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MARY JANE L. GENSOLA, RN, LPT, MN
“Implementing Health Reforms for the Rapid Reduction of Maternal and Neonatal Mortality”
To ensure rapid reduction of maternal and child mortality, the DOH issued Administrative Order 2008-2009 entitled;
Maternal Mortality rate
What does MMR mean?
Majority of maternal deaths directly result from pregnancy complications occurring during labor, delivery and the post-partum period
Majority of maternal deaths directly result from _________________ occurring during labor, delivery and the post-partum period
❑ Mistimed, unplanned, unwanted and unsupported pregnancy
❑ Not securing adequate care during pregnancy
❑ Delivering without being attended to by skilled health professionals (i.e. midwives, nurses, and doctors) and lack of access to emergency obstetric and newborn services
❑ Not securing proper post-partum and newborn care for the mother and her newborn, respectively.
4 RISK FACTORS CONTRIBUTING TO MATERNAL AND NEONATAL DEATHS
24-48 hours
What is considered as vigilance stage for hemorrhage during postpartum
Abortus
an embryo or fetus that is removed or expelled from the uterus at 20 weeks of gestation or less, weighs 500g or less, or measures 25 cm or less
Pregnancy-Associated Deaths
all deaths during pregnancy and within the 1 year following the end of pregnancy
Birth Rate
number of live births in 1 year per 1000 population
Pregnancy Related Deaths
deaths that are a complication of pregnancy, an aggravation of an unrelated condition by the physiology of pregnancy, or a chain of events initiated by the pregnancy
Fertility Rate
number of births per 1000 women between the ages of 15 and 44 years (inclusive), calculated on an annual basis
Neonatal Mortality Rate
number of deaths of infants younger than 28 days of age per 1000 live births.
Perinatal Mortality Rate
number of stillbirths and number of neonatal deaths per 1000 live births
Maternal Mortality Rate
number of maternal deaths from births and complications of pregnancy, childbirth, and puerperium (the first 42 days after termination of the pregnancy) per 100,000 live births
Stillbirth
an infant who at birth demonstrates no signs of life such as breathing, heartbeat, or voluntary muscle movements
Genetics
is the study of the way such disorders occur.
3 generations
Assessment measures for genetic disorders begin with a detailed family history, preferably of how many generations
A-Fetoprotein
a protein produced by the liver and yolk sac of a developing baby during pregnancy.
Chronic Villi Sampling (CVS) and amniocentesis
are both techniques that may be offered to women who are older than 35 years of age, or to those whose genetic testing is abnormal, to diagnose chromosomal genetic disorders
Inherited or genetic disorders
are disorders that can be passed form one generation to the next because they result from some disorder in the gene or chromosome structure.
occur in some ethnic groups more than others because people tend to marry within their own cultural group.
Genetic disorders
CYTOGENETICS
is the study of chromosomes by light microscopy and the method by which chromosomal aberrations are identified.
GENE REPLACEMENT THERAPY
is encouraging in the treatment of blood, neural tube, eye, and congenital metabolic disorders as well as for cancers and immunodeficiency syndromes.
STEM CELLS
can be obtained from bone marrow (adult cells), embryos, or umbilical cord blood (embryonic stem cells).
Genes
are the basic units of heredity that determine both physical and cognitive characteristics of people
A person’s phenotype refers to his or her outward appearance or the expression of genes
A person’s ________ refers to his or her outward appearance or the expression of genes
A person’s genotype refers to his or her actual gene composition
A person’s ________ refers to his or her actual gene composition
person who has two like genes for a trait–two healthy genes, for example (one from the mother and one from the father) is said to be homozygous for that trait
person who has two like genes for a trait–two healthy genes, for example (one from the mother and one from the father) is said to be____________for that trait
the genes differ (a healthy gene from the mother and an unhealthy gene from the father, or vice versa), the person is said to be heterozygous for that trait
the genes differ (a healthy gene from the mother and an unhealthy gene from the father, or vice versa), the person is said to be _______________ for that trait
genetic assessment
A ___________ begins with careful study of the pattern of inheritance in a family
DERMATOGLYPHICS
the study of surface markings of the skin) is also helpful because unusual fingerprints, abnormal palmar creases, hair whorls, or coloring of hair are also present with some disorders
CHORIONIC VILLI SAMPLING
AMNIOCENTESIS
PERCUTANEOUS UMBILICAL BLOOD SAMPLING
PREIMPLANTATION
DIAGNOSIS
Give examples of INVASIVE Genetic Screening test
NUCHAL TRANSLUCENCY
cfDNA
FETAL ANATOMY ULTRASOUND
NEWBORN SCREENING
What are the NON INVASIVE Genetic screen test
Chorionic Villi Sampli
This involves taking a small sample of placental tissue (chorionic villi) to analyze the baby's chromosomes. It is typically performed between 10 and 13 weeks of pregnancy.
Amniocentesis
Collection of amniotic fluid containing fetal skin cells through maternal abdomen . It is usually performed between 15 and 20 weeks of pregnancy.
