Journal article
Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide
S Miller, E Abalos, M Chamillard, A Ciapponi, D Colaci, D Comandé, V Diaz, S Geller, C Hanson, A Langer, V Manuelli, K Millar, I Morhason-Bello, CP Castro, VN Pileggi, N Robinson, M Skaer, JP Souza, JP Vogel, F Althabe
Lancet | ELSEVIER SCIENCE INC | Published : 2016
Abstract
On the continuum of maternal health care, two extreme situations exist: too little, too late (TLTL) and too much, too soon (TMTS). TLTL describes care with inadequate resources, below evidence-based standards, or care withheld or unavailable until too late to help. TLTL is an underlying problem associated with high maternal mortality and morbidity. TMTS describes the routine over-medicalisation of normal pregnancy and birth. TMTS includes unnecessary use of non-evidence-based interventions, as well as use of interventions that can be life saving when used appropriately, but harmful when applied routinely or overused. As facility births increase, so does the recognition that TMTS causes harm ..
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Awarded by National Institute of Child Health and Human Development
Funding Acknowledgements
The Bill & Melinda Gates Foundation and The John D and Catherine T MacArthur Foundation partially supported this work. Their individual institutions supported each of the authors. We would like to thank Lenka Benova, Clara Calvert, and Kerry Wong of the London School of Hygiene & Tropical Medicine for access to data, Ruwani Ekanayake for assistance on preparation of the tables, Julia Ofman of the Harvard School of Public Health for assistance with the review of abstracts for coverage data, Ingvild Odsbu of the Karolinska Institutet for assistance with translation of guidelines, and the Matemal Health Task Force at the Harvard School of Public Health.