Maternal Mortality...Serious yet not
- "The hand that rocks the cradle is the hand that rules the world".
This is a famous poem from William Ross Wallace which praises
motherhood as the preeminent force to change the world. But will this
ever happen when death strikes right at birth? How can a mother ever
rock her child when she dies even before she could even hear her baby
cry? This may sound rhetoric, on the contrary, maternal mortality is
indeed a serious problem the medical world especially in developing
countries are beset.
The World Health Organization (WHO) defines maternal death as the
death of a woman while pregnant or within 42 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.
Generally, maternal death is distinguished between direct and
indirect. Direct maternal death is the result of a complication of the
pregnancy, delivery, or their management while indirect maternal death
is a pregnancy-related death in a patient with a preexisting or newly
developed health problem. However, there are also maternal deaths
caused by accident or by domestic violence. But these two are more
considered as "other causes" or incidental.
In the past, the issue on maternal death has not received much
attention, but because of the alarming incidents reported especially
in third world countries during the early part of this century, not
only were the medical practitioners alarmed but the governments as
well. The United Nations estimated global maternal mortality at
529,000, of which less than 1% occurred in the developed world in the
year 2000. Another report revealed that there are approximately 27
maternal deaths per 100,000 live births each year in developed
countries but in developing countries, the average is 18 times higher,
at 480 deaths per 100,000 live births.
In 2003, the WHO, UNICEF and UNFPA produced a report with statistics
gathered from 2000. The world average was 400, the average for
developed regions were 20, and for developing regions 440. The worst
countries were: Sierra Leone (2,000), Afghanistan (1,900), Malawi
(1,800), Angola(1,700), Niger (1,600), Tanzania (1,500), Rwanda
(1,400), Mali (1,200), Somalia, Zimbabwe, Chad, Central African
Republic, Guinea Bissau (1,100 each), Kenya, Mozambique, Burkina Faso,
Burundi, and Mauritania (1,000 each).
Medical practitioners have specified the major causes of maternal
death and the top culprit is severe bleeding/hemorrhage which is 25%.
This is followed by infections (13%), eclampsia (12%), and obstructed
labor (8%). The report likewise indicated that 20% of maternal deaths
are due to other indirect causes such as malaria, anemia, HIV/AIDS and
cardiovascular disease, complicate pregnancy or are aggravated by it.
Despite the gravity of the problem, medical practitioners assured
that at least half of all maternal deaths can be averted through a
combined strategy of family planning, primary health care and legal
abortion. Researchers also concluded that a fertility rate reduction
of 25-35% resulting from more widely available family planning would
also lower maternal mortality by 1/4. Making abortions legal and safe
could reduce the toll an additional 20-25%. On the part of the
governments, a number of steps have been charted. Among these is to
make all pregnancies safer thru increased investments in prenatal
health care and reducing the number of high-risk pregnancies which is
foreseen to prevent another 20-25% of deaths. And to make everyone,
not only medical practitioners but all concerned individuals aware of
the rising maternal mortality, In 1998, WHO designated Safe Motherhood
as the focus for World Health Day (April 7), indicating the importance
of this issue globally.
And just as Wallace further said in his poem "Woman, how divine your
mission Here upon our natal sod!" we must value our women and make
them aware of their importance in this world.
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