Sending unprotected expectant women to battle

A GNA Feature by AUDREY DEKALU

Accra, 13 Sept, GNA - The birth of a baby is celebrated world wide, since society expects women to procreate to continue the biological line of replenishing the earth. While the celebration of the fertility of women has been going on for ages, only few people pause to consider the perilous nature of pregnancy and childbirth.

Through out the life-threatening journey, women are faced with prolonged labour, bleeding, while some are deformed or maimed for life. In less developed countries, more than half a million-mothers die from birth- related causes each year. Fati Alhassan, a citizen of Datoyilli, a village near Tamale, in the Northern Region was a typical example. Married at the age of 15, Fati joined her husband at Yapei, a

farming community and a year later she had her first child through a Traditional Birth Attendant (TBA). By 24, Fati had four children, all through untrained TBA's. She felt the compelling need for family planning but before she could get expert advise, she had become pregnant again. Her fifth delivery progressed initially without any complications then the unexpected happened. The baby's placenta refused to be discharged. The TBA, manoeuvred to pull it out but it was too late since Fati had bled profusely to death. Fati's tragic death was one amongst the many women who could have been saved if they were closed to a medical centre with qualified personnel and logistics.

According to Henrietta Odoi-Agyarko, Deputy Director of Maternal and Child Health Care of the Ministry of Health, Ghana recorded an average maternal mortality ratio of 214 to a 100,000 live births with a regional variation as high as about 800 per 100,000 live births. In the year 2001 alone, 954 women died in health institutions through pregnancy related ailments and childbirth.

In West and Central Africa, about 120,000 women die every year from complications during pregnancy or childbirth. The average maternal mortality ratio in sub-Saharan Africa is estimated at 940 to a 100, 000 live births. The immediate causes of maternal death in Ghana include post partum haemorrhage, severe anaemia and obstructed labour. Complications of pregnancy start suddenly, develop rapidly and may cause quick death. Post partum haemorrhage and obstructed labour for example cannot be predicted reliably and can lead to death within hours if prompt treatment is not given.

A greater proportion of maternal deaths, however, occur in the rural, urban and peri-urban disadvantaged communities. The magnitude of the tragedy becomes even more vivid when it is considered that for every woman who dies as a result of pregnancy and childbirth, at least 30 others are left incapacitated. This calls for antenatal and postnatal care and proper supervision of child deliveries to reverse the maternal and infant mortality rate.

There is scientific evidence that motherhood can be safer for all women, including the late Fati. In 2000, the United Nations General Assembly acknowledged that despite progress in some countries, maternal mortality and mobility remained unacceptably high in most countries, affecting over 500,000 women.

Although safe motherhood initiatives by Ghana's Health Ministry have focused mainly on preventive and primary healthcare, obstetric complication are major contributors to maternal mortality and cannot be contained without emergency curative interventions. As a first step towards reversing the trend, a maternal death audit desk has been set up to identify the real causes of these deaths and work out appropriate methods of reducing and preventing their occurrence.

The good news is that the Initiative for Maternal Mortality Programme Assessment (IMMPACT) has also been introduced. Additionally, a research institution, Nougochi Memorial Institute for Medical Research, has been selected to implement the project alongside other safe motherhood programmes. It is expected that these programmes would make child delivery more secured. However, these programmes would be more effective for all women if certain barriers such as the undue delays in seeking medical attention, misconceptions and expensive service delivery were removed.

Additionally, there should be strong political commitment at both the national and local levels to strengthen safe motherhood programmes. Maternal morbidity has dire social and economic consequences for families, communities and the nation at large hence the need for global efforts to reverse the trend.

Professor F.T. Sai, a Population Expert puts it aptly, "No country sends it soldiers to war... without seeing to it that they return safely, and yet mankind for centuries has been sending women to battle to renew the human resource without protecting them." Prof. Sai is the Former President of the International Planned Parenthood Federation and now Ghana's Presidential Adviser on Population and HIV/AIDS.