In northern Nigeria, merely trying to give birth puts women up against a struggle between life and death.
According to the World Health Organisation (WHO), 99% of maternal deaths occur in developing regions where women face significant challenges in maternal health during pregnancy, childbirth, and in the postpartum period. Due to a wide set of complications, which are often aggravated because of scarce resources and technology, women run the risk of developing serious and sometimes life-threatening conditions.
The major causes of maternal mortality include infection, hemorrhage, hypertensive disorders during pregnancy, obstructed labour, and complications from unsafe abortions. Severe bleeding known as postpartum hemorrhage (PPH) is the most common, accounting for nearly 25% of maternal deaths in developing countries, as cited by the WHO.
Atonic PPH is the most prevalent type of pregnancy-related hemorrhage and is prompted by the failure of the uterus to contract sufficiently after birth. Other cases, according to the WHO, include traumatic PPH, which is caused by the tearing of the genital track and the retention of placental tissue.
“Unfortunately, it is not possible to predict who will experience PPH,” Dr. Abdelhadi Eltahir told MediaGlobal. Eltahir is senior advisor for maternal and newborn health at Pathfinder International, which works to increase health services for women in developing regions. He added, “However, it is possible to take steps to prevent PPH and to manage it when it occurs. Having access to a skilled provider who can perform active management of the third stage of labor (AMTSL) can prevent PPH. When bleeding occurs, a blood collection drape or another standard method for measuring blood loss can signify when bleeding becomes excessive.”
The International Confederation of Midwives (ICM) identifies AMTSL as three components consisting of: administration of uterotonic agents, controlled cord traction, and a uterine massage after delivery of the placenta. In coordination with AMTSL, it is crucial that communities have the necessary technology and properly trained staff. But in many regions, such as Nigeria, where resources are lacking and mobilization poor, the dismal statistics reflect a sad reality for women.
According to estimates by the WHO, UN Children's Fund (UNICEF), UN Population Fund (UNFPA) and the World Bank, the adult lifetime risk of maternal death is the highest in Africa with a staggering ratio of one in 26 as compared to the ratio in developed regions of one in 7300.
Eltahir explained that during childbirth, blood that exceeds 500ml is an indicator of danger. He stressed that women who are anemic are at a higher risk of complications. Eltahir further emphasised that it is during this part of childbirth in which “clinical sense and judgment is extremely important and life-saving.”
Excessive bleeding can cause a woman to go into shock, but through the utilisation of an anti-shock garment, the path of blood can be directed back to her heart and brain. This is a preventative measure that can keep her alive.
Eltahir cited the new technology that Pathfinder has introduced into Nigeria and India: the non-pneumatic anti-shock garment (NASG), which is a proven life-saving measure for women. Nigeria and India are a focus of Pathfinder because the two countries have the highest rates of maternal deaths. Pathfinder is working to reduce these rates through continued intervention and preventive measures.
Recounting his experiences in Africa, Eltahir told MediaGlobal, “In northern Nigeria, I witnessed a woman brought to the hospital in shock due to [postpartum hemorrhage] as a result of [a] retained placenta. She had a very weak and rapid pulse and her blood pressure could not be recorded. The NASG was applied, she received a blood transfusion and the cause of her bleeding was treated. If the NASG had not been available, she almost certainly would have died.”
“At Pathfinder we have zero tolerance to maternal deaths,” Eltahir told MediaGlobal. “We are refusing to accept maternal mortality and we are doing everything we can—at every intervention point from when a woman first receives information about contraception to her prenatal care visits—to achieve that objective.”
Article published courtesy of GlobalMedia
