Prevention is better than Cure

 Prevention is better than cure, this is the constitution of the primary goal of health promotion programs, and health promotion activities targeted pregnant women in the prenatal periods because of its great importance of the mother and the child's life, as there is in this period, a lot of unwanted behaviors, which can be described as unhealthy where influence on maternal and fetal health that may extend its influence to the years after the birth (Bangal et al 2011). So health promotion aims to increase awareness of pregnant women the risk of these behaviors and educate women about some styles and health behaviors that target public health and well-being of the pregnant women and fetus. The health promotion activities is the best solution to the problem of increased morbidity and mortality in pregnant women and babies in the world, which has proven many studies that the main reason which is to follow the pregnant women to patterns of unhealthy behavior, and increase women's awareness of the risks of these behaviors will reduce morbidity and mortality rates among pregnant women and infants (Fatemeh et al 2010). The current assignment discusses prevalence of morbidity and mortality among pregnant women, especially in Saudi Arabia, and the role of health promotion in reducing these rates, and the role of nurses in providing prenatal care to reduce morbidity and mortality of pregnant women and infant mortality rates.

According to McNeill et al (2012) health promotion can be defined as one of the roles of nursing care, which aims at increasing the awareness of a specific category of the community to increase awareness and educate them to reduce diseases and help them to change behaviors that affect health and a healthy lifestyle contributes to improving the quality of life and well-being. Ladewig (2010) defined pregnancy as a period of formation of the fetus, which begins on the day following menopause and lasts for nine months as a natural pregnancy and women differ in this period from 32 to 36 weeks.

Pregnant women's health is directly linked with health of the fetus, especially in the formation of the child and is free of diseases that affect his life. Statistics indicate that the birth defects are one of the three main causes of infant mortality, which represents 12.7% of early neonatal death, due indirectly to a lack of health promotion and awareness of women and families of reasons congenital malformations both practices and unhealthy behaviors or genetic reasons (Olusanya and Solanke 2012). Abalos et al study (2015) also emphasizes that to be 70-80% of all deaths among newborns as a result of premature birth, which is due to the reasons, practices and patterns of unhealthy life during pregnancy. Also, infants born to women with diabetes are at higher risk of mortality in the postpartum period. As for the deaths of pregnant women and mothers in the postpartum period has varied in many statistics and research results. According to WHO, and the United Nations Children's Fund, about 529,000 women die each year due to complications of pregnancy and childbirth. A recent study confirms that 16.1% of maternal deaths are due to problems in pregnancy and childbirth period, especially in developing countries (Patel et al 2013). The World Bank report has pointed out in 2014 that the mortality rate in Saudi Arabia is 300/100 thousand residents, and was among the top causes of deaths decrease birth weight, congenital malformations, and came maternal deaths in an advanced position, reaching deaths of women (3882), which is often attributed to a healthy problems and wrong practices during pregnancy and childbirth, and the women at this stage not receiving adequately health promotion activities; and in spite of efforts to improve health, but that maternal mortality refers to the 16 / 100,000 in childbirth and pregnancy, a high rates in spite of its low than the previous periods, and similarly, the neonatal mortality rates of birth recorded 13 / 1,000 live births (World Bank 2014). Due to this increase in morbidity and mortality among mothers and infants, newborns, and because research reports emphasized that women receive adequate health promotion about health problems in pregnancy and childbirth and how to overcome them the importance of programs and interventions health promotion in improving child and maternal health and reduce rates morbidity and mortality, where health promotion programs contribute to increased awareness and educate mothers, especially in the subjects and behaviors that contribute to improving the health and lead to the selection of a healthy lifestyle enhances the health of mothers and fetus together (Temple et al 2006). Health promotion can contribute to health and the reduction of many of the health problems of pregnant women and especially with regard to the acquisition of women self-care skills and management of symptoms in addition to increasing their awareness of the importance of a healthy diet pattern (McKay 2008).

