Issues & Solutions

Supporting Healthy Mothers

Pregnancy is often a time of joy and anticipation, but in developing countries, it can be a life-threatening condition. Most of the risks for pregnant women in developing countries are related to poverty, poor nutrition, a high burden of infectious disease, limited access to care, and the lack of understanding about when to seek care.

In Brief

  • A woman dies every two minutes from complications during pregnancy or childbirth—more than 295,000 women each year.
  • Direct Relief’s humanitarian health efforts place particular emphasis on protecting women and babies through the critical periods of pregnancy and childbirth.
  • Direct Relief supports partners in countries around the world who provide critically needed maternal and child health services during the full spectrum of pregnancy.

Made for Women's Health

Direct Relief's Midwife Kits, which contain 59 essential tools for midwives to facilitate safe births, are seen here on International Women's Day, March, 8, 2018. (Lara Cooper/Direct Relief)

Midwife Kit

Direct Relief's Midwife Kit contains 59 essential tools midwives need to facilitate safe births.

Fistula Module

A standardized pack of high-quality medicines and surgical supplies necessary for fistula repair surgery and post-operative care.
Direct Relief and Medicines 360 are partnering to distribute IUDs to participating clinics across the U.S., providing women with no-cost birth control. (Lara Cooper/Direct Relief)


Direct Relief and Medicines 360 are partnering to provide women across the U.S. with no-cost birth control.

Five Ways Direct Relief Helps Moms Thrive

Direct Relief protects women through the critical periods of pregnancy and childbirth. This support includes ensuring more trained midwives are properly equipped, supporting healthy pregnancies with prenatal vitamins, expanding emergency obstetric care in areas of crisis, and supporting life-restoring surgeries for women who suffer the debilitating effects of obstetric fistula—a birth-related injury that affects women in low- and middle-income countries almost exclusively.

1. Equipping Midwives

The best way to keep mothers safe is to make sure every birth is accompanied by a trained and equipped professional. Midwives are the first line of assistance, providing high-quality care during routine deliveries, managing basic complications, and recognizing when to refer a mother to emergency obstetric care. But they can only do their work if they have the right tools.

To equip midwives with the resources they need to provide life-saving antenatal, delivery, and postpartum care, Direct Relief developed its midwife kit, which the International Confederation of Midwives has endorsed as a standard for midwives trained to ICM’s competency standards.

Over the past decade, Direct Relief has delivered over 2,000 midwife kits to midwives in low-resource settings, helping facilitate an estimated 100,000 deliveries.

2. Supporting Healthy Pregnancies

Pregnant women and developing babies are particularly vulnerable to micronutrient deficiencies, which increase the risk of dying during childbirth or of giving birth to a baby that is preterm, underweight, or impaired. Direct Relief addresses this issue by distributing prenatal vitamins to partner facilities and organizations around the world.

Direct Relief has both produced prenatal vitamins and partnered with Kirk Humanitarian to distribute prenatal vitamins to 46 countries.

3. Fighting Fistula, Restoring Dignity

Obstetric fistula is a hole in the birth canal caused by prolonged and obstructed labor. If untreated, a woman with obstetric fistula will experience constant and uncontrollable leakage of urine and/or feces. Many women with fistula suffer humiliation, isolation, and stigma as a result of the smell and constant leakage. In most cases of obstructed labor in which a fistula develops, the baby is stillborn.

According to the World Health Organization, there are 130,000 new cases of obstetric fistula each year, with an estimated 2 million women living with the condition, sometimes for decades.

Direct Relief, in partnership with the United Nations Population Fund (UNFPA) and The Fistula Foundation, developed the Global Fistula Map—the first-ever worldwide map of treatment for this devastating childbirth injury—to help better understand the current fistula treatment capacity, more effectively target scarce resources to where they are needed most, and identify where gaps in service may exist.

Since 2003, Direct Relief has maintained its commitment to expanding the understanding and quality of obstetric fistula repair services for women affected by this devastating and debilitating health issue in low-resource communities around the world. Direct Relief has established partnerships with facilities performing fistula repair surgeries according to best practices and provided a reliable supply of the materials needed to conduct these life-restoring procedures. In May 2016, the International Federation of Gynecology and Obstetrics (FIGO) officially endorsed the Obstetric Fistula Repair Module developed by Direct Relief to ensure that surgeons and other healthcare professionals are provided with high-quality, standardized, items necessary to perform fistula repair surgeries.

4. Emergency Obstetric Care

When complications occur, emergency obstetric care such as a cesarean section may become necessary. But few women in the developing world have access to such life-saving services. Direct Relief supports programs that increase that access, outfitting suitable health facilities with the equipment they need to provide quality care. This includes the provision of fetal monitors, oxygen concentrators, birthing beds, ultrasound machines, anesthetic machines, and more.

Needed equipment has been provided in 11 countries, including Haiti, El Salvador, Ghana, Uganda, and Malawi.

5. Expanding Access to Family Planning

The ability to delay and space childbearing is crucial to women’s social and economic advancement, yet the evidence suggests that the most disadvantaged women in the U.S. do not fully share in these benefits. Forty-five percent of all pregnancies in the US are unintended and occur at a higher proportion in young, poor, and minority women. Unintended pregnancies are also often associated with negative outcomes such as premature birth, maternal depression, and other lifelong health, economic and societal difficulties. Supplying health professionals with high quality contraception to allow their most disadvantaged patients to choose if and when to become pregnant, has the ability to transform lives.

Direct Relief, in collaboration with Medicines360, offers IUDs at no cost to health facilities providing family planning services to uninsured patients in need through the IUD Access Partnership.

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