PERCUTANEOUS UMBILICAL BLOOD SAMPLING
Fetal umbilical blood sampling through maternal abdomen usually after 18 weeks, and is often used when other tests have shown a potential problem.
Preimplantation Genetic Diagnosis (PGD):
Cell sample obtained from day 3 or day 5 embryo prior to implantation in mother during in vitro fertilization process
Nuchal Translucency (NT) Scan
This is an ultrasound performed between 11 and 13 weeks of pregnancy to measure the fluid at the back of the baby's nec
Cell-free DNA (cfDNA) Screening
This blood test analyzes fragments of fetal DNA circulating in the mother's bloodstream. It can be used to screen for conditions such as Down syndrome and trisomy 18.
18-22 weeks, ideal timing to assess the baby's physical development and look for any abnormalities.
Fetal Anatomy Ultrasound:
NEWBORN SCREENING
A blood sample via heel prick or blood draw from newborn blood draw from newborn peior to discharge
1. ALTERNATIVE INSEMINATION
instillation of sperm from a masturbatory sample into the female reproductive tract by means of a cannula to aid conception at the time of ovulation
2. IN VITRO FERTILIZATION (IVF)
used for couples who are unable to conceived because the woman has obstructed or damaged fallopian tubes, oligospermia, unexplained fertility
1. SURROGATE MOTHERS
both donor ova & sperm are used is a woman who agrees to carry the pregnancy to term for a sub fertile couple or an LGBT couple
TYPES OF SURROGACIES
TRADITIONAL SURROGACY
Surrogate is the biological mother of the baby she carries.
Gestational pregnancy
The statement "Surrogate does not use her own egg and, therefore, is not biologically related to the child she’s carrying" best describes which type of surrogacy?
Compensated Surrogacy
A surrogate will receive base compensation for carrying the intended parents’ child. in addition to the coverage of all pregnancy-related costs
ALTRUISTIC SURROGACY
Surrogate does not receive any additional compensation beyond the coverage of pregnancy-related costs.
Adoption
usually refers to the legal process of becoming a nonbiological parent to a child.
ADOPTION PROCESS
the process through which the adopted child becomes the lawful child of his adoptive parents with all the rights, privileges and responsibilities that are attached to a biological child.
AGENCY ADOPTIONS
FAMILY OR RELATIVE ADOPTIONS
PRIVATE OR INDEPENDENT ADOPTIONS
LOCAL ADOPTION IN THE PHILIPPINES THREE TYPES OF ADOPTION
Agency Adoptions
licensed agency finds and develops adoptive families
Family adoptions
biological parents make a direct placement of the child to a relative or a member of their extended family
PRIVATE OR INDEPENDENT ADOPTIONS
either be a direct placement to a family known by the child's biological parents or through the use of an intermediary or a go-between
CHILD – FREE LIVING
known as Voluntary Childlessness. Can be fulfilling as having children because it allows the couple more time to help other people and contribute to society through personal accomplishments
SURROGATE EMBRYO TRANSFER
• for a woman who does not produce ova • the oocyte is donated by a friend, relative or a donor
• the menstrual cycle of the donor & recipient is synchronized
December 1, 2021
A study found that a significant number of Filipino children experience various forms of violence. Which of the following dates is associated with the finding that three out of five Filipino children have experienced physical or psychological violence, and one out of five experienced sexual violence, with many of these incidents occurring within the home?
Any act or series of acts committed by any person against a woman
WHAT IS VIOLENCE AMONG WOMEN AND CHILDREN
Dating relationship
is one which has a romantic involvement. It means that a relationship existed between a woman and a partner who is abusive or has previously abused her, whether or not the relationship was formal
Sexual relations
refer to a single sexual act which may or may not result in the bearing of a common child.
Individuals below the age of 18 and those above 18 who are incapable of taking care of themselves due to physical or mental condition
According to Republic Act No. 7610, which of the following accurately defines the scope of children who are entitled to protection under the law?
Tension building
What is the first stage of the Cycle of Domestic Violence,
Incident
Which stage is characterized by verbal, emotional, and physical abuse
Apologizing and promising change
During the "Reconciliation" phase, what behaviors might the abuser exhibit
Tensions Building - Incident - Reconciliation - Calm
What is the typical pattern of the Cycle of Domestic Violence
To identify potential warning signs and seek help
Why is it important to understand the Cycle of Domestic Violence?
Articles 333 and 334
f the Revised Penal Code penalize a wife who commits adultery, but not a husband who commits the same adulterous act of having sexual relations with a woman who is not his wife.
husband may only be penalized for concubinage, or when he keeps mistress in a conjugal dwelling or when he has sexual intercourse with a woman who is not his wife, under scandalous circumstances
husband may only be penalized for ______, or when he keeps mistress in a conjugal dwelling or when he has sexual intercourse with a woman who is not his wife, under scandalous circumstances
PHYSICAL VIOLENCE
Bodily or physical harm
a) Hitting with the fist
b) Slapping
c) Kicking different parts of the body, stabbing with a knife, etc)
“BATTERY"
refers to an act of inflicting physical harm upon the woman or her child resulting to physical and psychological or emotional distress.
