Maternal Mortality - By Zakari Usman »

Child birth is a thing of great joy for families but the journey through pregnancy, delivery and the period immediately post-delivery is not always entirely smooth. No two pregnancies are the same as each comes with peculiar pregnancy related issues.

I have been lucky to have taken delivery of countless babies and also been present at the bedside for all of my wife’s labour/deliveries. The experience is harrowing for all spontaneous vaginal deliveries. Some other people deliver via caesarean section that is either planned (elective) or an emergency because of a number of reasons.
Normal delivery is therefore a diagnosis in retrospect. Only when there is complete spontaneous vaginal delivery of baby and placenta without complication to the mother and the baby within 3-18 hours of labour. All pregnancies can encounter complication.

In the last 2 days the Kogi social media space has been awash with heart rending tales of yet another case of perinatal mortality- Victoria Oyiza Ernest Balagbogbo . From the testimonies, the simplest conclusion is that, she was a nice person who did not entirely get the best deal out of life. May her soul rest in peace and may her family and friends be consoled. Many others have met similar fate, dying in an attempt to bring forth other lives.

No woman deserves to die in an attempt to give life to others.

Maternal mortality is defined by World Health Organization as the death occurring in women (excluding accidental or incidental death) during pregnancy or within 42 days of termination of pregnancy. This definition is irrespective of both the duration and site of pregnancy. As at 2017, it was estimated that about 810 women died from preventable causes related to pregnancy and child birth (WHO).

In 2017, an estimated 295 000 women died worldwide from complications of pregnancy and child birth. 94% of these death occurred in low income countries. Sub Saharan Africa and south East Asia contributed 254,000 (86%) out of which Sub Sahara Africa alone accounted for two-third of the total population (196,000).

In Nigeria, the maternal mortality rate is 814 death per 100,000 live births. An average Nigerian woman has a lifetime risk of 1 in 12 dying from complications of pregnancy, delivery and post-delivery/post abortion.

Maternal mortality has also been attributed to “Three delays

a. Delay in decision making (Many will Attempt delivery at home or go to prayers houses or even peripheral shops masquerading as hospital). Some will have to wait for Oga to come back because of money.

b. Delay in transportation (Distance to health facility, accessibility especially with those in hard to reach communities and availability of means of mobility

c. Delay in intervention at the health facility (availability of qualified skilled health care worker, skills of available health practitioner to take immediate operative action or otherwise.

WHY DO THESE WOMEN DIE?

Severe bleeding; mostly bleeding after giving birth (Postpartum Hemorrhage)
Infection (sepsis) after child birth
High blood pressure during pregnancy (Pre-Eclampsia and Eclampsia)
Complications from delivery
Unsafe abortion.
Others (Malaria, Anaemia)

HOW CAN MATERNAL MORTALITY BE PREVENTED.

All pregnancies should be planned
Register and attend all ante-natal visits in a hospital with skilled birth attendants as soon as you know you are pregnant
Plan for both normal delivery and caesarean section (save money, you never know)
Go to the hospital immediately you begin to have labor pains (not prayer homes)
Avoid home deliveries (you are not a Hebrew woman)
Caesarean section is safe, listen to your doctors when they recommend it.
Maintain impeccable personal hygiene
register with social health insurance scheme to avoid catastrophic health expenditure

God bless all mothers
✍✍✍

Zax 2021 (c)