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College Campaign Series on Safe Motherhood |
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4th Ashar
2062 |
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Nepal's maternal mortality rate one of world's highest. Maternal Mortality Rate
- 539/ 100,000 childbirth i.e. around 539 women, out of every 100,000 new
births, die during pregnancy and after giving birth in Nepal. - 91% of the women
in Nepal give birth in home.
Youth for Change, Nepal in association with Student Welfare Council, Kanya
Campus, organized a talk program in "Safe Motherhood" on 11th Baisakh, 2062
(24th April, 2004) in Kanya Campus. The program was chaired by Samixa Koirala,
President of Student Welfare Council, Kanya Campus, facilitated by Depti Kharel
of Youth for Change, Nepal and welcomed by Surya Prakash Gurung, President Youth
for Change, Nepal. The chief guest highly appreciated the initiatives of Youth
of Change, Nepal and emphasized on need of such activities The resource person
Ms Lal Kumari Gurung and Dr Santosh Sapkota explained various aspects of Safe
Motherhood.
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What is Safe Motherhood? |
Safe Motherhood means
ensuring that all women receive the care they need to be safe and healthy
throughout pregnancy and childbirth.
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Why do women die? |
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Most maternal deaths are due to five major medical causes:
• severe bleeding (hemorrhage);
• infection;
• unsafe abortion complications;
• hypertensive disorders of pregnancy; and
• Obstructed labor
More than 60 percent
of maternal deaths take place in the period immediately following delivery,
with more than half occurring within a day of delivery. An estimated 40 percent
or more of pregnant women--50 million each year--experience pregnancy-related
health problems (morbidities) during or after childbirth. Fifteen percent
of these women suffer serious or long-term, often debilitating, complications,
such as uterine prolapse (sliding of the uterus from its normal position),
fistulae (holes in the birth canal that allow leakage from the bladder or
rectum into the vagina), pelvic inflammatory disease, and infertility.
Preventing and managing these problems requires a well-functioning health
system that provides accessible, high-quality care--from the household to
the hospital level. In addition, a range of social, economic, and cultural
factors also contribute to women’s poor health before, during, and after
pregnancy.
Barriers to Care
Millions of women do not have access to good quality health services during
pregnancy and childbirth – especially women who are poor, uneducated,
or who live in rural areas:
• Almost 35% of women in developing countries receive no antenatal care
during pregnancy; in some countries, antenatal coverage is as low as 26%;
• Approximately half of all deliveries in developing countries take
place without a skilled attendant, with rates in some countries as high as
85%; and
• 70% of women receive no postpartum care in the six weeks following
delivery.
A number of barriers limit women’s access to care, including:
• Distance and lack of transport: Nearly 80 percent of rural women live
more than five kilometers from the nearest hospital, and many have no way
to get to health facilities except by walking – even when they are in
labor.
• Cost: Millions of women cannot afford to use services, even when fees
are low or services are delivered for free. This is due to additional, often
hidden, costs patients must cover – transport, drugs, medical supplies,
and even food and lodging for themselves and their families.
• Interactions with providers: Too often health care providers are rude,
unsympathetic, and uncaring. They often do not respect women’s cultural
preferences, e.g., for privacy, birth position, or treatment by women providers.
• Socio-cultural factors: Women in many areas of the world lack the
power to make choices about their health and lives, with negative consequences
for maternal health. Tradition, family mores, and even laws limit women’s
decision-making and rights with regard to childbearing, contraception, initiation
of sexual relations, and if and when to seek medical care. In some settings,
a husband’s permission is required for women to receive health services,
including life-saving care; in others, mothers-in-law decide whether women
can use available services.
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How Can Safe Motherhood Be Achieved? |
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Ensure access: Safe motherhood can be achieved by providing high-quality maternal
health services to all women during pregnancy, childbirth, and the postpartum
period. Services to help make motherhood safer include:
• care by skilled health personnel before, during, and after childbirth
• emergency care for life-threatening obstetric complications
• services to prevent and manage the complications of unsafe abortion
• family planning to enable women to plan their pregnancies and prevent
unwanted pregnancies
• health education and services for adolescents
• community education for women, their families, and decision-makers
Address gender inequalities: Women’s status must be improved and full
value accorded to their reproductive and productive roles. Family and community
attitudes that prevent women from receiving proper care during pregnancy and
delivery must be addressed.
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