Maternal and Child Health

Women’s health refers to their health during pregnancy, childbirth, and the postnatal period.

Women and their babies should have a positive experience at each stage, so they can reach their full potential for health and well-being.

MCH programs address issues concerning women, children and families, such as access to recommended prenatal and well-child care, maternal and infant mortality prevention, newborn screenings, child immunizations, child nutrition, and services for children with special health care needs. 

To strengthen communities and avoid unnecessary health care costs, states invest in healthy children and families.

Maternal and Child Health (MCH) supports programs to increase the availability of and access to high quality preventive and primary health care for all children, as well as reproductive health care for all women and their partners, regardless of their financial status.


Why Are Maternal, Infant, and Child Health Important?

In the United States, improving the health of mothers, infants, and children is an important public health goal. 

A child’s well-being determines the health of the next generation and predicts future health challenges for families, communities, and the health care system. 

Maternal, Infant, and Child Health aims to address a wide range of conditions, health behaviors, and health systems indicators that affect the health, wellness, and quality of life of women, children, and families.

Access to quality preconception (before pregnancy), prenatal (during pregnancy), and interconception (between pregnancy) care can reduce the risk of maternal and infant mortality and pregnancy-related complications. 

In addition, identifying and treating developmental delays and disabilities during infancy can help prevent death or disability as well as enable children to reach their full potential.

Understanding Maternal, Infant, and Child Health

The health, nutrition, and behaviors of mothers during pregnancy and early childhood may influence the cognitive and physical development of infants and children. 

Taking recommended amounts of folic acid before and during pregnancy can reduce the risk of neural tube defects. 

Infants receive the most complete nutrition from breast milk, which is associated with a range of benefits for their health, growth, immunity, and development. 

A child raised in a safe and nurturing home, free of maltreatment and other adverse childhood experiences, is more likely to succeed as an adult.

Diseases and Disorders That Affect Maternal And Child Health


Toxoplasmosis is caused by a parasite that may be present in cat feces or undercooked meat. 

Toxoplasmosis rarely causes symptoms more severe than the flu in adults, but pregnant women who are infected during or right before pregnancy can pass the infection on to their unborn child. 

Eye infections, enlarged livers, enlarged spleens, jaundice, and pneumonia are common in these newborns.

A few die shortly after birth. 

Survivors may have intellectual disabilities, severe impairments in their eyesight, cerebral palsy, seizures, and other problems.


Rubella, also known as German measles, has nearly been eradicated in the industrial world thanks to the vaccine developed in 1969. 

Nonetheless, it is important to know the risks of contracting rubella during pregnancy. 

Despite only causing discomfort for a week or so in the mother, the effects on the unborn child can be severe. 

Congenital rubella infection can cause birth defects such as cataracts, glaucoma, and blindness; deafness; congenital heart defects; and mental retardation. 

These conditions are collectively known as congenital rubella syndrome (CRS).


Typically, the Cytomegalovirus (CMV) lies dormant in the body after exposure, but can cause serious health problems for people with weakened immune systems or unborn babies. 

CMV infection before birth increases the risk of several birth defects, such as microcephaly (small head size), hepatomegaly (enlarged liver), jaundice (yellow skin and eyes), anemia (low blood count), pneumonia, seizures, vision loss, and hearing loss, among others. 

Children born without any of these defects can still suffer partial hearing loss, vision impairment, and other developmental and learning problems later in life.

Autism Spectrum Disorder (ASD)

Autism spectrum disorder (ASD) is a developmental disability that causes significant social, communication, and behavioral difficulties.

Even if someone does not necessarily have autism, they can be what is known as “on the spectrum”. 

This means that they can have behaviors that are similar to those that have autism.

Hepatitis A

The hepatitis A virus (HAV) causes hepatitis A, a liver disease. 

Anyone can contract hepatitis A. 

A vaccine is available for long-term protection against HAV infection in persons 1 year of age and older. 

The prevention of hepatitis A can also be achieved by maintaining good personal hygiene and proper sanitation.

Pertussis (Whooping Cough)

Pertussis, a respiratory illness that is also known as whooping cough, is caused by a type of bacteria called Bordetella pertussis. 

Bacteria adhere to the cilia (tiny hairlike extensions) in the upper respiratory tract. 

