The 130th Annual Meeting of APHA

Abstract #40515

Nguyen Thi Ngoc Toan, Professor, MD, Obstetrics and Gynecology, School of Medicine and Military Hospital, Hanoi, Vietnam (retired), 1 Tran Thanh Tong Street, Hai Ba Trung District, Hanoi, Vietnam, 011 84 08 8449589, quy-anh@hn.vnn.vn and Trude A. Bennett, MSW, MPH, DrPH, Dept. of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, CB# 7445, 401 Rosenau Hall, UNC-CH School of Public Health, Dept. of MCH, Chapel Hill, NC 27599-7445.

Historically the protection of mothers and infants in Vietnam has demanded ingenuity and sacrifice under conditions of economic hardship and strife. Since the end of the war and the reunification of the country, major reductions have occurred in both maternal and infant mortality. Unfortunately, one of the ongoing challenges for reproductive health has been maternal exposure to dioxin as a wartime legacy of Agent Orange. From 1962 to 1971, approximately 18 million gallons of Agent Orange defoliant were sprayed over the southern and central regions of Vietnam, an area currently inhabited by 36 million people. Primary prevention of dioxin exposure will require extensive and costly cleanup efforts, but a large number of Vietnamese women of childbearing age currently have significant body burdens of dioxin. Vietnam has a successful population policy of limiting families to two children, but childbearing is highly valued and desired. The greatest reproductive hazards of dioxin exposure occur during fetal development. However, breastfeeding confers additional exposure, since dioxin is fat soluble and concentrates in breast milk. From her experience as an obstetrician-gynecologist practicing in a military hospital in Hanoi from 1957 to 1997, the speaker will describe the changes she observed in the physiological and psychological experience of pregnancy, childbirth outcomes, and the conditions of motherhood during wartime and up until the present. She will describe public health interventions needed to ensure Safe Motherhood for women currently of reproductive age and those of future generations, and the potential for international collaboration in developing effective strategies for Safe Motherhood.

Learning Objectives: At the conclusion of the session, the participants (learners) in this session will be able to

• Describe the impact of war on reproductive health in the Vietnamese population, and the ongoing effects of chemical exposures;
• Identify current collaborative efforts to identify mechanisms of exposure to human teratogens and to remove such hazards;
• Assess the psychological and economic as well as physiological impact of barriers to Safe Motherhood in Vietnamese cultural and historical context; and
• Discuss efforts and opportunities to combine forces internationally for Safe Motherhood at different levels of prevention.

Keywords: Safe Mother Program, Agent Orange

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.