Women in developing countries experience the same problems during pregnancy and childbirth and die of the same complications, regardless of whether they live in stable situations or in situations of conflict and displacement. They need services and/or care during pregnancy and childbirth wherever they are and in whatever circumstances prevail. This article provides an overview of the Safe Motherhood Initiative, including the recent directions taken to prevent maternal and neonatal mortality and morbidity. In addition, pregnancy and childbirth care in complex humanitarian emergencies is examined, highlighting the experiences in refugee settings. In some of these settings, pregnancy outcomes have been better than in host or home countries. The challenge remains to ensure that good-quality pregnancy and childbirth care, in line with the global standards set for achieving safe motherhood, is consistently available and accessible to women affected by complex humanitarian emergencies. © 2004 by the American College of Nurse-Midwives.

Pregnancy outcome Safe motherhood Refugee setting Complex humanitarian emergency Pregnancy and childbirth care

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