MATERNA HEALTH

By Venter Mwongera

A Question and Answer Session with Dr. Nancy Kidula, Obstetrician/ Gynecologist and she is currently with the World Health Organisation as the National Professional Officer in charge of Making Pregnancy Safer Unit.

WOMEN MUST NOT DIE WHILE GIVING LIFE!

Pregnancy and the subsequent delivery of a child is in most cases a joyous occasion. It is considered by many people to be a natural event and therefore taken for granted. However, we now know that pregnancy and childbirth and their related complications are the most common cause of death and disability in women of childbearing age (15- 49yrs) in developing countries. In Kenya, the most common cause of admission into hospital for females is pregnancy, childbirth and their complications.

What is maternal mortality?

Maternal mortality is described as the death of a woman while pregnant or within 42 days of termination of pregnancy or delivery from any cause related to or worsened by the pregnancy or its management.

What can cause death of the mother during pregnancy and childbirth?

In Kenya, most deaths of mothers during pregnancy and child birth are due to severe bleeding. After delivery a woman can die within two (2) hours if she bleeds excessively! Other common causes of death include high blood pressure (Hypertensive disease) in pregnancy; severe infection /sepsis especially after delivery; abortion related complications; and obstructed labor. Indirect causes of maternal mortality include HIV/AIDS, Malaria and anemia (lack of enough blood).

How frequently do mothers die?

Worldwide, a woman dies every minute from pregnancy related complications. In Kenya about 21 women die per day (approximately one every hour) as a result of pregnancy and childbirth. That is equivalent to a Nissan matatu crashing every day with pregnant women on board and all of them dying!

Can someone know if they will die from pregnancy?

Actually one cannot predict if it is them who will die as a result of the pregnancy or during childbirth.
How then can one prevent this bad event from happening?
Prevention of death from pregnancy and childbirth is quite simple.
Expectant women need to attend the antenatal clinic starting early before 4 months of pregnancy and make sure they attend clinic at least 4 times during the pregnancy period and as advised by the health worker. At this time, she will be checked and any problems diagnosed and treated early enough. Several tests will be taken and preventive measures and drugs provided. The woman will also be assisted to develop an individualized birth plan and trained on how to recognize danger signs during pregnancy.

It is also recommended that for the safety of the mother and baby, delivery should take place in a health facility and under the care of a trained professional.

Delivery by untrained personnel even though for some it may appear cheaper and more convenient has been associated with more deaths and disability.

After delivery, the mother and baby must be reviewed by a trained health provider within 48 hours of delivery (most deaths occur at this time). Any complications will be detected and treated in time.

Family planning saves life. Therefore for the safety of mother and baby, couples must plan how many children they will have, when to start the family, how to space the pregnancies, and when to stop child bearing. This will prevent the common problem of having children too early (before 18 years), too close together (recommended spacing is at least 2 years apart), too many (more than 4 pregnancies is risky for the mother’s health) and too late in life (above 35 years of age).

All these have been shown to increase the risk of death for both the mother and baby.
If women of child-bearing age and girls are to survive, then they have to delay pregnancy through use of contraceptives.

Research indicates that if adolescents delay pregnancy until after their 18th birthday, maternal mortality would significantly be reduced Spouses, families and communities must support the pregnant women by ensuring that they have adequate food, they rest enough, they have the funds and transportation to get them to the hospital in case of emergency, and they have the psychological support they need during and after pregnancy.

Everyone can contribute to this. Let us not allow women to continue to die while giving life!