New Vision (Kampala)

14 May 2013

Uganda: Education of Girls Can Prevent Pregnancy Complications

Annually, 16 million girls aged between 15 and 19 give birth. Ninety percent of the births in developing countries occur in single teens or adolescent marriages. Many of these women have been married off as children and lack the education, money and status to get adequate healthcare services.

Complications run rampant in adolescent pregnancies. Children having babies will face substantial risk from having small pelvises that can obstruct labour, resulting in prolonged labour, birth injuries and an increased risk of stillbirths.

In many countries, the risk of maternal death is twice as high for adolescent mothers. However, maternal mortality rates of any age are unacceptably high throughout the world. The increased risk of dying from childbirth is linked to the increased rates of obesity, diabetes, high blood pressure and inadequate prenatal care.

Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth, according to the World Health Organisation (WHO). Severe bleeding, infections, unsafe abortion and high blood pressure conditions are the main killers that cause 70% of the deaths.

The good news - the WHO reports that maternal mortality has been cut in half in some of the most difficult areas since 1990. This dramatic improvement is primarily related to improved access to healthcare services before, during and after childbirth.

Continued advancement, education and policy development is needed to continue reducing the risk factors associated with maternal deaths.

Maternal death risk 1 in 150

Maternal health refers to the overall health of a woman during pregnancy, childbirth and the postpartum period. More than 136 million women give birth per year and about 20 million of them experience pregnancy-related complications.

Who is at greatest risk of pregnancy-related complications? A woman's risk increases with the number of pregnancies that she has. Therefore, adolescent girls under the age of 15 have the highest risks of developing complications over a lifetime.

It is important to know that the bleeding after a delivery can kill even a healthy woman, if not attended to properly. The risk of death is related to the access and availability of proper healthcare services. Generally, access to services is related to the income of the family or individual. Less income equates to less access to healthcare and greater risk of death or complications.

A woman's lifetime risk of maternal death - the probability that a 15-year-old girl will eventually die from a maternal health factor - is one in 3,800 in developed countries, versus one in 150 in developing countries.

Women who are attended to by trained healthcare professionals are fewer than you think. Nearly half of all childbirths in developing countries are not attended to properly. Attended childbirths still pose the risk of complications such as infections if cleanliness and hygiene standards are not adhered to.

Currently, about four million infants die within their first month. Improved access to medical care and maternal nutrition could significantly reduce stillbirths, which now number 3.3 million worldwide.

There are over 18 million unsafe abortions that are carried out every year that result in over 46,000 deaths. Half of these abortions are considered unsafe. The WHO defines unsafe abortion as a "procedure for terminating a pregnancy that is performed by an individual lacking the necessary skills, or in an environment that does not conform to minimal medical standards, or both."

Reducing risk factors

Maternal mortality is a largely avoidable cause of death. It is estimated that 80% of the deaths result from complications during delivery and the immediate post-partum period. Many of these complications could have been prevented through education and lifestyle intervention techniques.

Conditions that result from high blood pressure, heart disease, infections, home violence and increasing rates of HIV/AIDS can be prevented, maintained or reversed through proper interventions.

Malaria is one of the major factors that fuel maternal death. Data shows that up to 11% of deaths are attributed to malaria. It is common for women to be bitten by the mosquito and not even know that they are infected. Low-grade malaria parasite infections can cause harm to the unborn child and increase the risk of complications or even death.

Education addresses root causes

Experts at the WHO point to education as the primary way of addressing maternal health in many developing countries. Education can address the root causes - poverty, low status of females and lack of access to healthcare services.

The education of girls and young women does a lot more than just improving the lives of mothers; it protects children's health, facilitates healthy families, creates less of a burden on healthcare delivery systems and improves overall society.

Midwifery services saves lives

It is important that all births are attended to by a skilled health professional. Prompt management and treatment can make the difference between life and death.

A major complication is severe bleeding after childbirth that is linked to high blood pressure throughout the pregnancy, into the labour period. Increased rates of bleeding thus give rise to higher rates of life-threatening infections.

To reduce the risk of newborn deaths, experts agree that adequately nourished and appropriately attended to mothers from early pregnancy through the post-delivery period could eliminate three-quarters of deaths.

Midwifery services are key to a healthy and safe pregnancy and childbirth. Many maternal and newborn deaths can be prevented if competent midwives assist women before, during and after childbirth. It is important to be able to refer pregnancy complications to emergency obstetric care as soon as they arise. Many lives can be saved if a midwife attended to every birth.

This column is directed by your questions and comments. The advice provided is in collaboration with WHO and the International Diabetes Federation's goals of prevention, maintenance and natural treatment of disease. The advice is for educational purposes only. Email: info@drhealthshow.com. Facebook: Cory Couillard, Twitter: Cory_Couillard

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