Every Newborn: the professional organisations' perspective.

The International Federation of Gynecology and Obstetrics, the International Confederation of Midwives, the International Pediatric Association, and the Council of International Neonatal Nurses recognise and support the Every Newborn Action Plan, which is situated in the continuum of care for reproductive, maternal, newborn, and child health. The Every Newborn Action Plan calls for acceleration in action at country, regional, and local levels to accelerate reduction in stillbirth, and in neonatal and maternal mortality rates. Although some progress has been made since the Lancet Series on neonatal survival was published a decade ago, neonatal deaths have fallen at a slower rate than expected, stillbirths at an even slower rate, and, although maternal mortality has also declined, the relevant Millennium Development Goals for 2015 will not be achieved. Every year, 40 million mothers still give birth without any help from a midwife or another health worker trained and equipped to save the life of the baby or mother. Many babies die every year because mothers do not get the good quality care they need during labour and birth. Obstetricians and midwives are at the forefront of caring for the pregnant woman and newborn baby during the antenatal, intranatal, and postnatal periods. Often the midwife is the sole health-care professional responsible for both mother and baby. The causes of stillbirths and newborn and maternal deaths are closely related, and the solutions are known. Ensuring that essential care is provided around labour, delivery, and immediately afterwards is critical to ending newborn deaths. Available, skilled, well equipped birth attendants to assist women and newborn babies during labour and birth are vital to their survival. Additionally, because 85% of neonatal deaths relate to preterm complications, birth asphyxia, and infection, paediatricians, neonatologists, and neonatal nurses are essential to the care of preterm and ill newborn babies. There is a shortage of all health-care professionals, which is an issue that must be addressed; but most signifi cantly, because nurses and midwives are the most numerous health-care providers in many countries and are at the frontline of providing care, it is nurses and midwives with additional training in neonatal care that are needed to ensure that greater than 75% of all infants not breathing after birth receive bag and mask resuscitation, that all preterm or low birthweight (or both) infants receive kangaroo mother care, and that all newborn babies with possible infection receive appropriate antibiotic therapy within a short time after birth. Basic neonatal resuscitation and care in the so-called golden minute after birth reduces neonatal mortality in developing countries and is estimated to reduce full-term infant deaths by up to 30%. In countries challenged by social, economic, humanitarian, and health complexities, provision of interventions to every mother and newborn baby to improve survival will not be without diffi culty. However, the international professional organisations of obstetricians and gynaecologists, midwives, paediatricians, neonatologists, and neonatal nurses working together are able to promote a high standard of maternal and newborn care and requisite education and training; strengthen input into health plans and policy development; and foster international liaisons. Our organisations are pleased that The Lancet has published the Every Newborn Series, to bring attention to actions that are needed to accelerate progress towards Millennium Development Goals 4 and 5. The papers in this Series emphasise the important links between the various professional organisations to achieve the objectives of the Every Newborn Action Plan. The lifecourse approach is emphasised, highlighting the continuum of care needed from woman to newborn baby to childhood; the need for workforce planning and task Published Online May 20, 2014 http://dx.doi.org/10.1016/ S0140-6736(14)60692-9