Health promotion activities dealing with many topics and issues that aim to improve the overall health of the members of the community, and the longer the period of pregnancy and childbirth are important in the lives of women at the same time the stages that women face many health problems as a result of wrong practices and patterns of life do not contribute to the improvement of women's health, but cause more of the harm, which directly affects the fetus and infant health, health promotion is so essential part of nursing care in pregnancy and childbirth stage (Wilkinson and McIntyre). Health promotion activities focus on the causes of morbidity and mortality of mothers and infants at this stage, which was confirmed by clinical research results and the most important of these topics are malnutrition problems, which is the main cause of morbidity and mortality among mothers and infants and extends its influence for long periods, so a large amount of health promotion activities is to increase pregnant women's awareness of the importance of diet in which the collection of nutrients that must be met for maternal and fetal growth normally, and the malnutrition problems in pregnancy linked to many of the health problems after birth and continue for long periods may affect infant growth after birth (Wilkinson et al 2010). Oteng-Ntim et al (2012) confirmed malnutrition in the health promotion activities link to breastfeeding and how breastfeeding and the benefits to mothers and baby together on these activities and health education for mothers are in pregnancy and with the early hours of birth. Health promotion also focused on the problem of smoking and the need to pregnant women smoking cessation and the risk caused by smoking on child and maternal health, which is one of the risk factors of many diseases as targeted health promotion to support mothers in how to quit smoking. Sternfeld et al (2009) adds that the physical activity practice is one of the most health behaviors that focuses in health promotion activities because of its many benefits for the health of mothers, including the facilitation of birth, and low risk of preterm delivery that cause many health problems for the child and one of the main causes of death among newborns. Also, physical activity leads to burning fat and protects mothers from obesity, which is the one of the main risk factors of many diseases. Wilkinson and Miller (2007) refers to the need to acquisition women skills of self-care, especially that pregnancy is not an illness period require hospitalization, but is in-home care so women administration should symptoms and do self-care and request advice or referral in case of any health problems in order to achieve early and self-diagnosis which protects pregnant women from many forms of morbidity and lower rates of diseases suffered by women to the risk of mortality, such as pregnancy, diabetes poisoning. Ickovics et al (2007) confirmed on the need for attention of health promotion to unhealthy behaviors that affect the health of mothers and increase the risk of premature birth or stress such as travel and transfer and work in stressful environments cause health problems and physical problems for mothers. It is clear that the issue of the wellbeing of mothers and fetus and infant are related mainly to health promotion, particularly with regard to follow a healthy lifestyle provides for pregnant women's quality of life and contribute to improving the overall health of pregnant women and reduce the morbidity and mortality in this important period to the women.

The nurse has an important and pivotal role in the reduction of morbidity and mortality in mothers, particularly through the nursing care activities in pre-natal period. This was confirmed by Kemppainen et al (2012) of the need to nurses provide sufficient health education for pregnant women and women intending to pregnancy and are not limited to these health promotion activities to health care environments rather, extends to the sittings that increase the women's gatherings, especially in large commercial markets and universities, and to use the multiple media of brochures, leaflets, paper and SMS messages individually and collectively with women and meetings. Beaudet et al (2011) refers to the need to address health promotion in the prenatal lifestyles and bad special feeding pattern which is a fundamental cause of malnutrition as the lead in many cases to a lack of fetal growth and wounding mothers by malnutrition disease, including eclampsia and miscarriage and premature birth, nurses must offer a balanced diet lists at every stage of pregnancy and help mothers choose and to follow this kind of food and how to control the symptoms of malnutrition and appropriate interventions as a kind of self-care for pregnant women. Whitehead (2011) confirmed that nurse has an important role in monitoring the health problems in every visit by pregnant women in the prenatal period and to educate pregnant women about monitoring these problems, and how to perform early detection to reduce morbidity and mortality and open more channels of communication with women, especially during a visit health care facilities, with a focus on the need to quit the unhealthy behavior patterns such as smoking and lack of physical activity and the risk of travel during pregnancy. Lazarou and Kouta (2010) added that located on the nurses play a key role in monitoring and assessing the health and physical changes of pregnant women that can be an indicator of the presence of a health problem, especially diseases that may lead to miscarriage or premature birth or death, this point the nurses educate women about this problem and how pregnant women monitoring the problem to prevent its development and reduce them and then maintain the health of the mother and prevent illness.

In conclusion, the pregnancy is one of the most important stages of the women stages; pregnant women are subjected to many complications and diseases that may lead to the risk of morbidity and mortality. So illustrate the importance of prenatal period in increased interest of health promotion activities because of its significant role in the reduction of morbidity and mortality among mothers and fetus and infant. In spite of the efforts to improve the health of pregnant women, and attention to the child's health, in particular, the statistics indicate high rates of morbidity and mortality among pregnant mothers and infants. On that nurses play an important and pivotal role in the prenatal period through nursing care interventions and private health promotion activities, which must address the issues that constitute the main reasons in the morbidity and mortality of children and women, a malnutrition, smoking and travel during pregnancy, so nurses should focus on the increase pregnant women's awareness of the importance of a balanced diet and quit smoking and how to do self-care and stay away from what can cause health problems such as a stressful work environments and frequent and unnecessarily travel during pregnancy.