Why mothers still lose life extending life to newborns

By Elizabeth Mwai

At least 21 women die daily from childbirth-related complications in Kenya.

The women, who carry their pregnancies almost to term, do not enjoy the pleasure of cajoling their crying bundles of joy to silence.

Annually this adds up to about 7700 families losing their mothers, sometimes the sole breadwinners in the process of delivering an offspring.

These grim statistics have remained unchanged over the last decade, despite advancements in technology.

The World Health Organisation (WHO) and African Medical and Research Foundation (Amref) say such loss of life is preventable.

WHO Country Representative David Okello describes the reasons for continued high maternal mortality as a "puzzle."

"Pregnancy is not a disease. Why should we allow natural phenomena to kill?" Okello posed.

Children whose mothers die during delivery are 10 times more likely to die within two years of their mothers’ death.

The report shows that babies whose mothers died during the first six weeks of their life are more likely to die before their second birthday than infants whose mother survives.

Okello is calling on professionals to undertake maternal death audits to unlock the deadlock that has seen women continue to lose their lives.

Mothers and their babies. Advances in medical technology are yet to translate into safer deliveries. [PHOTOS: FILE/STANDARD]

He says if medics could pressure each other to release information on circumstances of each maternal death, a solution could be found.

Home deliveries

"We need a better understanding of why many mothers die during child birth," said Okello. The current mortality ratio given by the Government is 414 deaths per 100,000 live births. This has not changed as recorded by the Kenya Demographic Health Survey of 2003.

Despite technological advancement and publicity on the dangers of delivering at home, 60 per cent of women continue to give birth under unskilled care.

The WHO boss said action to reverse the trend could only be possible if professionals outlined the problems.

The Amref Director of Reproductive and Child Health Dr John Nguba says reasons for the high maternal mortality are ordinary but disturbing.

"Ordinary because they are preventable. For example over-bleeding because one has delivered at home and there is no competent person to assist her," says Nguba.

According to the Kenya Demographic Health Survey of 2009, 55 per cent of women deliver at home.

Nguba says reasons include delay in transport, health facility being far and sometimes not getting the care required in the available health centres.

The poor state of health facilities in remote areas and the lack of constant medical supplies are a major reason why women do not deliver in health centres.

It is estimated that about a quarter of hospitals have constant supply of medicines.

Sometimes such facilities have constant shortage of oxygen and anaesthetic equipment. According to Nguba, this is caused by low budgetary allocation.

Kenya has failed to implement the recommendation of the Abuja Declaration advising countries to increase their health budgetary allocation to 15 per cent.

Nguba points out that traditional and cultural practices by some communities in North Eastern and Coast Provinces are also responsible for women preferring to deliver at home.

BLOOD PRESSURE

This is rampant among nomadic and pastoral groups, while in Nyanza it is due to a multiplicity of reasons including high prevalence of HIV and Aids and malaria.

But Nguba, cautions against home delivery due to poor hygiene, which is responsible for about 22 per cent death, bleeding estimated to be 30 per cent, while high blood pressure, malaria and HIV and Aids contribute to the rest of deaths.

When women become pregnant their immunity is very low and therefore susceptible to disease.

On the other hand, if a woman has HIV and Aids, a mild ailment like throat infection turns into a complicated condition.

This has been the reason for the growing numbers of child headed families and unless reversed, poverty will remain a daunting reality for the affected.

Further, poor investment in reproductive health services is also to blame for the high maternal deaths. According to the latest Kenya Demographic and Health Survey (KDHS), more women and children are dying at birth than was the case five years ago. The 2008-09 survey says there are approximately 488 maternal deaths per 100,000 live births, up from 414 in 2003.