Maternal Mortality - Essay Example

 Maternal mortality Introduction Maternal mortality refers to the death of a woman or girl arising from the complications related to pregnancies. The definition extends to the death of a woman arising within forty-two of terminating a pregnancy. Pregnancy-related complications are major causes of women death often killing more than eight hundred women on a daily basis. India has the highest rate of maternal mortality in the world. The country recognizes the appalling statistics and continues to collaborate with various international bodies including the United Nations and non-governmental organization to combat the vice responsible for the death of more than two hundred women on a daily basis in the country (Koblinsky, 2003). Maternal mortality is a serious global problem with diverse causes and equally diverse consequences. Combating maternal mortality requires an interagency approach as the discussion below portrays. Maternal mortality is a complex problem that has numerous direct and indirect factors. Direct factors are those that that arise in the course of pregnancy or delivery. Such factors, therefore, occur in the management of both pregnancies and deliveries. Indirect factors are preexisting or new health complications and infections that become severe with either the pregnancy or delivery thus leading to the death of the woman. Among the direct factors are postpartum bleeding, hypertensive disorders of pregnancy, complications from unsafe abortions, obstructed labor, and postpartum infections. Indirect causes of maternal mortality include HIV/AIDS, malaria, anemia and cardiovascular diseases among many others (Koblinsky, 2003; pg 45). The prevalence of the factors above arises from the complex nature of both the pregnancies and the delivery processes. Each of the above factors is serious and, therefore, requires prudent and effective management to save the life of the woman, the baby or both. Postpartum bleeding that causes about 15% of maternal death refers to the excessive bleeding of women during childbirth. In most cases, women lose 50ml to 1000ml of blood and may continue for hours. The excessive loss of blood causes the deficiency of both oxygen and nutrients to such vital organs of the body as the brain thus causing instantaneous deaths. Causes of the excessive bleeding include tearing of the uterus walls, poor contraction of the uterus and poor blood clotting. Postpartum infections on the other cause more than 10% of the reported maternal mortalities. Postpartum infections refer to any bacterial infections of the female reproductive tract after childbirth (AbouZahr & Wardlaw, 2004; pg 32). Among the notorious risk factors of the infections is the cesarean section, prolonged labor, presence of such bacteria as group B streptococcus in the reproductive organ and premature rapture of the membranes of the uterus among others. Complications arising from unsafe abortions cause more than 15% of the reported cases of maternal mortality. The complications are always as diverse as the techniques that people use to procure abortions. In most countries, abortion is an illegal practice a feature that compels pregnant women to seek the services of quacks especially in such developing countries as India. Most women die from excessive bleeding and infections among other complications arising from unsafe nature of the procedures. The prevalence of maternal mortalities in India represents the gap between the rich and the poor since most of the reported cases occur in the impoverished neighborhoods and are minimal among the rich. Furthermore, they portray the inequalities that exist in accessing high-quality health care services. Maternal mortalities are always preventable through effective health care services. Failure to seek such services heightens the danger thus causing the deaths. Numerous social and economic factors conspire to account for the high rates of maternal mortality among the poor in India. In the country, the rate of deaths is high in rural and poor areas within urban centers (Koblinsky, 2003; pg 93). Additionally, statistics shows that adolescents and young adults are at higher risks of maternal mortality than married female adults are. Among the social factors that lead to the high prevalence of maternal mortality is lack of information. Most women in the rural areas and those in impoverished parts of the urban centers lack adequate information on pregnancies. Pregnancies are complex processes that require effective management. Managing both a pregnancy and the delivery process requires adequate information coupled with skilled professions to guide the women. Lack of adequate information on the dangers of sexual activities among adolescents and young adults handles the high number of teenage pregnancies. In fear of social ridicule, scolding, and prejudice, most