Good Health And Well-Being: Introduction to the challenges for maternal health #maternalhealth #sdgs

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Maternal mortality rates are going down because of better health services. Above: A mother nurses her newborn at a maternity ward in Sierra Leone.

Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While motherhood is often a positive experience, for too many women it is associated with suffering, ill-health and even death.
The major direct causes of maternal morbidity and mortality include haemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labour.
99% of all maternal deaths occur in developing countries.
Women in developing countries have on average many more pregnancies than women in developed countries, and their lifetime risk of death due to pregnancy is higher. A woman’s lifetime risk of maternal death – the probability that a 15-year-old woman will eventually die from a maternal cause – is 1 in 3800 in developed countries, like the US or France, versus 1 in 150 in developing countries. In Somalia, 1 in 12 women will die in childbirth.
The major complications that account for 80% of all maternal deaths are:
  • severe bleeding (mostly bleeding after childbirth)
  • infections (usually after childbirth)
  • high blood pressure during pregnancy (pre-eclampsia and eclampsia)
  • unsafe abortion
The remainder are caused by or associated with diseases such as malaria, and AIDS during pregnancy.
Maternal health and newborn health are closely linked. More than three million newborn babies die every year, and an additional 2.6 million babies are stillborn
The high number of maternal deaths in some areas of the world reflects inequities in access to health services, and highlights the gap between rich and poor.
Maternal mortality is higher in women living in rural areas and among poorer communities. Young adolescents face a higher risk of complications and death as a result of pregnancy than older women. Access to skilled care before, during and after childbirth can save the lives of women and newborn babies.
Why do women not receive the care they need?
Some factors that prevent women from receiving or seeking care during pregnancy and childbirth are:
  • poverty
  • distance
  • lack of information
  • inadequate services
  • cultural practices.
How can women’s lives be saved?
Most maternal deaths are avoidable, as the health-care solutions to prevent or manage complications are well known. All women need access to antenatal care in pregnancy, skilled care during childbirth, and 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.
Severe bleeding after birth can kill a healthy woman within two hours if she is unattended. Injecting oxytocin immediately after childbirth effectively reduces the risk of bleeding.
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.
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.
To avoid maternal deaths, it is also vital to prevent unwanted and too-early pregnancies. All women, including adolescents, need access to family planning, safe abortion services to the full extent of the law, and quality post-abortion care.
In sub-Saharan Africa, a number of countries have halved their levels of maternal mortality since 1990. In other regions, including Asia and North Africa, even greater headway has been made. However, between 1990 and 2010, the global maternal mortality ratio (i.e. the number of maternal deaths per 100 000 live births) declined by only 3.1% per year.

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