When communities don’t realise that traditional practices are contributing to poor maternal health and ultimately maternal death, they carry on the way they are. Being trained in reproductive health and family planning can help to shift thinking in the communities which will save lives.
Introducing the concept of child spacing leads us to talk about the medical and natural methods of family planning. Benefits of these to the mother can improve her health as it allows her to recover between each birth, breast feed each child for longer and have fewer children less often.
I remember the day I watched with horror as 3 women who desperately needed a caesarian to avoid maternal death or stillbirth, or at the very least an obstetric fistula, were told they could not have one until they found the money to pay the Doctor.
Major causes of Maternal deaths
- Haemorrhage
- Obstructed labour leading to a ruptured uterus
- Infection
- Abortion
These 4 causes of death are preventable with a greater understanding of the causes.
Haemorrhage is common in childbirth and needs the skills of a trained birth attendant, access to safe blood transfusions to save a mothers life. After the birth of the 6th baby the risk of bleeding increases. Women in Uganda have an average of 7 babies each, and only 42% have a trained attendant at the birth.
Abortion is the all too common solution to unplanned pregnancy. When young girls find themselves with an unplanned pregnancy they are faced with the dilemma of the uncertainty of living. In desperation, many choose illegal and unsafe abortions leading to complications of bleeding, infection or permanent infertility due to poor unclean technique. An older mother who dies from an abortion leaves behind many uncared for children.
Obstructed labour This happens when the baby’s head is too big to fit through the pelvis. It can occur at any time but is most common amongst the very young girl trying to have her first baby. The often small sized pelvis leads to lengthy labours of up to 3 days resulting in either a stillbirth, maternal death or permanent damage to the young girls pelvic organs, the bladder, bowel.
An obstructed labour in a woman who has had babies can lead to a ruptured uterus, once again causing stillbirth and maternal death.
Obstetric fistula occurs when the bowel and bladder are permanently injured during a long, obstructed labour. This leaves the women leaking faecal fluid uncontrollably. The repair requires a difficult operation that few can afford. They remain permanent outcasts in a village.
Infection can be avoided if hygiene principles are followed for labour, birth and care for the mother post-delivery. Ensuring the mother has a clean, safe place to deliver with access to clean water are basic necessities. And ensuring that infections after the birth are treated immediately at the Health Clinic can be life-saving.
