Maternal Mortality : Developing Countries

The poor state of maternal health has spurred Maternal Life International- a non-profit organization based in Montana- to direct their efforts for better maternal and neonatal healthcare at Haiti. Their objective is to build family health offices in the country to assist pregnant women and newborns.

Childbirth is one of the greatest privileges on the earth anyone could have and we, as women, should feel proud to be major contributors for it. Thus, a mother has to play a key role in aiding the healthcare workers to mitigate the health crisis associated with childbirth by performing her duties faithfully. One such associated health crisis is “Premature (preterm) birth” which occurs when the baby is born too early, before 37 weeks of gestational period (CDC, 2015). The rate of preterm birth ranges from 5% to 18% of babies born across 184 countries (WHO, 2015).

Infant deaths in the neonatal period are caused by complications arising from preterm births, birth defects, maternal health conditions, complications of labor and delivery, and lack of access to appropriate care at the time of delivery. Infant deaths in the post-neonatal period are driven by sudden unexpected infant death (SUID) (including sudden infant death syndrome [SIDS]), injury, and infection (MMRW, 2013). An increasing proportion of post-neonatal infant deaths occur among infants who were born preterm but survived the neonatal period (Callaghan, 2006). On the other hand there is lesser knowledge of the incidence and etilogy of fetal mortality which according to MacDorman et al, makes fetal mortality an overlooked public health issue. Lee et al, echoed the same idea when they said infant mortality has been the main focus of public health programming while fetal deaths have gone untargeted. However, with the decrease in infant mortality rates there have been recent approaches such as perinatal period of risk analysis framework (PPOR) that highlight the need to include fetal

Maternal mortality represents more than the loss of lives for individual women, as it also reflects the larger value and prioritization of women 's health and threatens the health and survival of families, young children, and even the communities in which they live (Royston and Armstrong, 1989). Maternal mortality is unacceptably high (WHO, 2015b). Globally, approximately 830 women die every day from pregnancy- or childbirth-related complications (ibid.). The causes of maternal mortality are predominately preventable and can be classified into three fundamental causes: (1) medical - consisting of direct medical problems and pre-existent/coexistent medical problems that are aggravated by pregnancy, (2) underlying - social and legal conditions, and (3) health systems laws and policies that address availability, accessibility, and quality of reproductive health services (PHP et al, 2011).

Watson and Mason’s article, “Power of the first Hour” and Risworth, et al.’s article “I was on the way to the Hospital but I Delivered in the Bush” both focus on aspects of maternal and infant care and demonstrate the fundamental differences between western policies enacted to improve women’s lives in developing countries and the local realty in those developing countries.

Maternal Mortality tells the story of Mama Seesay her family and friends, as well as all childbearing women in Sierra Leone and sub-Saharan Africa:

Centre for Maternal and Child Enquiries (CMACE) (2011) Saving mothers’ lives; reviewing maternal deaths to make motherhood safer: 2006-2008. BJOG 18(1): 1-203. London. Blackwell Synergy.

The most tragic part of maternal mortality in Sierra Leone is that almost all deaths are preventable. An article from TIME magazine tells the story of a young girl's "journey from pregnancy to death." Like other girls her age, Mamma Sessay was forced into marriage at 14. It was at age 15 that she experienced her first birth, but three years later she experienced her last. At 18, she gave birth to her first child in a set of twins. When she no longer felt the contractions of her second child, she was sent by canoe/ambulance from her local clinic to the nearest hospital. After delivering the second child, Mamma began hemorrhaging and losing substantial amounts of blood at a time. The constant loss of blood and decreasing blood pressure forced nurses to bring her to the surgical ward. With only one doctor in the district, Mamma waited a half hour before she could reach him. By the time he arrived her pulse had ceased and the doctor pronounced her dead. Mamma's body was soon preserved for the rituals of burial while her family mourned for their own

