Maternal Mortality: Causes, Demographics, Factors And Prevention

According to the World Health Organization, maternal health “refers to the health of women during pregnancy, childbirth and the postpartum period”. Although, motherhood is mostly perceived as a fulfilling and a positive experience, many women across the world undergo ill-health, suffering and in some cases, this proves to be fatal.

The World Health Organization has cited the following as the direct causes of maternal mortality as well as morbidity:

  • hemorrhage
  • infection
  • high blood pressure
  • unsafe abortion
  • obstructed labor

Maternal Mortality Demographics

Countries that contribute to half of the world’s maternal mortality rate are as follows:

  • India: 17%
  • Nigeria: 14%
  • Democratic Republic of Congo: 7%
  • Ethiopia: 4%
  • Indonesia: 3%
  • Pakistan: 3%
  • United Republic of Tanzania: 3%
Maternal Mortality

Image courtesy of childinfo.org

 

The number of women and girls who died each year from complications of pregnancy and childbirth declined from 523,000 in 1990 to 289,000 in 2013. These improvements are particularly remarkable in light of rapid population growth in many of the countries, where maternal deaths are highest. Still, about 800 women are dying each day in the process of giving life. And for every woman who dies, approximately 20 others suffer serious injuries, infections or disabilities. Almost all maternal deaths (99 per cent) occur in developing countries.

Two regions, sub-Saharan Africa and South Asia, account for 86 per cent of maternal deaths worldwide. Sub-Saharan Africans suffer from the highest maternal mortality ratio – 510 maternal deaths per 100,000 live births, or 179,000 maternal deaths a year. This is nearly two thirds (62 per cent) of all maternal deaths per year, worldwide. South Asia follows, with a maternal mortality ratio of 190, or 68,000 maternal deaths a year, accounting for 24 per cent of the global total. That said regional and global averages tend to mask large disparities both within and among countries.

Additional data on the topology of maternal health can be found on this page.

Factors

Sociological factor

  • One of the primary reasons of maternal mortality is directly linked with the development of countries; that is in some area of the world, unequal health services which essentially underlines the gap between the rich and poor. Deaths reported mostly are in developing countries. These belts of mortality include sub-Saharan Africa and nearly one third of South Asia.
  • The sociological factors often determines shift in maternal mortality rate, one of these being,
  • The maternal mortality ratio in developing countries in 2013 was 230 per 100 000 live births versus 16 per 100 000 live births in developed countries. And, since development varies from one country to another, some countries have mortality rate as high as 1000 per 100 000 live births.
  • Then again, disparity between women of higher income in urban areas and that of lower income ones in rural areas inverse the proportion of mortality accordingly.
  • For adolescent girls under 15 years old mortality is the highest. Complications during both pregnancy and childbirth have been significant in causing death in developing countries.
  • In developing countries, women on average have more pregnancies than women in developed countries. Moreover, the risk of death due to pregnancy becomes higher. According to statistic, of WHO “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 3700 in developed countries, versus 1 in 160 in developing countries”.
  • Other factors that prevent women from receiving or seeking care during pregnancy and childbirth are:
  • poverty
  • distance
  • lack of information
  • inadequate services
  • Cultural practices.

Barriers that mostly limit access to quality maternal health service should be identified as well as addressed. To have a better insight on this story you can read more in this article.

Biological factors

While complications during pregnancy and child birth persist to be the leading causes of maternal mortality, complications during the former has been reported as the most frequent cause for mortality. Almost 75% of these deaths are accounted due to:

  • Severe bleeding (mostly bleeding after childbirth)
  • Infections (usually after childbirth)
  • High blood pressure during pregnancy (pre-eclampsia and eclampsia)
  • Complications due to delivery.
  • Unsafe abortion.
  • Pre-existing conditions
  • Severe bleeding
  • Pregnancy-induced high blood pressure
  • Infections
  • Obstructed labor
  • Abortion complications
  • Blood clots/embolism
Distribution of Maternal Deaths in Africa by Cause

Image courtesy of UNICEF

 

While the other causes could be malaria or AIDS during pregnancy. To have a closer look you can refer detailed information in this article.

Prevention

Maternal deaths have been reported to be mostly preventable since medical advancements have enabled health care solutions to prevent or manage known complications. Basically women need access to basic health services, which include antenatal care in pregnancy, skilled care during childbirth, along with proper care and support weeks after childbirth. The following are the basic preventative steps practiced:

  • Unwanted or too early pregnancies must be avoided.
  • Access to contraception and abortion services inclusive of post abortion care.
  • Severe bleeding after birth can prove to be fatal for a healthy woman, within 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.
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