Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth. 99% of all maternal deaths occur in developing countries, that would mean 822 women die each day in developing countries due to pregnancy and child birth. Globally 303,000 mothers died in 2015 from pregnancy-related causes.
According to WHO the following number of women died last year from child bearing in these countries
- Nigeria: 58000
- Democratic Republic of Congo: 22000
- Kenya: 8000
- Uganda: 5700
- Cameroon: 5100
- Chad: 5400
- Ivory Coast: 5400
- Ghana: 2800
- Sierra Leone: 3100
- Senegal: 1800
- Central African Republic: 1400
- Liberia: 1100
- Gabon: 150
- Equatorial Guinea: 100
Basic maternal health services before and after delivery could prevent up to 80% of these deaths.
Maternal health and newborn health are closely linked. Children who lose their mothers are five times more likely to die in infancy than those who do not. Approximately 2.7 million newborn babies die every year (4), and an additional 2.6 million are stillborn(5).
Educating women could ensure that mothers know how and when to seek health care services for themselves and their children.
Key facts
- Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth
- 99% of all maternal deaths occur in developing countries.
- Maternal mortality is higher in women living in rural areas and among poorer communities
- Self care before, during and after childbirth can save the lives of women and newborn babies
- Children who lose their mothers are five times more likely to die in infancy than those who do not
- If levels of under-five mortality for each country remain at today’s levels, 94 million children under the age of 5 will die between 2016 and 2030. Many of these deaths are from entirely preventable and treatable causes, such as pneumonia, diarrhoea, malnutrition and malaria.
- With proper care and treatment, nearly all of these deaths could be avoided.
Main Causes of Maternal Mortality
Women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy and most are preventable or treatable. Other complications may exist before pregnancy but are worsened during pregnancy, especially if not managed as part of the woman’s care. The major complications that account for nearly 75% of all maternal (3) deaths are:
- severe bleeding (mostly bleeding after childbirth)
- infections (usually after childbirth)
- high blood pressure during pregnancy (pre-eclampsia and eclampsia)
- pre-eclampsia is a combination of high blood pressure and protein in urine during pregnancy
- pre-eclampsia can proceed into a convulsion called eclampsia, which easily leads to death
- obstructed labor (a major cause of obstetric fistula)
- newborn asphyxia
- unsafe abortion
Other factors which contribute to maternal deaths include:
- many pregnancies and un-spaced births
- Teenage pregnancies: the probability that a 15 year old female will eventually die from a maternal cause is 1 in 4900 in developed countries, versus 1 in 180 in developing countries. In countries designated as fragile states, the risk is 1 in 54. In many communities girls still marry at very young ages and contraceptive advice is poor or non-existent. Many of the worst complications in pregnancy are suffered by teenage mothers; giving birth is a physically traumatic experience for a girl whose body is still developing.
- poor nutrition
- poverty
- lack of information
- lack of skilled midwives, doctors and operating theaters ( 50% of women in low income settings not assisted by a midwife, a doctor or a trained nurse)
- lack of antibiotics and drugs to ensure that, should complications arise, the mother is rapidly brought back to good health
- lack of infrastructure. In particular, women in poor and remote communities are far from the nearest health services
- cultural practices
How can women’s lives be saved?
Most maternal deaths are preventable. Simple and affordable training will save lives and ensure that childbirth is a matter of joy and not a life-or-death crisis.
- Unwanted and too-early pregnancies should be prevented. All women, including adolescents, need access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care.
- All women need antenatal care, that is a follow up during pregnancy. Most developed countries recommend at least 4 visits wherein
- the overall health of the mother and child is checked
- blood pressure and sugar level are tested as well as your urine (for protein and infection)
- prevention and treatment of malaria in pregnancy and prevention of mother-to-child transmission of HIV is checked
- Pre-eclampsia should be detected and appropriately managed before the onset of convulsions (eclampsia) and other life-threatening complications. Administering drugs such as magnesium sulfate for pre-eclampsia can lower a woman’s risk of developing eclampsia.