BATTERED WOMAN
Is one who is repeatedly subjected to any forceful, physical or psychological behavior by a man in order to coerce her to do something he wants her to do without concern for her rights.
acknowledges that women who have retaliated against their partner or who commit violence as a form of self-defense may have suffered from Battered Woman Syndrome (BWS).
WHAT IS BATTERED WOMAN SYNDROME (BWS)
REPUBLIC ACT 9262
Anti-Violence Against Women and Their Children Act of 2004.
PSYCHOLOGICAL AND EMOTIONAL VIOLENCE
Acts or omissions causing mental or emotional suffering of the victim.
Sexual Violence
Treating a woman or child as a sex object, making demeaning and sexually suggestive remarks. What category of violence does this belong?
STALKING
refers to an intentional act committed by a person who, knowingly and without lawful justification, follows the woman or her child, or places the woman or her child under surveillance directly or indirectly or a combination thereof
SEXUAL VIOLENCE
Acts that are sexual in nature committed to a woman or her child.
Sexual Violence
Acts causing or attempting to cause the victim to engage in any sexual activity by force, threat of force, physical or other harm or threat of physical or other harm or coercion;
4. ECONOMIC ABUSE
Acts that make or attempt to make a woman financially dependent
Withdrawal of financial support
Threat of deprivation of financial resources
Destroying household property; and controlling the victim's own money
What are the qualifications of Economic Violence
POLITICAL VIOLENCE
such as tolerance of gender-based violence, trafficking, domestic violence, sexual abuse, forced pregnancy and forced sterilization,
CUSTODIAL VIOLENCE
such as military and police rape, torture, and suppression of the political acts of the women's movement, abuse of women in refugee and relocation camps and in prisons;
INSTITUTIONAL VIOLENCE
such as enforcement of discriminatory laws and regulations, policies and programs such as abortion policies, reproduction policies and matrilineal laws.
• Economic Violence – product, production and environmental violence.
• Family Violence – child, spouse, and elder abuse
• Religious Violence – intersect violence, crusades, persecutions, and ritual sacrifices
• State Violence – violence by police, military and private militia surrogates
EXAMPLES OF INSTITUTIONAL VIOLENCE
VIOLENCE AGAINST WOMEN AND CHILDREN
"violence that occurs within the private sphere, generally between individuals who are related through intimacy, blood or law."
REPUBLIC ACT 9262
ANTI-VIOLENCE AGAINST WOMEN AND THEIR CHILDREN (VAWC) ACT OF 2004
The law recognizes the unequal relations between a man and a woman in an abusive relationship where the woman is usually at a disadvantage
Thus, the law protects the woman and her children
WHO GETS PROTECTED UNDER THE LAW?
Under the law, the offended party may file a criminal action, or apply for Protection Order
WHAT CAN WOMEN AND CHILDREN DO UNDER RA 9262
PROTECTION ORDER
It is an order issued by the Barangay or the Court to prevent further acts of violence against a woman or her child and to grant other necessary relief, under RA 9262.
1. BARANGAY PROTECTION ORDER (BPO) = 15 days
2. TEMPORARY PROTECTION ORDER (TPO) = 30 days
3. PERMANENT PROTECTION ORDER (PPO)
There are three (3) kinds of protection order
True: At least two (2) concerned citizens of the city or municipality where VAWC happened and who have personal knowledge of the offense committed
T/F: A citizen who is not blood related nor any relationship to the offended party may file a Permanent Protection Order.
Regional Trial Court
True: At least two (2) concerned citizens of the city or municipality where VAWC happened and who have personal knowledge of the offense committed
women can also be liable under the law
IS VAWC COMMITTED BY MEN ALONE?
REVISED PENAL CODE
What if the male spouse/partner complains about abuses committed by his wife/partner?
➢ Imprisonment ranging from 1 month and 1 day to 20 years ➢ Payment of P100,000 to P300,000 in damages ➢ Mandatory psychological counseling or psychiatric treatment
PENALTIES FOR COMMITTING VAWC?
REPUBLIC ACT 7877
What RA does ANTI-SEXUAL HARASSMENT ACT OF 1995 Belong?
VERBAL SEXUAL HARASSMENT
Whistling, making sexual comments, sexual jokes, and sexual topics is what kind of Sexual Harassment?
PHYSICAL SEXUAL HARASSMENT
An act where someone inappropriately touched you against your will
PHYSICAL SEXUAL HARASSMENT
“Every day for a summer, I was brutally molested by a guy with down syndrome” said by your male patient. This is what type of Sexual Harassment?
NON-VERBAL OF SEXUAL HARASSMENT
Offensive gestures like staring, leering, with an intention to cause discomfort to the other party
