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Developing Handheld Educational Material for High-risk Mothers
in a Sub-urban Referral Hospital

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L. Herrera Cadillo, E. Campomanes Pelaez, K. Suga, and C. Sakakibara 1
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1 Faculty of Health Sciences, Department of Nursing, Asahi University, Japan, and Nursing and Midwifery
Department, Universidad de San Martin de Porres, Peru

Background: Maternal mortality ratio has decreased to 69 x 100,000 lb in 2022. Causes of maternal
mortality are obstetric hemorrhage, hypertensive disorders of pregnancy, abortion. Most maternal
deaths occurred during the puerperium, after women are discharged and lose contact with health
facilities. About 70% of deaths in the country occur in health facilities, 30% of deaths occur at home
or on the way to the hospital, more than 30% of pregnant mothers cannot recognize warning signs,
and mortality is higher in large cities. Evidence drawn from experiences of the Japanese Maternal and
Child Health Handbook and the “Pink Book” in Thailand.

Objective: 1) To develop the contents of a handheld educational booklet for mothers admitted to the
obstetric high-risk (OHR) ward and to assess the utility of the contents to ensure the continuum of care
for maternal, newborn and child health. 2) To establish collaboration with community health workers
and volunteers to follow-up high-risk mothers.

Methods: Data from the OHR ward of hospital “A” was collected retrospectively to analyze maternal
mortality causes and indications for high-risk maternity admission. OHR Booklet contents were developed
by midwives in charge of the ward and content assessment is to be conducted during follow-up.

Results: There were 2200 admissions to the OHR ward in 2022. Indications for admission: hyperemesis
gravidarum, urinary infection, dengue fever, hypertension, obstetric hemorrhage, diabetes, preterm
labor, etc.

Poster Presentation Abstracts
Selected topics were included in the booklet using plain language and illustrations. Warning signs
during pregnancy and postpartum were included, with emphasis on how to behave in case they
occur and simulate the situation with midwives and other health providers. Self-care by condition and
a page for mother’s experiences and questions is included to promote involvement.

Conclusion: Handheld material education informs mothers during admission and is taken home after
discharge to ensure the continuum of maternal care.

Keywords: handheld educational material, high-risk mothers, maternal mortality, pregnancy,
puerperium, warning signs

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Correspondence: Lourdes Herrera Cadillo, Faculty of Health Sciences, Department of Nursing, Asahi
University, Japan
E-mail: herrera@alice.asahi-u.ac.jp

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