- skilled care during childbirth is essential. Increased capacity of skilled providers (doctors, midwives and nurses) should be aimed. Some communities have traditional midwives who could be trained to recognize emergencies and what to do in such situations. This could ensure that the approximately 15% of births that develop complications are promptly identified and managed. This includes identification and management of pre-eclampsia and eclampsia, prevention and treatment of obstructed labor, postpartum hemorrhage and newborn asphyxia.
- skilled care and support in the weeks after childbirth. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for both the mother and the baby. Training traditional birth attendants in certain communities oh how best to recognize life threatening complications on time and making the right referral.
- Severe bleeding after birth is called postpartum hemorrhage (PPH) and it can kill a healthy woman within hours if she is unattended. Applying certain medications immediately after childbirth effectively reduces the risk of bleeding.
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- PPH may happen within 24 hours of giving birth (primary PPH), or between 24 hours and 6 weeks after the birth (secondary PPH). It may be caused by insufficient contractions of the uterus after birth, tearing of the uterus, poor blood clotting or poor healing after caesarean birth.
- Seek help if:
- The bleeding suddenly becomes very heavy, and soaks more than one pad an hour
- The bleeding becomes persistently fresher (bright red) and heavier four days
- You pass lots of large blood clots that are bigger than a small coin
- You start to feel faint, dizzy, cold or restless
- Your blood pressure drops
- Unconsciousness
- fast irregular high heartbeat
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- Infection after childbirth can be eliminated if good hygiene is practiced and if early signs of infection are recognized and treated in a timely manner. Knowledge and availability of antibiotics are needed to reduce complications.
- warning signs of infection:
- vaginal secretion or blood has an unpleasant smell
- You have a fever and/or chills
- Bleeding stays heavy or is bright red after the first week
- Pains in your lower abdomen/tummy, on one or both sides
- warning signs of infection:
- Severe bleeding after birth is called postpartum hemorrhage (PPH) and it can kill a healthy woman within hours if she is unattended. Applying certain medications immediately after childbirth effectively reduces the risk of bleeding.
What is a high risk pregnancy
“A high-risk pregnancy” means you need more follow-up by skilled workers and doctors than others. This ensures early detection of problems so as to avoid complications. If you have the following conditions, then you have a high-risk pregnancy.
- mothers younger than 18 and those older than 35
- smoking cigarettes, drinking alcohol and using illegal drugs during pregnancy
- medical history of C-section, low birth weight baby or premature birth, a family history of genetic conditions, a history of pregnancy loss or the death of a baby shortly after birth
- chronic conditions — such as diabetes, high blood pressure and epilepsy
- anemia, an infection or an underlying mental health condition
- problems with the uterus, cervix or placenta
- Rh (rhesus) sensitization — a potentially serious condition that can occur when your blood group is Rh negative and your baby’s blood group is Rh positive
- women carrying twins or more children
- obese women
Through simple changes lives could be saved..Spread the word…
References
1Conde-Agudelo A, Belizan JM, Lammers C. Maternal-perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: Cross-sectional study. American Journal of Obstetrics and Gynecology, 2004, 192:342–349.
2 Patton GC, Coffey C, Sawyer SM, Viner RM, Haller DM, Bose K, Vos T, Ferguson J, Mathers CD. Global patterns of mortality in young people: a systematic analysis of population health data. Lancet, 2009, 374:881– 892.
4 UNICEF, WHO, The World Bank, United Nations Population Division. The Inter-agency Group for Child Mortality Estimation (UN IGME). Levels and Trends in Child Mortality. Report 2015. New York, USA, UNICEF, 2015.
5 Cousens S, Blencowe H, Stanton C, Chou D, Ahmed S, Steinhardt L et al.. National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: a systematic analysis. Lancet, 2011, Apr 16, 377(9774):1319-30
