Safe Motherhood and The Three Delay Model_20251017_120720_0000.pdf

Safe Motherhood and The Three Delay models

1. SAFE MOTHERHOOD
&
THE THREE DELAY MODELS 'No mother should die giving life' Hamid Bin Tariq, Suleman Saeed, Palwasha Shabbir

2. SAFE MOTHERHOOD
Safe Motherhood means ensuring that all women receive the care they need to
be safe and healthy during pregnancy, childbirth, and the postpartum period.
It is the ability of a mother to have a safe and healthy pregnancy and child
birth.
GOAL: 1.To improve wellbeing of mothers through a comprehensive approach
of providing, preventing, promotive, curative and rehabilitative health
care.
2.To reduce maternal and neonatal morbidity and mortality.

3. MATERNAL MORTALITY
Death of a woman while pregnant or within 42 days of
termination of pregnancy, irrespective of the duration and site
of pregnancy, from any cause related to or aggrevated by
pregnancy or its management but not from accidental or
incidental causes.MMR:
No. of maternal deaths per 100,000 live births.

4. Every day ~800 women die from preventable pregnancy-related causes (WHO).
99% of these deaths occur in low- and middle-income countries like Pakistan.

6. Helps women space births, avoid unintended pregnancies,
and recover between pregnancies.
Reduces maternal depletion and unsafe abortions.
Provides counseling on contraceptive choices (temporary
and permanent). FAMILY PLANNING Early registration of pregnancy (preferably before 12 weeks).
At least four focused visits during pregnancy.
Screening for anemia, hypertension, diabetes, and infections
(e.g., HIV, syphilis).
Tetanus immunization, iron–folate supplementation, and
health education.
Promotes birth preparedness and complication readiness. ANTENATAL CARE

7. Availability of Basic and Comprehensive EmOC at all levels.
Basic EmOC: Oxytocics, antibiotics, anticonvulsants, manual
removal of placenta, assisted delivery.
Comprehensive EmOC: Caesarean section, blood transfusion,
anesthesia.
Referral systems for timely transfer of complicated cases. OBSTRETIC CARE First 48 hours postpartum are most critical — monitor for
hemorrhage, sepsis, hypertension.
Support for breastfeeding, family planning, and mental
health.
Regular postnatal visits.
Early detection of neonatal problems such as jaundice,
sepsis, or feeding difficulties. POST NATAL CARE

8. Provide access to safe, legal abortion where allowed; ensure
early pregnancy assessment.
Post-abortion care (PAC): treat complications (hemorrhage,
infection), uterine evacuation when needed, counselling, and
immediate contraception. ABORTION CARE: Routine screening & treatment in ANC (HIV, syphilis, Hep B),
prevention of mother-to-child transmission (PMTCT)
programs, condom promotion, partner notification and
treatment, integration of HIV services into maternal care.
Voluntary Counselling & Tesing (VCT)STD/HIV CONTROL:

9. THE THREE DELAY MODEL
(THADDEUS AND MAINE, 1994)
Delay 1
Decision to
Seek Care
Delay 2
Reaching the
Health Facility
Delay 3
Receiving
Adequate
Care

10. DELAY 1: DECISION TO SEEK CARE
Poverty
Lack of
Knowledge
Patriarchy
Culture

11. DELAY 2: REACHING THE HEALTH FACILITY
Poor Quality
of Roads
Road Traffic
Accidents
Ambulatory
Availability
Traffic Jam

12. DELAY 3: RECEIVING ADEQUATE CARE
Medical
Negligence
Long
waiting
durations
Lack of Hospital
Infrastructure
Overcrowding

13. STRATEGIES TO REDUCE THE DELAYS
DELAY 1
Community
Education
Antenatal
Counselling
Advocate
for Women
Rights
Family
Support
DELAY 2
Emergency
Transport
Transport
Access
Referral
Systems
Financial
Support
DELAY 3
Skilled
Staff
Supply
Availability
Staff
Motivation
Quality
Assurance

14. PAKISTAN: A CONTINUING
CHALLENGE
Pakistan’s MMR ≈ 154 per 100,000 live births (2023).
Many deaths are due to delay in seeking and reaching care.
National initiatives:
Lady Health Worker (LHW) program
Maternal, Neonatal and Child Health (MNCH) program
Basic & Comprehensive EmOC centers

15. CONCLUSION
Safe Motherhood = Timely, Skilled, and Accessible Care.
Addressing all three delays is essential to prevent avoidable
maternal deaths.
Collective effort needed, community + health system +
policymakers.

16. THANKYOU! Safe motherhood is not a privilege. It is every woman’s right
and every nation’s responsibility.