What is maternal mortality and how can it be reversed?

Pregnancy and childbirth are usually times for celebration, togetherness, and joy. But for those mothers who have limited access to healthcare infrastructure or complications that may arise before, during, or after birth, it can be a source of immense stress, anxiety, and trauma.

This is because for every 100,000 live births, 152 pregnant women die from causes like postpartum hemorrhage, eclampsia, obstructed labor, and sepsis. Maternal mortality refers to all the mothers who die pre- or post-pregnancy, or during childbirth.

However, with recent leaps in medicine, science, and technology, these deaths are mostly preventable. Despite this, maternal mortality continues to be high in South Asia, Sub-Saharan Africa, North Africa, and the Middle East. This is because of the limited access, awareness, and affordability of high-quality health care for many pregnant women living in developing countries.

According to the WHO, there are many reasons behind high rates of maternal mortality:

• severe bleeding before, during, or after childbirth

• infections post-childbirth

• high blood pressure during pregnancy

• complications from delivery

• unsafe abortion

• anemia, malaria, and heart disease

• delay in seeking help for complications

• unavailable emergency equipment or services like ambulances

• lack of mental health support post-birth

• lack of access to good physicians and gynecologists in remote, rural areas

• lack of trained midwives

• lack of post-abortion or post-birth care

• lack of pregnancy education

• poor nutrition during pregnancy

• child marriages or child brides whose bodies aren't ready for pregnancy

• psychiatric illnesses

• partner violence during pregnancy

• tuberculosis, epilepsy

While mortality refers to the deaths of women from pregnancy-related complications, maternal morbidity deals with health problems that result in the short or long run from being pregnant and giving birth.

These could include cardiovascular problems, diabetes, high blood pressure, infections, especially from cesarean section, blood clots, excessive bleeding, or a condition called anemia, in whichyour blood produces a lower-than-normal amount of healthy red blood cells. It's important to note that globally maternal morbidities are more common and affect a larger percentage of women and girls.

Neither of these should be confused with the child mortality rate or ratio, which takes into account the number of deaths of children under the age of 5. 

According to UNICEF, Chad, Sierra Leone, and South Sudan have the highest maternal mortality rates.

According to OurWorldinData, Afghanistan is also one of the countries with the highest maternal mortality rates. Data shows that 638 women die per 100,000 live births.

The Maldives has shown a 90% improvement when it comes to reducing its maternal mortality ratio bringing it down from a high of 677 deaths to 68 deaths per 100,000 live births.

Finnish, Icelandic, Greek, and Polish women, on the other hand, have the lowest risk of dying from pregnancy or childbirth-related complications.

Absolutely! There are many lessons to learn from countries that have been able to do so! These interventions include:

• better access to advice, care, and supervision by trained medical staff

• improving post-partum care (e.g. at home visits)

• access to prenatal or pre-birth care for new mothers

• training more midwives or birth attendants

• community mobilization for family planning and emergency medical assistance

• educating people on health services so they rely less on spiritual healers or unlicensed doctors in emergencies

• identifying high-risk populations

• preventing unwanted pregnancies, forced marriages, child marriages where a woman isn't physically or mentally ready for childbirth

• better hygiene protocols during childbirth

• abandoning certain cultural customs around pregnancy that aren't science-backed (e.g keeping pregnant women in birthing huts)

• provide all women with higher decision-making power when it comes to reproductive health choices

What can countries do to help eliminate maternal mortality?