Lack of safe, affordable, medically indicated caesarean delivery is a primary contributor to global health inequity. In low-income and middle-income countries (LMICs), it perpetuates preventable morbidity and mortality caused by prolonged or obstructed labour. Adequate intervention alone would avert 1 million disability-adjusted life-years (DALYs), with a median benefit-to-cost ratio of 6·0 at US$304 per DALY averted, reflecting an eradicable burden of disease that undermines sustainable development, economic growth, and human rights.
Effect of Addition of an Intimate Partner Violence Intervention to a Nurse Home Visitation Program on Maternal Quality of Life A Randomized Clinical Trialby Jack et al
This cluster randomised trial assessed whether augmentation of a nurse home visitation program with an intimate partner violence intervention, starting in pregnancy, compared with the home visitation program alone, leads to improved maternal quality of life at 24 months after infant delivery? The trial included 492 pregnant women, randomization to the augmented program compared with nurse home visitation alone resulted in maternal quality-of-life scores at 24 months postdelivery of 311.3 vs 316.2 (measured using the WHOQOL-BREF scale; range, 0-400)—a difference that was not statistically significant. These findings do not support augmenting a nurse home visitation program with this complex, multifaceted intimate partner violence intervention.
Randomized controlled pilot of a group antenatal care model and the sociodemographic factors associated with pregnancy-related empowerment in sub-Saharan Africaby Patil et al
The study compares pregnancy-related empowerment for women randomly assigned to the standard of care versus CenteringPregnancy-based group ANC (intervention) in two sub-Saharan countries, Malawi and Tanzania. Pregnant women in Malawi (n = 112) and Tanzania (n = 110) were recruited into a pilot study and randomized to individual ANC or group ANC. The findings suggest that Group ANC empowers pregnant women in some contexts. More research is needed to identify the ways that models of ANC can affect pregnancy-related empowerment in addition to perinatal outcomes globally.