By releasing toxins (poisons), the bacteria cause swelling in the cilia and airways.

Pertussis is only found in humans and is very contagious. It can be spread from one person to another. 

Usually, pertussis is spread to another person by coughing or sneezing or by spending a lot of time near one another where you share breathing space. 

Children who get pertussis are often infected by their older siblings, parents, or caregivers, who might not even know they have the disease.

Infected people are most contagious for the first 2 weeks after they develop the cough. 

Some antibiotics can shorten a person’s contagious period.

In spite of the fact that pertussis vaccines are the most effective tool to prevent this disease, no vaccine is 100% effective. 

In a community where pertussis is prevalent, a fully vaccinated person of any age can contract this disease. 

If you have received the pertussis vaccine but become ill, the infection generally is not as bad as it would be without it.

Early Symptoms

Cold-like symptoms and a mild cough are usually the first signs of the disease. 

In babies, the cough may not even be present. 

Babies may suffer from a symptom known as “apnea”. 

Apnea occurs when a child’s breathing pattern pauses. 

The most dangerous form of pertussis is in babies. 

Approximately half of babies younger than 1 year with the disease require hospitalization. 

Symptoms can last for one to two weeks, and usually include:

  • Apnea – a pause in breathing (in babies)
  • Low-grade fever (generally minimal throughout the course of the disease)
  • Mild, occasional cough
  • Runny nose

Early on, pertussis appears to be nothing more than a common cold. 

Consequently, healthcare professionals often don’t notice or diagnose it until it manifests more severe symptoms.

Later-Stage Symptoms

Symptoms of pertussis typically appear after 1 to 2 weeks and include:

  • Exhaustion (very tired) after coughing fits
  • Paroxysms (fits) of many, rapid coughs followed by a high-pitched “whoop” sound
  • Vomiting (throwing up) during or after coughing fits

Pertussis can cause rapid, violent coughing that lasts until the air leaves your lungs. 

A loud “whooping” sound occurs when there is no more air in the lungs. 

Excessive coughing may result in vomiting and exhaustion. 

Despite often being exhausted after a coughing fit, you usually appear relatively healthy in between.

As an illness continues, coughing fits can become more frequent and more severe, and can occur more often at night. 

Coughing fits can last up to 10 weeks.

If your disease is milder (less serious), then you may not experience the “whoop.”. 

Pertussis in teens and adults is generally milder, especially in those who have been vaccinated.

Pertussis in Babies

It is extremely important to note that pertussis does not always cause babies to cough. 

Instead, they turn blue and stop breathing.


If you get rotavirus particles in your mouth, you can become infected with it.

This can happen if you

  • eat contaminated food
  • put unwashed, contaminated hands in your mouth
  • put your fingers in your mouth after touching contaminated objects or surfaces

A person infected with rotavirus sheds the virus in their stool (poop). 

This is how the virus enters the environment and spreads to other people. 

During illness and the first three days following recovery, people shed the most rotavirus, and are more likely to spread it to others. 

Rotavirus can also be spread before an individual has symptoms.

Rotavirus is easily spread among infants and young children.

Family members and others with whom they have close contact are at risk of contracting the rotavirus. 

Rotavirus is most likely to infect children in the winter and spring (January through June).

The importance of good hygiene such as hand washing and cleanliness cannot prevent the spread of disease. 

Vaccination against rotavirus is the best way to protect your child.

Watery diarrhea, vomiting, fever, and abdominal pain are the most common symptoms of rotavirus.

Rotavirus usually causes symptoms two days after exposure. 

You may experience diarrhea and vomiting for three to eight days. 

Additionally, infants and young children may suffer from loss of appetite and dehydration (loss of body fluids), which can be dangerous.

Dehydration can cause the following symptoms:

  • crying with few or no tears
  • decreased urination
  • dry mouth and throat
  • feeling dizzy when standing up
  • unusual sleepiness or fussiness

Spina Bifida

Spina bifida affects the spine and is usually evident at birth. The defect is a common neural tube defect (NTD).

Spina bifida can occur anywhere along the spine if the neural tube does not close completely. 

Whenever the neural tube doesn’t close all the way, the backbone that protects the spinal cord doesn’t form and close properly. 

Nerves and the spinal cord are often injured as a result.

