Global leaders have laid out road maps for ending all preventable deaths of women, children, and adolescents within a generation. Achieving these ambitious targets requires intentional efforts to minimize and equities and access and quality of care around the time of birth. Including increased focus on care for mothers and babies in humanitarian settings where risks are exacerbated and availability of services may be lower. Globally, nearly half of all maternal and newborn deaths take place on the day of birth. The majority of maternal and newborn deaths can be prevented by ensuring that mothers and babies receive timely, high-quality care during pregnancy, childbirth, and the immediate postpartum period. High burdens of maternal and perinatal mortality exist in some settings, because not all women are able to access quality care. Although there is some variation from place to place, the main causes of maternal and newborn complications and the life-saving interventions needed to address them are well known. Maternal deaths occur when women do not receive adequate care to address severe bleeding, high blood pressure, infections, and other complications. Stillbirths and newborn deaths occur due to prematurity, complications during labor and delivery, and infection. Although there are often many urgent needs to be addressed in humanitarian settings and pregnant women or newborns may make up a relatively small portion of the population, needs for health services during pregnancy, childbirth, and the first month of life do not see stirring humanitarian crises. Given the exacerbated risks of complications ensuring a continuum of care throughout pregnancy, childbirth, and postpartum is even more essential. On the next few slides, we will look in more detail at the most essential services needed during each of these periods. During pregnancy, antenatal care is important for every pregnant woman. The World Health Organization recommends frequent visits with a health worker during pregnancy to help women and their families prepare for childbirth, ensure women receive critical vaccinations to protect themselves and their newborns, and tests to detect complications. The World Health Organization recommends at least eight contacts with a health worker during pregnancy. Some can be with a community health worker, but others should be at a health facility with staff able to provide these key services. Intrapartum care or care on the day of birth is critical because this is when risks are highest for both mothers and newborns. Skilled health personnel, which may include doctors, nurses, and midwives in a health facility with adequate resources and conditions, can provide basic care to mitigate the risk of complications. This includes monitoring women when they are in labor, providing a clean place for delivery to prevent infection, administering drugs to prevent bleeding after birth, and ensuring that babies are properly dried, kept warm and fed. Even when this essential care is provided, some women and newborns may experience complications that require lifesaving medications or procedures. Most of these procedures, such as administering drugs to manage hypertension and bleeding after birth, or initial stimulation and resuscitation of baby's not breathing can be performed at a basic clinic with trained staff and supplies. A smaller proportion of cases may need surgery, blood transfusions, or other special care typically available at hospitals. Not all complications happen during childbirth, some happen afterwards. These can include bleeding after birth, hypertension, and infections. It's important for women to be aware of warning signs and receive immediate care when needed. Some may also have injuries from childbirth that need care or have trouble feeding their newborns and need support. The first week of life is a particularly vulnerable period. Key care practices protect newborns from possible illness and certain danger signs indicate the need for immediate care. Small and sick babies may need care that can only be provided at a health center or hospital. Think about your own community. What options are available to pregnant women? The graphics on this slide show a typical range of settings where women may give birth from their home, or a relative's home to a health center with basic capacities, or hospital with capacity to care for small and sick newborns. Some may also give birth in transit or elsewhere. In any setting where a woman gives birth and who attends childbirth are key determinants of the level of care she will receive. Whenever I'm making recommendations on how to improve health services in a crisis affected setting, I try to understand the situation from a client's perspective. These are some of the questions a pregnant woman might have to consider. What are my options? It's the health facility open 24 hours a day. How accessible is it? Is it affordable? What are the conditions there? What type of health worker will care for me? Where did they train? How much experience do they have? Will they be kind? How long will I need to stay? What if something goes wrong? What will my family say? Imagine how different the answers to these questions might be immediately after an earthquake or a cyclone where roads and infrastructure are destroyed. Or in a rural area where armed conflict has devastated the economy and there are fuel shortages, power cuts, and stock outs of market goods on a regular basis. [MUSIC]