Maternal Death: Our tears

pregnancy, sickness, abortion, maternal death, baby, babies, Nigeria

Maternal death is the death of a woman while pregnant or within 42 days of termination of a pregnancy. This is irrespective of the duration and site of the pregnancy.

The death comes from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.

Generally, most pregnancies will be uneventful; that is, they will not be associated with any complication from the onset of the pregnancy till labour, delivery and after. But about 15 out of every 100 pregnant women will develop a potential life-threatening complications that calls for skilled care (qualified medical expert), while some will require a major obstetrical intervention to survive.

As sad as it is, the statistics for maternal death from pregnancy complications are real:

•Every day,  approximately 800 women die from preventatble causes related to pregnancy and childbirth

• Every hour, about 33 women die of the same cause

• Every two minutes, at least a woman dies of preventable causes related to pregnancy and childbirth

• 99 per  cent of all maternal deaths occur in developing countries, including Nigeria. Only one per cent occurs in the developed nations

• Maternal death is higher in women living in rural areas and among poorer communities

• Young adolescents face higher risk of complications and death as a result of pregnancy than older women

• Nigeria, with the population of 162 million out of the global population of over seven billion, contributes 10 per cent of the world’s maternal deaths

• In Sub-Sahara Africa, a woman faces a one-in-39 lifetime risk of dying due to pregnancy or childbirth related complications

• In South Eastern Asia, it is one/290 and in developed countries, it is one/3,800

Ten countries are leading the global maternal death and they account for 60 per cent of the world’s maternal death. And the highest of these countries is India, contributing 56,000 maternal deaths  annually, out of the country’s population of over 1.2 billion. Nigeria is the second highest, contributing 40,000 maternal deaths out of her population of about 162 million.

When a plane crashed and killed about 150 people, the whole world was troubled, the fever touched every continent, and millions of dollars were spent to find the cause of the plane crash so as to prevent re-occurence. But what happens to the “maternal crash” that kills 800 women daily worldwide?

Generally, maternal death can be divided into Direct Maternal Death and Indirect Maternal Death.

Direct maternal deaths are complications  of the pregnancy itself; that is, complications of pregnancy, labour, delivery and complications that may arise within six weeks after the delivery period (post-partum). Direct cause accounts for about 80 per cent of all maternal deaths and cannot be predicted.

Direct causes include: haemorrhage (uncontrolled bleeding), sepsis (infections), hypertensive disorders (complications of high blood pressures), prolonged or obstructed labour and unsafe abortion.

Indirect maternal deaths are those related to medical illness before the onset of pregnancy. These medical conditions are usually aggravated by the body changes associated with pregnancy or because of the demand of pregnancy. These include malaria, anaemia (shortage of blood), HIV/AIDS, heart diseases, Hepatitis, etc.

Among the direct causes, haemorrhage accounts for about 25 per cent, that is a quarter of all maternal deaths in developing countries.

Most maternal deaths are avoidable. If a woman has access to antenatal care during  pregnancy, has trained (skilled care) at labour, both the baby and the mother are under standard medical care during and after delivery, and continue till the first six weeks after delivery, excess bleeding will be identified at the right time.

Again, underlying cause(s) of any abnormal bleeding will be identified and necessary intervention will be provided, with blood transfusion, if necessary. Surgery may also be performed to stop the bleeding, or the womb may be removed outright if the bleeding refuses to respond to all conservative methods of controlling blood loss.

If all maternity centres are well equipped with facilities and manpower, controlling excessive bleeding during labour and, especially after childbirth, will reduce a quarter of all maternal deaths worldwide.

The high number of maternal deaths in developing countries reflects the inequalities in access to health services — a signal to the gap between the rich and the poor, even in the same developing countires.

The rate of maternal deaths at Abuja Central city cannot be compared to that of a remote village or town in the rural far north or south, where access to standard health care is far from the reach of the citizens.

Maternal mortality is a disaster; it’s a calamity that befalls the human race, which every nation must rise up to prevent immediately, especially in developing countries where thousands of women within their reproductive ages are buried annually.



Culled from