Besides the great feeling of being pregnant, maternal mortality is also a colossal truth to accept. Thanks to the medical science and our distinctive doctors, the Maternal Mortality Rate (MMR) has reduced from 130 deaths per 100000 births in 2014-16 to 113 deaths per 100000 births IN 2016-18 as per the Sample Registration System (SRS) report by Registrar General of India (RGI). Still, maternal death is a significant concern for all the ”to-be Moms”.
What is Maternal Death?
Maternal death is when a woman expires in the course of pregnancy or before the end of 42 days after pregnancy due to health issues related to pregnancy.
Why do women often die during pregnancy?
Women may die as a result of complications during pregnancy or complications at the time of childbirth. Most of these complications develop during pregnancy, and some may exist in the female body before pregnancy and worsen if not taken care of.
The significant reasons for maximum maternal mortality are as follows:
1. Excessive bleeding aka Postpartum Hemorrhage (PPH)
Postpartum Hemorrhage is the excessive bleeding leading to blood loss right after giving birth. PPH is responsible for approximately 27% of all maternal deaths. An experienced doctor usually can stop the bleeding, but without proper skill and knowledge might cost a mother smothers life.
2. High blood pressure and eclampsia
Regular testing and checkups usually pick up issues such as high blood pressure and eclampsia, which the mother may have. Hypertensive being the reason for approximately 14% of total deaths, stands second in the cue. Early detection and good medical care can treat such issues.
Infections from unsafe abortion, unsanitary delivery, or very long labor are some of the deadly reasons for maternal mortality. Disinformation, lack of knowledge and understanding can put new mothers at risk of infection. Such infections result in approximately 11% of maternal deaths.
4. Pulmonary Embolism (PE)
Pulmonary Embolism is a blood clot in the lungs that can develop after delivery. About 3% of deaths are due to Pulmonary Embolism. The risk of pulmonary embolism is higher in a cesarean section. Complications from c- section other than (PE) include anaesthesia reaction, Infections, blood loss, injury to other organs during surgery may lead to maternal death.
However, this is to be noted that C- section also saves many lives as there are several cases where the C- section is mandatory. For such cases, it reduces the chances of maternal death and neonatal death while making delivery a lot safer.
5. Other Direct Complications
Roughly 10% of pregnant women die from other issues related to pregnancy such as placenta previa, uterine rupture and ectopic pregnancy, which can cause complications and are life-threatening if not taking prompt care and treatment.
Indirect causes are those not directly related to the pregnancy but may arise and worsen during pregnancy. Health problems such as HIV, heart disease, diabetes and anaemia can worsen during pregnancy. Approximately 28% of all deaths of pregnant women are due to these issues.
Factors that Act as a fuel in maternal mortality
Age – is also a major contributing factor for maternal deaths. It is said that women in their twenties tend to have fewer complications than at their younger or older age. Young girls, i.e. girls under 15 years, can face much more complications. This risk remains the same for women who become pregnant in their late 30s, 40s, and 50s.
Socioeconomic status – Women in lower socioeconomic are poor, and they lack proper education, diet and barriers to healthcare. Lack of education leads to unplanned and earlier pregnancies. Lack of nutrition leads to deficiencies and poor pregnancy outcomes. Access to proper health care puts women at risk of infections and other health complications which could have been prevented by proper treatment and care.
Gender Inequality – This results in some women having less opportunity or access to education. Women in some countries are often denied financial resources and have no say in their lives and family choices.
Available resources – For a lot of women getting prenatal care and medical help is a challenge in itself as this necessity is far from their reach. This lack of reach results in the delivery of babies without a doctor, nurse or midwife. Even in this era, some women give birth to women at home with the help of older women like other women in some places. Non- access to critical emergency services and antibiotics can be life-threatening as not all cases of pregnancy are the same; some require immediate medical help. Even without any complication, pregnant women need regular checkups and monitoring to ensure a safe pregnancy.
Parity – It is no. of times a woman has had a pregnancy. The risk is higher for a first pregnancy and pregnancies after fifth or more. At the same time, it is lower upto 2-4 pregnancies.
- Each day in 2017, roughly 810 women expired from preventable causes related to pregnancy and childbirth.
- In the midst of 2000 and 2017, the maternal mortality ratio (MMR), i.e., the number of maternal deaths per 100,000 live births, dropped by about 38% globally.
- 94% of all maternal deaths were found to be from low and lower-middle-income countries.
- Children aged between 10-14 are at a higher risk of complications and death due to pregnancy than other women.
- Expert care before, after, and during childbirth can save the lives of women and newborns.
How to make pregnancy safer?
As we all know the maternal mortality has seen a significant fall with passing the time. Between 1990 and 2015, the number of women dying because of pregnancy and childbirth has reduced to 44%. This fall is due to women women’s education, an increase in the usage of contraceptives, prenatal care, skilled doctors and medical experts, availability of medical treatments, blood transfusions, antibiotics, and advancements in medicine, which lowers pregnancies and delivery risks.
Despite this, some places still lack such medical help; therefore, work needs to be done to make available medical treatment and care and educate every woman about pregnancy and related to lower maternal mortality in such countries.
Cleanliness – the importance of good personal hygiene and care needs to be taught to all. Taking good care of your body to keep germs away, regular handwashing, and clean the perineal area during prenatal checkups is crucial. Hygienic delivery surroundings during childbirth also prevent infection and reduce the risk of death of new mothers.
Postpartum Monitoring – A women needs care not just at childbirth but also after delivery. Postpartum checkups for abnormal bleeding or infection can make a huge difference. Availability of services, affordability, availability of antibiotic services and postpartum care can save lots of lives.
Goals on maternal mortality – countries have come together with a target to accelerate the decline of maternal mortality by 2030. Sustainable development goals (SDG) includes a target to reduce the global MMR to less than 70 per 100000 births, with no country having a maternal mortality rate of more than twice the global average.
What is the WHO response?
WHO states that improving maternal health is one of its top priorities. It contributes to reducing maternal mortality by increasing research evidence, providing evidence-based clinical and programmatic guidance, setting global standards, and providing technical support to member states on developments and implementing effective policy and programs.
According to the Ending Preventable maternal mortality strategy Who is working along with its partners in supporting countries towards specific steps, they are:
- addressing the inequalities in access to and maintaining the quality of reproductive, maternal, and newborn health care services;
- securing universal health coverage for comprehensive reproductive, maternal, and newborn health care;
- addressing all the causes of maternal mortality, reproductive and maternal morbidities, and related disabilities;
- strengthening health care systems to collect high-quality data to respond to the needs and priorities of women and girls, and ensuring accountability to improve quality of care and equity.
In earlier times, pregnancy and childbirth were comparatively more dangerous, but this is a different story in the present. Today childbirth is much safer. Regular prenatal care, a good diet, a good lifestyle and skilled health care services and providers at your delivery had enormously increased the odds of having a healthy pregnancy and childbirth.
However, in parts of the world, women are still facing difficulties of childbirth and pregnancy-related issues. Every woman, irrespective of where they come from, having similar fear and hopes for pregnancy. This fear of childbirth and complications needs to be eradicated from the hearts and minds of all women worldwide so that they can be more hopeful.
Organizations such as WHO, UNICEF, USAID, UNFPA and many others are working hard to bring awareness to these issues. They are developing programs to help conquer maternal mortality and make a better future for all women globally.
If you like, you can be a part of this mission by participating in any opportunities you might come across and help the less fortunate in your community or donating support to the organizations that are working towards educating, providing medication and care to women globally.