Spina bifida can lead to mild to severe physical and intellectual disabilities. 

The severity depends on the following factors:

  • The size and location of the opening in the spine.
  • Whether part of the spinal cord and nerves are affected.

There are three main types of spina bifida:


Most often, when people mention spina bifida, they are referring to myelomeningocele. 

Myelomeningocele is the most severe form of spina bifida. 

A sac of fluid comes out of the baby’s back because of this condition. 

Located in this sac are a portion of the spinal cord and nerves that are damaged. 

A person with this type of spina bifida may have moderate to severe disabilities, including problems going to the bathroom, losing feeling in their legs or feet, and not being able to move their legs.


Meningocele is another type of spina bifida. 

Meningocele is characterized by a sac of fluid coming out of the baby’s back. 

This sac does not contain the spinal cord. 

In most cases, there is little or no nerve damage. 

Spina bifida of this type can cause minor disabilities.

Spina Bifida Occulta

Spina bifida occulta is the mildest form of the condition. 

Sometimes it is referred to as “hidden” spina bifida. 

The spine has a small opening, but there is no back opening or sac with it. 

The spinal cord and the nerves are normally intact. 

Spina bifida occulta is often not discovered until late childhood or adulthood. 

Normally, this type of spina bifida does not cause any disabilities.

Group B Strep

There are bacteria known as group B Streptococcus (group B strep, GBS) that commonly reside in people’s gastrointestinal and genital tracts. 

The gastrointestinal tract is the part of the body that digests food, including the stomach and intestines. 

In women, the genital tract includes the vagina, which is involved in reproduction. 

Most of the time, bacteria are not harmful and do not cause symptoms or make people ill. 

The bacteria can sometimes invade the body and cause an infection known as GBS disease.

GBS bacteria can cause many types of infections:

  • Skin and soft-tissue infections
  • Pneumonia (lung infection)
  • Meningitis (infection of the tissue covering the brain and spinal cord)
  • Bone and joint infections
  • Bacteremia (bloodstream infection) and sepsis (the body’s extreme response to an infection)

In newborns, GBS most commonly causes bacteremia, sepsis, pneumonia, and meningitis. 

It is very rare for GBS to cause meningitis in adults.

Down Syndrome

A person with Down syndrome has an extra chromosome. In the body, chromosomes are small “packages” of genes. They determine how a baby’s body develops and functions during pregnancy and after birth. In general, babies are born with 46 chromosomes. Down syndrome babies carry an extra copy of one of the chromosomes, chromosome 21. 

The medical term for having an extra copy of a chromosome is trisomy. Down syndrome is also referred to as trisomy 21. Having an extra copy of the baby’s DNA changes how the baby’s body and brain develop, which can cause mental and physical challenges. Although people with Down syndrome might look and act alike, each person has different abilities. Typically, people with Down syndrome have an IQ (a measure of intelligence) in the mildly to moderately low range, and they speak more slowly than other children.

Down syndrome is characterized by the following physical characteristics:

  • A flattened face, especially the bridge of the nose
  • A short neck
  • A single line across the palm of the hand (palmar crease)
  • A tongue that tends to stick out of the mouth
  • Almond-shaped eyes that slant up
  • Poor muscle tone or loose joints
  • Shorter in height as children and adults
  • Small ears
  • Small hands and feet
  • Small pinky fingers that sometimes curve toward the thumb
  • Tiny white spots on the iris (colored part) of the eye

In the United States, Down syndrome remains the most prevalent chromosomal disorder. 
About 6,000 babies born in the United States each year have Down syndrome. That means that about one in every 700 babies has Down syndrome. Down syndrome comes in three types.  Physical features and behaviors of each type are similar enough that people cannot tell the difference without looking at the chromosomes.

Trisomy 21

Ninety-five percent of people with Down syndrome have Trisomy 21. 

In this type of Down syndrome, each cell in the body contains three copies of chromosome 21 instead of two.

Translocation Down Syndrome

There are only a few people with this type of Down syndrome (about 3%). 

There is an extra part of or whole chromosome 21 that is present, but it is attached, or “trans-located”, to a different chromosome rather than being a separate chromosome 21.

Mosaic Down Syndrome

Mosaic refers to a mixture or combination and affects about 2% of the Down syndrome population. 

