherhood activities, maternal mortality and morbidity rates in developing countries, particularly Sub-Saharan Africa and Asia continue to be alarmingly high.

The lifetime risk of maternal death is as follows:

World	1 in 74
Sweden	1 in 30,000
Top 10 Countries	1 in 16,400
USA	1 in 2,500
Latin America & Caribbean	1 in 160
Asia	1 in 94
South-Central Asia	1 in 46
Sub-Saharan Africa	1 in 22
Afghanistan & Niger	1 in 7

United Nations Millennium Development Goals, 2000

The Home Based Life Saving Skills program (HBLSS) is carried out together with host country representatives over a period of 18 months. Field testing has shown that communities which have participated in this program have more births attended by attendants able to provide care and recognize emergencies. Click here to learn more about the HBLSS program.

Skilled attendance at all births is considered to be the most critical intervention for ensuring safe motherhood, because it hastens the timely delivery of emergency obstetric and newborn care when life-threatening complications arise. In addition to the attendance of midwife or others with midwifery skills (MOMS), the presence of an enabling environment which can provide comprehensive emergency obstetric care is vital.

Safe Passage to Motherhood is seeking to increase the numbers of "MOMS" (Midwife or Others with Midwifery Skills) who will be able to recognize, respond and refer women who suffer these life threatening obstetrical emergencies in some of the world’s poorest communities.

This page provides more detailed information on the topics introduced in other pages. Thank you for taking the time to become familiar with Safe Passage to Motherhood and the Home Based Life Saving Skills program.
Our Motivation
Every minute a woman dies in childbirth or from an illness related to childbearing, an estimated 600,000 per year. Childbirth is the leading cause of death and disability for women of reproductive age in the world. Left behind are their 1 million children, motherless and vulnerable. More women and consequently babies and young children die as result of pregnancy related complications than from malaria, tuberculosis and AIDS.	Safe Passage to Motherhood, (SPM) was founded to help address this compelling issue. We are a group of health care providers and educators who are committed to empowering communities to improve outcomes for mothers and newborns by bringing the internationally acclaimed Home Based Life Saving Skills program to high need communities.
Our Mission
Our mission is to improve health and survival in childbirth for mothers and newborns in low resource settings by sharing knowledge of	life savings skills in a culturally sustainable manner.
Our Philosophy
We believe that the health of a society is reflected in the well being of its mothers and children. Working for the survival of mothers is a human rights imperative. Watching mothers and children die from preventable complications of childbirth drains the assets and spirit of a community. Education about pregnancy and birth, shared with sensitivity and in collaboration with our	hosts will empower a community to improve their own maternal and neonatal health by having access to skilled care at the time of birth. Guidance through knowledge and appropriate referrals to quality emergency obstetric care will create meaningful change that will outlast our presence in a community.
Home Based Life Saving Skills
More than 80% of maternal deaths worldwide are due to five direct causes: hemorrhage, hypertensive disease of pregnancy, unsafe abortion, infection, and obstructed labor. Some 3.4 million newborns die within the first week of life. Encouragingly, with proper training, skilled attendants can recognize problems early and can intervene directly or stabilize the condition and help the patient reach specialized care. Skilled birth attendants and improved access to emergency obstetrical and neonatal care can greatly reduce the rates of death and disability in a community. Addressing these concerns requires a combination of approaches to expand access to skilled care and extended life saving interventions along a continuum of care from community to hospital. Safe Passage to Motherhood will first focus work at the home or village level while strengthening linkages with obstetric services in the community and beyond. Since 2000, the American College of Nurse Midwives, (ACNM) has been field testing theHome Based Life Saving Skills (HBLSS) program. Many complex issues affect the	motivation and mobilization of pregnant women, families and communities in seeking appropriate care. Careful participatory approaches are necessary to design interventions that really improve pregnancy outcomes. HBLSS is implemented by trained guides who are selected by their communities. Guides may be midwives, traditional birth attendants, or lay persons. They impart HBLSS knowledge and skills to women, family caregivers and home birth attendants, all those who are expected to be present at a birth. Developing and strengthening the links between home, community, and referral facilities through community mobilization is crucial to saving more lives. The HBLSS program is carried out together with host country representatives over a period of 18 months. Field testing has shown that communities which have participated in this program have more births attended by attendants able to provide care and recognize emergencies. For more information about Home Based Life Savings Skills program, please visit the American College of Nurse-Midwives website.
History of Safe Motherhood
The Safe Motherhood Initiative is a worldwide effort, launched in 1987, that aims to reduce the number of deaths and illnesses associated with pregnancy and childbirth. Its aim was to draw the world’s attention to the thousands of deaths and millions of serious illnesses that afflict women every year. Despite international Safe Motherhood activities, maternal mortality and morbidity rates in developing countries, particularly Sub-Saharan Africa and Asia continue to be alarmingly high. In the developing world, only	about 58% of all births are reported as attended by skilled health providers. In some countries, the figure is closer to 10-12 per cent. Over the past several decades local, national and international organizations and researchers have well identified why this devastating challenge remains. Limited access to basic health care, human rights education discrimination, poverty, illiteracy, cultural barriers, concurrent disease and lack of decision-making power in the household and community and violence against women all contribute to this global tragedy.
Skilled Attendance at Birth
Skilled attendance at all births is considered to be the most critical intervention for ensuring safe motherhood, because it hastens the timely delivery of emergency obstetric and newborn care when life-threatening complications arise. In addition to the attendance of midwife or others with midwifery skills (MOMS), the presence of an enabling environment which can provide comprehensive emergency obstetric care is vital. In countries such as China, Cuba, Egypt, Honduras, Jordan, Malaysia, Sri Lanka, Thailand and Tunisia, professionally trained midwives have been a key component of success in achieving significant declines in maternal mortality. Many of these countries have halved their maternal deaths in the space of a decade as more women have gained access to family planning and skilled birth attendance with backup emergency obstetric care. In contrast, severe shortages of trained health providers with midwifery skills are holding back progress in many countries.	Women and their families often are unable to recognize the danger signs that indicate a life threatening emergency. Even when they recognize the warning signs, they are frequently unable to procure transport from their village to a health center that can address the problem. Once at the health center, they may not find a skilled practitioner or available medication. If they are fortunate enough to reach a hospital, there may be no room or the personnel may not have the training or equipment required to respond to the life threatening emergency. It is this collaboration between the skilled birth attendant who can assist in recognizing and then responding to obstetrical emergencies and the availability of more advanced services which are within a couple hours reach which ultimately will save the lives of millions of women and children. Safe Passage to Motherhood is seeking to increase the numbers of “MOMS” who will be able to recognize, respond and refer women who suffer these life threatening obstetrical emergencies in some of the world’s poorest communities.

	"Our mission is to improve health and survival in childbirth for mothers and newborns in low resource settings by sharing knowledge of life saving skills in a culturally sustainable manner."