teenagers procure abortions oblivious of the dangers of such processes (Dutta, 2012; pg 66). Lack of information on the delicate nature of pregnancies is responsible for the careless lifestyles of most women during pregnancies thereby increasing the risk of infections among other indirect factors that lead to maternal mortality. Illiteracy among women in India further aggravates the situation with studies showing that rates of maternal mortality are higher among illiterate women. Illiterate women can neither seek nor access information. The government and the numerous non-governmental organizations operating in the country circulate information through printed media and the social media both of which are elitist thereby secluding the poor and illiterate populations living in the rural and impoverished areas in the urban centers throughout India World (Health Organization & Safe Motherhood International Conference, 1987; pg 4). Traditional gender roles further contribute to the predicament of the women and girls in India. Women work hard in fields in their attempt to fend for their families. Women in rural India spend more than ten hours working as unskilled laborers in companies and plantations. The need to provide for their families compels women to forgo such vital resources as clinics during pregnancies a feature that increases the dangers of acquiring infections that later contribute to the deaths. Schwartz, (2009; pg 41) explains that Cultural values and traditions in India heighten the risk for adolescents and young adults. Premarital sex is common among adolescents and young adults most of whom are vulnerable owing to the poverty of their families. India has had cases of culturally accepted rape. While the society does not discourage premarital sex, girls who give birth before birth find it difficult to find husbands. Such cultural practices and values force young girls to procure abortions. Statistics shows that cases of maternal mortality are high among adolescents and young adults. Such vulnerable populations seek abortions owing to the fear they have given their cultural values. Another equally important factor that accounts for the high rates of maternal mortality among poor women in India is the state of infrastructural development of their neighborhood coupled with their poor economic state. Rural areas in India are marginalized thus underdeveloped. The areas lack such basic infrastructure as roads and hospitals. Seeking emergency health care is difficult owing to the poor state of roads coupled with the fact that most health facilities are in the urban centers. Ambulance services do not extend to the rural populations and the urban poor. Health care is costly thus unaffordable for a significant number of Indians. Most of the people living in rural areas in India survive on subsistence farming. The urban poor either are unemployed or survive on informal wages. Such economic factors make it difficult for the people to access high-quality health care and such emergency services as ambulance services (Dutta, 2012). The state of public health care system in India further contributes to the high rates of maternal mortality in the country. Public hospitals and health care centers are few and concentrated in the urban centers. The marginalized rural populations walk for tens of kilometers to reach such facilities. The equally poor state of roads in the countryside further makes the prospects futile. Additionally, most of the public health facilities lack some of the basic facilities including Intensive Care Unit facilities, the lack of such facilities account for the large number of women who die in the health facilities (Gary & Hunt, 2013; 21). The rich in India seek health care services from private health facilities. The private institutions are businesses and, therefore, offer their services at high costs and are available only in big cities across the country thereby discriminating against the rural populations and the urban poor. Maternal mortality has numerous social and economic effects in the society. The deaths of the women most of whom are always the breadwinners in their families complicate the lives of other children in the families. When the women die, some leave behind numerous children who must begin living without the love and care of their mothers. In most cases, the children die alongside their mothers. Teenagers and young adults seeking abortions often die alongside the fetus they kill in the processes. In cases where the women survive the numerous pregnancy-related complications, they survive with serious and permanent injuries that affect their physical wellbeing and ability to deliver in future. Indian culture discriminates against physically handicapped and women who cannot deliver irrespective of the courses. The ordeals, therefore, leave the women with pain and agony for the rest of