After losing her sister and her sister's baby from complications during childbirth, Robin Lim became a certified midwife. She is the mother of eight, author of several books, and in 2003, she founded the first Yayasan Bumi Sehat clinic (Healthy Mother Earth Foundation) in Bali where she is referred to as "Ibu" or "Mother Robin." She has devoted her time to improving maternal and infant health and raising awareness worldwide about the importance of prenatal care and the right of every woman to have a skilled birth attendant at every birth. On December 11, 2011, Lim was honored as the 2011 CNN Hero of the Year, chosen by public vote from the top 10 Heroes of 2011. In her acceptance speech she proclaimed, "Every baby's first breath on Earth could be one of peace and love. Every mother should be healthy and strong. Every birth could be safe and loving. But our world is not there yet."1
According to the Partnership for Maternal, Newborn and Child Health (PMNCH),2 358,000 women die during pregnancy and childbirth every year, and 7.6 million children under the age of 5 years die worldwide. Within the first 28 days of life, 40% of infant deaths occur. Infant mortality was associated most commonly with preterm birth, severe infections, and asphyxia. Maternal mortality resulted primarily from bleeding, elevated BP, prolonged or obstructed labor, infections, and unsafe abortions, or conditions during or immediately after childbirth. The highest rates of both maternal and infant mortality occurred in sub-Saharan Africa and Southern Asia with more than half of the women in these areas receiving no prenatal care or less than the minimum four prenatal visits recommended by the World Health Organization (WHO). These women also were not attended during childbirth. The infant mortality rate in the United States was 6.61 per 1,000 live births in 2008 most commonly due to congenital malformations, preterm/low birth weight, and sudden infant death syndrome.3
The United Nations (UN) established the 2015 Millennium Development Goals (MDGs) to combat issues affecting the health of the world's population.4,5 Goals 4 and 5 are intended to significantly reduce maternal and infant mortality. Progress toward achieving the goals is monitored but has not been indicative of success in meeting the 2015 goals.
PMNCH evaluated research findings on the effectiveness of different strategies to improve the health of women and infants. A summary table of the essential evidence-based interventions is included in the PMNCH document.2 Recommendations in the table are classified according to the continuum of care- and the following categories: Adolescence and Pre-Pregnancy, Pregnancy (Antenatal), Childbirth, Postnatal (Mother), Postnatal (Newborn), and Infancy and Childhood. The information in the table is useful for advanced practice nurses in primary and specialty care.
Lim's story touched the public. The motto for CNN Heroes is "Everyday People Changing the World." Resources and greater efforts, however, are indicated if we are to meet the 2015 MDGs.1 Healthy women and healthy babies remain a goal and challenge for communities and healthcare professionals everywhere.
Jamesetta Newland, PhD, RN, FNP-BC, FAANP, FNAP
Editor-in-Chief
[email protected]
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