Maternal Morbidity of Bangladesh
A Circumlocutory Gender Issue
Bangladesh has a high maternal mortality ratio, with 320 deaths per 100,000 births. (UNICEF, 2001). This means there are about 11,000 to 12,000 women dying from pregnancy or childbirth complications every year in Bangladesh. Maternal mortality for adolescents is double the national figure. However maternal morbidity is not a gender issue but it became a gender issue in Bangladesh because women are treated inferiorly. The cause of maternal mortality rate are: nine out of every 10 deliveries take place at home (UNICEF, 2001) and unskilled attendants or relatives assisting, adolescent girl marriage, some prejudices practice regarding delivery, the low status of women health education, poor quality and low uptake of services. The analysis of my paper is about the cause of maternal mortality rate in Bangladesh.
The practice of home delivery of a baby has been going on traditionally for a long time in rural Bangladesh. Though the delivery process is a natural process and normally it need to be occurred at hospital, clinic or any trained places but it becomes a rick when it occurred at home by a non trained person without the use of standard practice. Only 8.6 per cent of births take place in hospitals or local health centers and only 11.8 per cent of deliveries were assisted in 2001 by doctors, midwives, nurses or family welfare visitors. The remaining 88.2 per cent were attended by relatives or other people, of whom only 11.9 per cent by trained traditional birth attendants (TBAs) (UNICEF, 2009). Sometimes the absence of essential medical knowledge and facilities causes physical injury or death both mother and baby. Furthermore the traditional birth attendant (obviously a woman) serves the pregnant women in unhygienic and sometimes in wrong way which tend the pregnant women death. According to “Home Delivery Practices in Rural Bangladesh: A Case of Passive Violence to the Women” written by Munirul Khan and Khaleda Islam,
“In case of prolong labor there is the risk of causing injury to the urinary bladder and female genital system leading to different types of fistula such as vescico-vaginal fistula of recto-vaginal fistula (VVF, RVF). Some studies have found that this type of injury eventually lead to breakup of the conjugal relationship between husband and wife” (Munir & Khaleda,2006)
The explanation about home delivery of child shows the accurate figure of rural maternal situation ob Bangladesh. The main cause of home child delivery is that, rural people believe that the pregnant women is not allowed to appear to male doctor because of Islam says that women are not allowed to appear to man.
Bangladesh has one of the world’s highest rates of adolescent motherhood, based on the proportion of women younger than 20 giving birth every year. According to UNICEF’s 2011 State of the World’s Children report, about a third of women in Bangladesh aged 20-24 are married by the age of 15, and 66 percent of girls will get married before their 18th birthday - up 2 percent from 2009. Moreover, a malnourished mother is very likely to give birth to a low birth weight baby. In rural areas parents get their daughter early marriage to get a good husband, because Bangladeshi people think that adolescent girl are good for production of child and this girl are good for leading a good conjugal life. Without finishing the development of physical and mental health when a girl become pregnant it’s really damage her physical condition and death of the girl is not unpredictable. Another report from Arifa S Sharmin showed a adolacent girl, Jasmin(16). She explain that because of social norms, women put their lives at risk. Jasmine, 16, is recovering in hospital and was lucky to survive after a difficult delivery at home. Jasmine’s sunken eyes and ashen face show the struggle she endured the last few days. “She was admitted to hospital with a ruptured uterus and non–stop bleeding. As a teenage mother she was already at risk but her family did not realize it. They used a unskilled traditional birth attendant who was not able to handle her delivery properly,” Dr. Munwar Sultan said. In rural Bangladesh adolescent girl are facing these kind of health problems because of the discriminative social norms which maintaining in our society.
