Nothing can cause greater fear of a mother than the prospect of her unborn child being defective. Pragmatically, there are some external and internal influences that can have serious and debilitating effects on the life of the unborn human beings. The unborn child, although seem to live in a protected, comfortable environment is not totally immune to the larger world surrounding the mother. The environment can affect the child in many well-documented ways. There are a lot of babies that born defective are the results of events that occur in the mother's life and such events are classified as teratogens.
Birth defects are known to occur in 3-5 percent of all newborns. They are the leading cause of infant mortality in the United States, accounting for more than 20 percent of all infant deaths. Seven to ten percent of all children will require extensive medical care to diagnose or treat a birth effect. Although significant progress has been made in identifying etiologic causes of some birth defects, approximately 65 percent have no known or identifiable cause. It was previously believed that the mammalian embryo developed in the impervious uterus of the mother, protected from all extrinsic factors. However, after the thalidomide disaster of the 1960's, it became apparent and more accepted that the developing embryo could be highly vulnerable to certain environmental agents that have negligible or non-toxic effects to adult individuals. (Wikipedia, 2011)
Women of childbearing age with chronic medical conditions are often concerned about hazards from drug exposure during pregnancy and lactation. The number of mothers who take drugs during pregnancy is not known, but a U.S. survey showed that about 45 percent of women may use at least one drug on prescription, and many more use drugs bought over the counter. A British prospective study suggested that only 10 percent of women take drugs in early pregnancy. The avoidance of any medication after conception may often be unwise for maternal well-being. Proper prescribing of drugs in pregnancy is a challenge and should provide maximal safety to the fetus as well as therapeutic benefit to the mother. Double-blind, randomized, prospective drug trials are generally impossible to perform during pregnancy. Certain medical disorders occur infrequently at any one medical centre or cannot be studied during pregnancy for ethical or regulatory reasons. (Citrin & Koren, 2011)
A high number of children are being born with birth defects in an Iraqi city where U.S. forces may have used chemical weapons during a fierce battle in 2004. Children in Fallujah are being born with limb, head, heart and nervous system defects. There is even a claim that a baby was born with three heads. The number of heart defects among newborn babies is said to be 13 times higher than the rate in Europe. (http://www.disinfo.com, 2011)
China has a high incidence of birth defects. About 800,000 to 1.2 million children are born with congenital malformations every year, which accounts for around 5 percent of the total births. In the US in 2009, the comparable figure was 0.68 percent. Both genetic and environmental factors trigger congenital disorders, and nutritional deficiency and a weak sense of self-protection make rural ares more vulnerable, say experts of maternity and child health. In addition to poor nutrition intake, women at childbearing age in the countryside are less familiar with health knowledge, including prescribed medication, and keeping away from radiation exposure and environment pollution," said Zhu Jun, director of the national maternal and Child Health Surveillance Office. (english.eastday.com, 2011)
Congenital anomalies continue to be in the top 10 causes of infant mortality in the Philippines for the past 50 years. All newborns with single of multiple birth defects are all put under this category. Until the present times, there are no clear details on the types of birth defects and the causes are generally unknown. To address this need, the Philippine Birth Defects Surveillance Study Group was establish in 2008. The study group is spearheading the establishment of a surveillance program for newborns with birth defects in every hospital in the country. The group started with 32 participating facilities and has expanded to another 42 facilities and has expanded to another 42 facilities last January 2009. Another 64 facilities are targeted to be included in the study group by the year 2010. the Philippine Birth Defects Surveillance Project is envisioned to cover all babies born in health facilities and at home. The project is a collaboration of the IHG-NIH-UP and the National Center for Disease Prevention and Control of the Department of Health. It is partly supported fby the MArch of Dimes Foundation, USA. (Mossey & Castilla, 2012)
National and community based on the causes of birth defects in the Philippines are not available. A Philippine Birth Defects Surveillance Group has been established just last 2008 and conduct their surveillance only in hospitals. But more pregnant women especially in rural areas, like the area which the researcher conduct this study, deliver their babies in a Barangay Health Station or Rural Health Unit under the care of a midwifes. And no data has been collected for the occurrence and causes of birth defects.
The researcher observed that health care member especially the midwives who provide obstetrical care in rural areas may not discuss everything to pregnant women about all the risk during pregnancy. A complete health history taking on pregnant women is not also done by the midwives during prenatal check up which could be an essential basis in knowing the possible risk during her pregnancy. History taking may include their unhealthy lifestyle like smoking of or drinking alcohol, existing diseases which includes the medications used, and the hazards in their home or workplace, etc. And it has also been observed that most of the pregnant women in rural area receive delayed or no prenatal care. And there are still pregnant women who take medications without doctors' approval, drink and smokes.
Moreover, she observed that children in the area of study who are born with physical abnormalities or mentally retarded. But data's were not collected like maternal history to trace the cause of the abnormalities of these children. for low birth weight infants for example, there is no data on the outcomes of low birth weight infants exist.
The researcher being a nurse advocating for the welfare of mother and child, aims to impart sufficient health teaching to women, to ensure that they gain enough knowledge on teratogens. Advising women about their teratogenic risk early in pregnancy may prevent unjustified termination of many pregnancies and may help to inform women exposed to proven teratogens about the known risk.
With the primary aims of assessing the awareness level of pregnant mother on teratogenic agents and their degree of exposure, this can be a basis for health teaching plan that may help to inform women exposed to teratogens about the known risk this study was conducted.