Dying too young: Maternal mortality is preventable, we must plan

One of the greatest monuments man has ever built is the Taj Mahal in India. The Emperor Shah Jeehan created an ornate mausoleum in honour of his wife who died in childbirth. Sadly, there is no monument to honour the millions of women who die in childbirth, they are merely a statistic. Some 529,000 women die prematurely in childbirth globally every year. So, in my lifetime some 15 million women have died giving birth, a staggering figure. The health of a nation is defined by the health of its women; one cannot tackle maternal mortality on its own because it is linked to many other healthy related issues. A report in 2003 ranked Rwanda as having the 7th highest mortality rate for pregnant women, this was collated with data from 2000, so there have been massive strides forward since then. Most of the countries on the list had been through turmoil or war, with a breakdown in health and social services. The data always shows a correlation between; high population growth to, high child mortality and high maternal mortality. Put simply, the fastest way to reduce all these negative indicators is to reduce the overall number of pregnancies. The pressures of population growth always produces negative effects, and Rwanda is the most densely populated country in Africa. Some 350,000 – 500,000 Rwandans are born every year, and this figure is set to rise given the majority of Rwandans still under 18. In our culture, there are old negative myths that still prevail, like a woman’s worth being attached to her fertility, Rwandan women produce 6 children in their lifetime, herein lies the problem. How can we change our cultural outlook? In primary school we often find a 50-50 balance in gender, but by secondary three the numbers start to dip. This is because some parents cannot afford to educate girls, and some even marry off their daughters at an early age. Mothers should defer childbirth till well into their 20’s; young mothers and first-time mothers are most likely to die in childbirth, often because their pelvic floor is not developed enough to relax and contract. Basic hygiene during childbirth would reduce another 25% of deaths that are due to infection, as would a better pre-natal diet with all the food healthy groups. Cases like pre-eclampsia, obstetrical haemorrhage, ectopic pregnancy, puerperal sepsis (childbed fever), amniotic fluid embolism, and complications of unsafe or unsanitary abortions will need long-term strategic planning to reduce. However, 80% of maternal mortality cases are preventable through mass-education; diet, hygiene, reducing infections, reducing pregnancy levels and basic training of informal midwives can eradicate this problem. We need more health care volunteers; at the moment we are still short of the 300,000 health workers that we need to spread comprehensive awareness on basic health issues. We have to reduce the pressure on our healthcare system, this issue is linked to population growth, infant mortality, education of women, women’s emancipation and all these have to be addressed collectively. The author is a social commentator ramaisibo@hotmail.com