There are many practices and prejudice regarding pre and post delivery has been followed in rural Bangladesh and the victim women has to suffer physically and mentally. There are some prejudice are mentioned according to Elizabeth A. Goodburn, Rukhsana Gazi and Mushtaque Chowdhury. There is some discrimination in allocation of food in pregnancy. Mother in low gives pregnant woman a small amount of food in pregnant period. People believe that, if a pregnant mother eats more her baby will be big and therefore it will be difficult to delivery. Moreover, Pineapples are said to cause abortion, coconut are believed to make a baby blind, duck egg may cause asthma in the baby. Other restricted foods are mlk, Hilsha fish, other fish and cucumber. For that reason a pregnant women get low nutrition which is shocking for both mother and child. Furthermore, A pregnant women are not suppose to cut anything due to her baby will be physically disordered. She cannot go outside after sunset since her child would be attacked by ghost. On the other hand, traditionally children are born at home in Bangladesh in a certain room. The name of the room called ‘atur ghar’. After giving birth the women have to live 40 days in that room without going outside. The windows of the room are not supposed to open in those days. The cloths which she uses for her bleeding are not supposed to dry in sunlight due to getting away from man eyes, because the issue ‘ministration’ is a secret matter in Bangladesh. Therefore these cloths turn into unhygienic and the women suffer bacteria related disease. Moreover, due to the introvert role of women, many complain stay hidden and are not treated at all. Therefore women face more physical illness than man.
In pregnant period there were some restrictions on pregnant woman activity in past time which are not strongly followed now but still those are believed. If pregnant women fall people think that she will face miscarriage. “Heavy lifting and using the ‘dheki’ (rice husking machine) were also identified as activities to be avoided.”( Elizabeth A. Goodburn) . Therefore pregnant most of the time sleep and do not do any physical exercise which cause the women physically week. Though the prejudice and practice are not followed strongly like before but those are still maintained in rural Bangladesh and cause maternal morbidity.
Lake of giving nitration from childhood is one cause of maternal morbidity. In a family, girl has to eat less than boys, sometimes girls and women eat after father and boys.. From the childhood a girl take low nutrition. Because of low nutrition a girl grow up with a week physical condition. This week physical condition tend to increase maternal moebidity.
In rural Bangladesh people particularly women are not aware about the health education and they usually uptake low health services. They do not have necessary information about the contraceptives to make the right choice for themselves. They don’t know even what they should do after marriage. In our society there is no discussion about women health. Only women use contraceptives not man in Bangladesh. A survey on women In mahtab, Bangladesh has examined the nature of morbidity due to reproductive tract infection among user of various contraceptives. About 22 percent of the 2,929 women surveyed the reported the symptom of reproductive tract infection. A clinic based report about 60 present frequency of RTI among poor urban women (Halida, 1999: 118). Domestic violence is also a strong reason for maternal morbidity. To exist the socio economy, culture and religion factors women face physical, sexual and psychological violence which increase their anxiety and weakness. Giving birth is the most courageous thing of the word. Women need to be strong doing this object. Therefore it is undoubted to all that domestic violence and lake education about health increase maternal morbidity.
Bangladesh is a dance populated country where the proportion of women and man are quite same. Women are related in every aspect of the development of Bangladesh. If a woman, a mother, is discriminated, entire ethnicity will be discriminated. It is need to practice respecting a woman from their birth to make a healthy civilization.
“Maternal Health and Care-seeking Behavior in Bangladesh: findings from a National Survey” by Michal, Kanta, Streatfield, Tuls and, Yasmin.
"January 2010." The Indian Stammering Association. Web. 17 Apr. 2011. <http://t-tisa.blogspot.com/2010_01_01_archive.html>.
- Beliefs and Practices Regarding Delivery and Postpartum Maternal Morbidity in Rural Bangladesh by Elizabeth A. Goodburn, Rukhsana Gazi, Mushtaque Chowdhury
Vol. 26, No. 1 (Jan. - Feb., 1995), pp. 22-32
Published by: Population Council
Stable URL: http://www.jstor.org/stable/2138048
"Bangladeshi Parents Still Don't Heed Warnings about Child Marriage - TrustLaw." Thomson Reuters Foundation Homepage - Trust.org. Web. 17 Apr. 2011. <http://www.trust.org/trustlaw/news/bangladeshi-parents-still-dont-heed-warnings-about-child-marriage
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