their lives a feature that lowers the quality of their lifestyles (World Health Organization & Safe Motherhood International Conference, 1987; pg 05). The discussion above shows the seriousness of maternal mortality. It further shows the socioeconomic factors that lead to the deaths. Preventing maternal mortality requires a multi-agency approach. The Indian government, the United Nations and numerous non-governmental organizations in the country, must collaborate and share resources thereby invest in strategic policies to help stop the deaths. The government must invest in improving the plight of the girl child in India. The government in collaboration with the United Nations and the various NGOs must encourage the rural and low-income families to take their female children to school and to encourage a shift in cultural practices and encourage safe sex practices (India & University of Toronto, 2006). As contentious as it may sound, the government should investigate the prospects of making abortions legal and offered in legitimate health facilities in the country. The government must invest in developing health facilities in rural areas and equip them with functional equipment and trained personnel. Improving roads and infrastructural network in the region will further open up the region thereby making it easy for the population to access health services. Availing information is important in combating maternal mortality. The non-governmental organizations must invest in educating women, female adolescents, and young adults on the importance of pregnancies thereby recommending effective ways of preventing infections and maintain healthy pregnancies. In retrospect, maternal mortality is a serious global issue with the World Health Organization striving to reduce the percentage through the formation of the Millennium Development Goals. Combating the vice requires the extensive contribution of every institution including the government and non-governmental organizations. India, a country that has one of the highest rates of maternal mortalities, provides a perfect case for analysis. The case shows that the rural populations and the urban poor are some of the most vulnerable. The agencies must, therefore, target such populations, initiate cultural change, and improve the availability of information on maternal mortalities. Additionally, they must educate the community on dangers of pregnancies and the need for teenagers to either abstain from sex or practice safe sex through civic education among other functional methods to create a holistic solution to the problem thus reducing the statistics globally. References Koblinsky, M. A. (2003). Reducing maternal mortality: Learning from Bolivia, China, Egypt, Honduras, Indonesia, Jamaica, and Zimbabwe. Washington, DC: World Bank. https://books.google.co.ke/books?id=YKgOJNhtT84C&pg=PA35&dq=Reducing+maternal+mortality:+Learning+from+Bolivia,+China,+Egypt,%09Honduras,+Indonesia,+Jamaica,+and+Zimbabwe.+Washington,+DC:+World+Bank.&hl=en&sa=X&redir_esc=y#v=onepage&q=Reducing%20maternal%20mortality%3A%20Learning%20from%20Bolivia%2C%20China%2C%20Egypt%2C%09Honduras%2C%20Indonesia%2C%20Jamaica%2C%20and%20Zimbabwe.%20Washington%2C%20DC%3A%20World%20Bank.&f=false Gary, T. & Hunt, P. (2013). Maternal Mortality, Human Rights and Accountability. New York: Routledge. https://books.google.co.ke/books?id=9eMdAAAAQBAJ&pg=PR22&dq=Maternal+Mortality,+Human+Rights+and+Accountability&hl=en&sa=X&ved=0CBsQ6AEwAGoVChMIjcCH2JzNyAIVCe0UCh1eaw1V#v=onepage&q=Maternal%20Mortality%2C%20Human%20Rights%20and%20Accountability&f=false Kashyap, A., & Human Rights Watch (Organization). (2009). No tally of the anguish: Accountability in maternal health care in India. New York, NY: Human Rights Watch. https://books.google.co.ke/books?id=B639dyE5VH4C&printsec=frontcover&dq=No+tally+of+the+anguish:%09Accountability+in+maternal+health+care+in+India.&hl=en&sa=X&ved=0CBsQ6AEwAGoVChMIj5KE9JzNyAIVA7wUCh2KFQ9Q#v=onepage&q=No%20tally%20of%20the%20anguish%3A%09Accountability%20in%20maternal%20health%20care%20in%20India.&f=false India., & University of Toronto. (2006). Maternal mortality in India, 1997-2003: Trends, causes, and risk factors. New Delhi: Office of the Registrar General India. Dutta, D. K. (2012). Insight Maternal Mortality: An Indian Facebook. New Delhi: Jaypee Brothers Pvt. Ltd. AbouZahr, C., & Wardlaw, T. (2004). Maternal mortality in 2000: Estimates developed by WHO, UNICEF and UNFPA. Geneva: Department of Reproductive Health and Research, World Health Organization. http://apps.who.int/iris/bitstream/10665/68382/1/a81531.pdf Schwartz, L. (2009). Milton and maternal mortality. Cambridge: Cambridge University Press. World Health Organization., & Safe Motherhood International Conference. (1987).Measuring maternal mortality. Geneva?: World Health Organization. http://www.biomedcentral.com/1741-7015/6/12 Read More