High number of maternal deaths a cause for concern

THE EDITOR, Madam:

IT IS estimated that approximately 800 women die daily giving birth, according to the United Nations Population Fund. Despite the fact that maternal mortality figures have decreased worldwide, there are still persistent challenges that cause complications for women both during pregnancy and during childbirth.

The World Health Organization (WHO) states that the high number of maternal deaths reflects inequalities in access to quality health services, and highlights the gap between rich and poor. Humanitarian, conflict, and post-conflict settings hinder progress in reducing the burden of maternal mortality. In the 2020 Fragile States Index, nine countries were deemed as “very high alert” or “high alert” (from highest to lowest: Yemen, Somalia, South Sudan, the Syrian Arab Republic, the Democratic Republic of the Congo, the Central African Republic, Chad, Sudan and Afghanistan). Women in low-income countries have a higher lifetime risk of maternal death.

Maternal mortality is still significantly higher in Caribbean countries than in developed regions. Alarmingly, 350 women die per 100,000 live births due to pregnancy-related causes in Haiti. The World Bank notes that, the maternal mortality ratio in Haiti has improved from 400 in 2000 to 350 in 2020. In most Caribbean countries, the ratio is between 27 (Barbados) and 169 (Guyana) maternal deaths per 100,000 live births. Only some countries in the English- and Dutchspeaking Caribbean have data on maternal mortality, with five countries identified at or above the SDG’s target of 70. These are The Bahamas (70), Jamaica (80), Saint Lucia (117), Suriname (120) and Guyana (169). Interestingly, within the Spanish-speaking Caribbean, Cuba’s maternal mortality rate for 2020 was 39. It is very clear that giving birth continues to be a high risk for many women across the world.

Women die as a result of complications during and following pregnancy and childbirth. Most complications develop during pregnancy, and most are preventable or treatable. Other complications may exist before pregnancy but are worsened during pregnancy, especially if not managed as part of the woman’s care. The major complications that account for nearly 75 per cent of all maternal deaths are:

• Severe bleeding (mostly bleeding after childbirth);

• Infections (usually after childbirth);

• High blood pressure during pregnancy (pre-eclampsia and eclampsia);

• Complications from delivery; and

• Unsafe abortion.

All women need access to highquality care in pregnancy, and during and after childbirth. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for the women, as well as for the newborn.

WAYNE CAMPBELL waykam@yahoo.com