Children with mosaic Down syndrome have some cells with three copies of chromosome 21, but other cells have two copies. 

Children with mosaic Down syndrome may have the same characteristics as other children with Down syndrome. 

There may be fewer symptoms of the condition due to the presence of some (or many) cells with a typical number of chromosomes.

Fetal Alcohol Syndrome Disorders (FASDs)

FASDs are a group of disorders that can occur in a person who is exposed to alcohol before birth. 

They can cause physical problems, behavioral problems, and learning problems. 

FASD patients often have a combination of these problems.

Cause and Prevention

When a person is exposed to alcohol before birth, he or she may develop FASDs. 

Alcohol in the mother’s blood is passed to the baby through the umbilical cord.

While pregnant or trying to become pregnant, alcohol is not considered safe in any amount. 

There is also no safe time to consume alcohol during pregnancy. 

During pregnancy, including before a woman is aware that she is pregnant, alcohol can cause problems for a developing baby. 

Wine and beer are both equally hazardous to a developing baby.

If a woman is pregnant or might be pregnant, she should avoid alcohol to prevent FASDs. 

Women might not know they are pregnant for up to six weeks after getting pregnant.

During pregnancy, it is never too late to stop drinking. 

Since brain development occurs throughout pregnancy, stopping alcohol use will improve the baby’s health and well-being. 

If a baby is not exposed to alcohol before birth, FASDs can be prevented.

Signs and Symptoms

FASDs are a collection of diagnoses that represent the range of effects that can occur in those who were exposed to alcohol before birth. 

Different people are affected by these conditions in different ways, and they can range from mild to severe.

FASD may be characterized by:

  • Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum)
  • Difficulty in school (especially with math)
  • Difficulty with attention
  • Hyperactive behavior
  • Intellectual disability or low IQ
  • Learning disabilities
  • Low body weight
  • Poor coordination
  • Poor memory
  • Poor reasoning and judgment skills
  • Problems with the heart, kidneys, or bones
  • Shorter-than-average height
  • Sleep and sucking problems as a baby
  • Small head size
  • Speech and language delays
  • Vision or hearing problems

FASD Diagnoses

FASD diagnoses are based on specific symptoms and include:

Fetal Alcohol Syndrome (FAS)

FASD represents the most complicated end of the spectrum. 

A person with FAS has problems with the central nervous system (CNS), minor facial features, and growth problems. 

A person with FAS may have difficulties learning, remembering, concentrating, communicating, seeing, or hearing. 

Some people have problems with more than one of these. 

FAS is often associated with difficulty getting along with others and having difficulty in school.

Alcohol-Related Neurodevelopmental Disorder (ARND)

ARND may cause intellectual disabilities and behavior and learning problems for some individuals. 

They might struggle in school and have problems with math, memory, attention, judgment, and impulse control.

Alcohol-Related Birth Defects (ARBD)

With ARBD, people might have problems with their hearts, kidneys, bones, or hearing. 

There could be a combination of these problems.

Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure (ND-PAE)

When a child or youth has ND-PAE, he or she will experience three types of problems:

  1. Problems with planning and memory, where the child might forget material he or she has already learned,
  2. Behavior problems such as tantrums, mood problems (for example, irritability), difficulty shifting attention from one task to another, and
  3. Day-to-day living difficulties, such as problems bathing, dressing for the weather, and playing with other children.

ND-PAE cannot also be diagnosed unless the mother of the child consumed more than minimal levels of alcohol before the child’s birth, which APA defines as drinking more than 13 alcoholic drinks per month of pregnancy (that is, for every 30-day period of pregnancy) or drinking more than 2 alcoholic drinks in one sitting.

Cerebral Palsy

A person with cerebral palsy (CP) has problems moving, maintaining balance and posture. 

CP is the most common motor disability among children. 

The term “cerebral” refers to brain-related disorders. 

A palsy refers to weakness or difficulty using the muscles. 

The condition is caused by abnormal brain development or damage to the developing brain that affects a person’s ability to control their muscles.

Individuals with CP experience different symptoms. 

A person with severe cerebral palsy might need special equipment to walk or might not even be able to walk at all and require lifelong care. 

In contrast, a person with mild CP may walk a little awkwardly, but may not need any special assistance. 

