Maternal and Neonatal Health Technical Update No.2: Overcoming Operational Policy Barriers to Essential Safe Motherhood Services POLICY (June 2006)  Full Document (English)     The term ?safe motherhood? refers to efforts to prevent maternal and infant death and disability through improved access to healthcare and other supportive services (White Ribbon Alliance, 2005). Sadly, women in the developing world experience a 1 in 61 lifetime risk of dying from pregnancy- or childbirth-related complications (World Health Organization, 2003). This is compared to a 1 in 2,800 lifetime risk for their counterparts in developed countries. Common causes of maternal and neonatal mortality and morbidity are excessive bleeding, obstructed labor, infections, and hypertensive disorders. They can occur suddenly, often with little warning. However, negative outcomes can be greatly reduced with proper nutrition throughout the pregnancy, skilled assistance at delivery, and access to regular antenatal checkups, emergency obstetric care, and postpartum care. Effective operational policies are essential for ensuring access to maternal health services, especially for underserved and hard-to-reach populations. Operational policies are the rules, regulations, codes, guidelines, and administrative norms that governments and organizations use to translate laws, policies, and resources into programs and services on the ground (Cross et al., 2001). These policies and guidelines affect all aspects of service quality and accessibility. Examples of operational barriers include unreliable supplies of medicines, unnecessary restrictions on the types of services that can be performed by various healthcare providers, high user fees for services, and inconsistent resource allocation and staffing plans that neglect rural health facilities.