Globally, people’s health is improving. Since 1990, with a significant contribution from UK development programs, the number of children dying from preventable causes has fallen from around 12 million a year to around 7 million. In this period, the number of girls and women dying during pregnancy and childbirth has fallen from 543,000 a year to 287,000.Yet there is still much to be done. The poorest people in the world’s poorest countries suffer the most from ill health, and women suffer more than men. Much of this suffering could be prevented by using existing treatments and by applying the latest knowledge about what works. The challenge is to get these treatments to the people who need them the most - the poorest, the most marginalized, and those in fragile or post-conflict states. We want to speed up progress in improving people’s health.

In 2013, 289 000 women died during pregnancy and childbirth and it was estimated that everyday 800 women all over the world died from childbirth or childbirth-related problems (World Health Organization, 2014). Often, maternal mortality is found to occur more often in developing countries than developed countries. Maternal mortality refers women who died from the situation like during pregnancy, termination of pregnancy within 42 days, regardless of duration and place of pregnancy, from aggravation caused by the pregnancy or pregnancy management (Nwagha et al, 2010). Maternal mortality may be resulted from direct or indirect cause. Direct causes are from obstetric complications of pregnancy, labour, and puerperium, and interventions whereas indirect causes are from the worsening of current conditions by pregnancy or delivery (Givewell, 2009). This paper aims to examine the causes for maternal mortality in both developed and developing countries and will end with a proposal for government to ensure women are given reproductive health rights.

Because in many developing countries, there are all too often issues with women’s rights and negligence in women’s health, they are also striving to specifically provide women’s health care to those who are pregnant or who have been sexually abused. Just this year, Medecins Sans Frontiers notes one of their major accomplishments to be treating over 100 individuals for sexual assault after two instances of mass rape in the Democratic Republic of Congo by militias.

There are numerous issues surrounding maternal and infant health in South Africa. The maternal mortality ratio in South Africa is estimated at 156.5 per 100000 live births (Pattinson et al 2012). It is suggested that 60% of maternal deaths in South Africa are preventable (Amnesty International 2014). The three leading underlying causes of maternal mortality in South Africa include: HIV/AIDS, hypertension and obstetric haemorrhage (Pattison et al 2012). Approximately 30% of South African pregnant women and girls’ are HIV positive (Amnesty International 2014; DOH 2013a). KwaZulu Natal is the province with the highest prevalence of HIV at 37.4% for pregnant women (DOH 2013b). Hypertension and obstetric haemorrhage can be avoided through appropriate nutrition and dietary-related practices (Bradshaw et al 2008).

The leading causes of death and disability for Somali women of reproductive age are complication during pregnancy and childbirth, lack of access to skilled birth attendants, narrowly spaced births, early adolescent marriages, and female genital mutilation/cutting. Maternal mortality in Somalia is high and on the rise, it’s significantly higher than that of other developing countries. Country make steps towards reducing maternal mortality rates in Somalia. Cost is the main reason why mothers deliver at home and don’t seek help, even when there is a local clinic. By providing mothers with good nutrition and access to services without asking for payment, more women will seek out the care they need and that more lives will be saved.

The current death rate is 29 per 1,000 live births and of the 2.8 million newborns dying at birth worldwide, India accounts for 700,000 children dying at birth or shortly after. The National Health Policy to improve care children and women. Poor neonatal health conditions, widespread illiteracy, poverty, poor sanitation and nutrition have also been identified and India’s hopes to tackle these issues by passing this policy.

Throughout African countries, 16,000 babies and children are dying daily. This statistic is equivalent to eleven deaths occurring every minute, and these devastating numbers continue to increase yearly. However, catastrophic statistics in Africa can simply be decreased if hospitals utilize a baby hat mechanism called the Neopenda. Additionally, more than one million babies are currently dying the day they were born each year. Millions of babies die every year in Uganda, therefore the Neopenda device should be implemented to decrease this tragic problem.