- Death & Loss of Life
How Maternal Health Can be Improved
Improving Maternal Health
Improving Maternal health is the fifth of the eight Millennium Development Goals (MDGs) of the United Nations. It is universally important and must be handled with the seriousness it deserves. According to World Health Organization: A maternal death is defined as the death of a woman while pregnant or within forty two days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.
Where do maternal deaths occur?
The high incidence of maternal death is one of the signs of major or inequity spread throughout the world, reflecting the gap between rich and poor. A total of 99% of all maternal deaths occur in developing countries, where 85% of the population lives. More than half of these deaths occur in sub-Saharan Africa and one third in South Asia.
Because women in developing countries have many pregnancies on average, therefore they are more prone to maternal death, thereby reflecting the overall burden of these women. In addition to the difference between countries, there are also large disparities within countries between people with high and low income and between rural and urban population.
The rich can afford medical bills in standard hospitals while the poor cannot. As a result they are most likely to patronize quakes instead of skilled professionals. In most countries, the urban areas are known to have several hospitals with different charges, thereby increasing the possibility of a poor family accessing medical care especially during pregnancy.
Why do mothers die?
Women die from a wide range of complications in pregnancy, childbirth or the postpartum period. Most of these complications develop because of their pregnant status and some because pregnancy aggravated an existing disease. The four major killers are: severe bleeding (mostly bleeding postpartum), infections (also mostly soon after delivery), hypertensive disorders in pregnancy and obstructed labor. Complications after unsafe abortion cause some percentage of the maternal deaths.
On April 15 1998, my wife delivered a baby boy and was discharged from the hospital three days after. she was in perfect condition with our baby, but a week after delivery she started to bleed. I rushed her to the hospital, and was told that her womb had "Retained Matter" and that was the cause of the bleeding. the doctor carried out D&C to flush out the "Retained Matter" before the bleeding stopped.
On May 19 2000, she started to bleed immediately after delivery of our last baby. all attempts to stop the bleeding with injections failed until a doctor examined her properly and discovered that her womb had a tear during delivery. He quickly snitched it and the bleeding stopped. Think what would have happened in these cases, if she was not registered with a good health provider with skilled professionals.
Globally, about 80% of maternal deaths are due to these causes. Among the indirect causes of maternal deaths are diseases that complicate pregnancy or are aggravated by pregnancy, such as malaria, anemia and HIV. Women also die because of poor health at conception and a lack of adequate care needed for the healthy outcome of the pregnancy for themselves and their babies.
How can maternal health be improved?
The first step for avoiding maternal deaths and improve maternal health is to ensure that women have access to family planning and safe abortion. This will reduce unwanted pregnancies and unsafe abortions.
The women who continue pregnancies need care during this critical period for their health and for the health of the babies they are bearing. Most maternal deaths are avoidable, as the health care solutions to prevent or manage the complications are well known. Since complications are not predictable, all women need care from skilled health professionals, especially at birth, when rapid treatment can make the difference between life and death. For instance, severe bleeding after birth can kill even a healthy woman within two hours if she is unattended.
Sepsis – a very severe infection is the second most frequent cause of maternal death. It can be eliminated if aseptic techniques are respected and if early signs of infection are recognized and treated in a timely manner.
The third cause, eclampsia, emerges as pre-eclampsia, a common hypertensive disorder, which can be detected during pregnancy. Although, pre-eclampsia cannot be completely cured before delivery, administering relevant drugs can lower a woman’s risk of developing convulsions (eclampsia), which can be fatal.
Another frequent cause of maternal death is obstructed labor, which occurs when the fetus head is too big compared with the mother’s pelvis or if the baby is abnormally positioned. A simple tool for identifying problems early in labor and the maternal and fetal condition are available. Skilled practitioners can use the photograph to recognize and deal with slow progress before labor becomes obstructed and if necessary, ensure that Caesarian Section is performed on time to save the mother and the baby. For women to benefit from those cost-effective interventions they must be attended by skilled health providers and they need support in the weeks after delivery.
Why do some mothers not get the care they need?
Data show that less than two thirds (62% of women in developing countries receive assistance from a skilled health worker when giving birth. In high income countries, virtually all women have at least four ante-natal care visits, are attended by a midwife and/or a doctor for childbirth and receive postnatal care. In low and middle-income countries, just above two thirds of women get at least one antenatal care visit, but in some countries less than one third have this.
There are many reasons why women do not receive the care they need before, during and after childbirth. Many pregnant women do get it because there are no services where they live, or they cannot afford the services because they are too costly. Some women do not use services because they do not like how care is provided or because the health services are not delivering high-quality care.
Further, cultural beliefs or a woman’s low status in society can prevent a pregnant woman from getting the care she needs. To improve maternal heath, gaps in the capacity and quality of health systems and barriers to accessing health services must be identified and tackled at all levels, down to the community level.