Percent of mothers examined every 30 minutes during the first two hours after delivery

Definition:

The number of newly-delivered mothers receiving standardized checks every 30 minutes after delivery for the first two hours.

“Examined” refers to a series of standardized checks: vital signs, bleeding, and uterine status.

The indicator is calculated for a given reference period as:

# of mothers examined every 30 minutes during the two hours after delivery x 100
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# of deliveries

Data Requirement(s):

Number of newly-delivered mothers receiving standardized checks every 30 minutes after delivery for the first two hours; number of women delivering at the facility during the reference period. The checks must be timely (every 30 minutes) to be considered valid.

Data Source(s):

Review of medical records; direct observation from supervisor or external evaluator.

Purpose:

An important proportion of maternal deaths occur after delivery. The most important single cause of these maternal deaths is hemorrhage, most commonly in the immediate postpartum period (WHO, 1999a). Hence, routine checking for vital signs (especially blood pressure) and for vaginal bleeding and uterine status during the first two hours after delivery is an important standard of quality care that will help in the early detection of a potential life-threatening complication.

If a specific post-partum record is available and designed according to the standard of care, then it reminds providers to comply with the standard. If a specific form is unavailable, focusing attention on this standard may trigger the development of a specific job-aid.

Issue(s):

This indicator measures monitoring of women every 30 minutes for the first two hours following delivery as one component of quality postpartum care. However, it does not address other aspects of quality care, such as the level of monitoring (e.g., is the facility too overcrowded for adequate monitoring), if skilled attendants are available at all times, and if there are necessary drugs, equipment, and supplies to effectively manage complications.