Though the exact symptoms of CP can change over a person’s lifetime, the condition does not get worse.

People with CP have problems with movement and posture. 

Many also have other conditions, such as changes in the spine (such as scoliosis); intellectual disability; joint problems (such as contractures); problems with vision, hearing, or speech; or seizures;

Types of Cerebral Palsy

Doctors classify CP in accordance with the main movement disorder involved. One or more of the following movement disorders can occur depending on which parts of the brain are affected:

  • Poor balance and coordination (ataxia)
  • Stiff muscles (spasticity)
  • Uncontrollable movements (dyskinesia)

CP can be classified into four types:

Spastic Cerebral Palsy

Spastic CP is the most common type of CP. Approximately 80% of those with CP suffer from this condition. Spastic CP patients have increased muscle tone. In other words, their muscles are stiff, which makes their movements difficult. In most cases, spastic CP can be described by which parts of the body are affected:

  • Spastic diplegia/diparesis
    • Muscle stiffness in this type of CP is mainly found in the legs, whereas the arms are less affected or not affected at all.
    • Those with spastic diplegia have difficulty walking because their legs pull together, turn inward, and cross at the knees (also known as scissoring).
  • Spastic hemiplegia/hemiparesis
    • People with this type of CP have only one side of their body affected. 
    • Usually, the arm is more affected than the leg.
  • Spastic quadriplegia/quadriparesis
    • Spastic quadriplegia is the most severe form of spastic CP, affecting all four limbs, the trunk, and the face.
    • A person with spastic quadriparesis usually cannot walk and often has other developmental disabilities, such as intellectual disability; seizures; or problems with vision, hearing, or speech.
Dyskinetic Cerebral Palsy

As a result of dyskinetic CP, people have difficulty controlling their hands, arms, feet, and legs, making it difficult to sit and walk. 

Movements can be rapid and jerky or slow and writhing. 

In some cases, the face and tongue are affected, and the affected person has difficulty sucking, swallowing, and talking. 

A person with dyskinetic CP has muscle tone that changes (from too tight to too loose) not only from day to day, but even within a single day.

Ataxic Cerebral Palsy

Ataxic CP patients experience balance and coordination problems. 

Their walking may be unsteady. 

It might be difficult for them to make quick movements or movements that require a lot of control, like writing. 

When they reach for something, they might have difficulty controlling their hands and arms.

Mixed Cerebral Palsy

Symptoms of more than one type of CP can be present in some people. 

The most common form of mixed CP is spastic-dyskinetic CP.

Maternal and Child Health Frequently Asked Questions

Prenatal care (ANC), delivery care (DE) and postnatal care (PNC) are maternal health services that ensure the health of women during pregnancy, childbirth, and the postpartum period.

Women, children, and families are the focus of maternal and child health (MCH) programs, including prenatal and well-child care, infant and maternal mortality prevention, maternal and child mental health, newborn screening, child immunizations, and child nutrition.

A brain injury or abnormal brain development causes cerebral palsy. 

It usually occurs before a child is born, but it can also occur during early infancy.

On average, children with cerebral palsy can expect to live between 30 and 70 years. 

The people with the longest life expectancy usually have better mobility, better medical care, and adaptive equipment, as well as greater autonomy and independence. 

Cerebral palsy cannot be cured, and it is a lifelong condition.

An individual with Down syndrome lives an average of 60 years today. 

In 1983, most people with Down syndrome lived to the age of 25.

Almost 95 percent of the time, Down syndrome is caused by trisomy 21 – the person has three copies of chromosome 21 instead of two, in all cells. 

An abnormal cell division occurs during the development of either the sperm cell or the egg cell.

Alcohol consumption during pregnancy can lead to FASDs. 

It is possible for alcohol to pass from a mother’s blood to a baby through the placenta, just like other drugs. 

Alcohol is broken down more slowly in babies than in adults.

Fetal alcohol syndrome (FAS) occurs when a pregnant woman drinks alcohol during pregnancy. 

The term syndrome refers to a group of symptoms arising from a particular disease or abnormal condition.

The basic characteristics of FAS have remained essentially the same since it was first described in 1973: selected facial malformations, growth retardation, abnormalities of the Central Nervous System (CNS), and maternal alcohol consumption during pregnancy.