There has been huge progress in the last two decades in reducing both maternal and
child mortality globally. In particular the Millennium Development Goals for maternal
and child health have focused many countries to develop strategies to accelerate the
decline in mortality. However there are still places where the risks to pregnant women
remain high and neonatal mortality makes up an increasingly large proportion of the
under-five mortality rate. Sub-Saharan Africa continues to have some of the highest maternal
and newborn mortality including stillbirth in the world where many women who
are poor, uneducated and from marginalised or rural populations live. The HIV epidemic
also has an impact on maternal and child survival.
Many pregnant women attend antenatal services at least once and an increasing number
are beginning to receive care from skilled professionals during childbirth. However
the postnatal period is a neglected period. The 6 week postnatal check is a visit for survivors.
The artificial division that is commonly drawn between labour and delivery and
the immediate postnatal period (within 12– 24 hours after birth) become mixed up with
the values and meaning of late postnatal care at 6 weeks. This has fatal consequences
in the first few days after childbirth. Indeed postnatal care is often called the Cinderella
of maternity services due to the fact that it is considered the least important and least
resourced component of a woman’s journey from pregnancy to motherhood and is often
not prioritised in maternal and child health national policies. However it appears that
postnatal care is now receiving more attention globally. There is increasing discussion
on what the content of each contact should include and how frequently these contacts
should occur. It is hoped that the studies described here can contribute to the global
discussion—so that women both survive their pregnancies and enjoy their children.