Where Pregnancy May Be Life or Death: Maternal Mortality in Africa

Everyday E! News or US Weekly seems to be reporting on a new pregnant celebrity and what she is craving, how she is preparing the nursery or how she plans to get that "pre-baby body" back. Expectant women in the U.S. have the normal fears that a mother would have; will the baby be healthy? Will I know how to do everything right? Do I have a good doctor? But in Africa, pregnancy is much more frightening. On the continent where there is a general lack of health care, (especially for women and children), death is a realistic concern when it comes to giving birth. This specifically caught my attention when the Washington Post wrote an article in October that followed a Sierra Leone woman through her life-threatening delivery and resulting stillbirth. When browsing the internet this week, I realized this sad circumstance has also caught the attention of other bloggers who are upset that these preventable deaths occur. The first blog I encountered, RH Reality Check, has a post written by Edna Adan Ismail, a lady involved in the medical field in Somaliland. Her entry, titled, "On Maternal Mortality, Why Africa Falls So Far Behind" tells the story of a patient who had given birth and remained at home for five days, while near death from a complicated delivery including bleeding, infection and dehydration before finally entering a hospital. From the perspective of a health care professional, Ismail is able to discuss the situation from an educated view, and lists six main factors that are contributing to this disheartening problem. The picture to the right is of Ismail at work on a project called "Safe Motherhood" that focuses on providing prenatal and delivery care to women. The Partners in Population and Development's (PPD) blog has a recent entry, "MP's Want More Investment in Maternal Health" by Evelyn Lirri that describes the event in which members of parliament from 13 African countries met to "deliberate on health issues affecting the continent." Lirri, part of PPD, focuses on the group's discussion of issues relating to pregnancy, and included statistics and quotes from the conversation to illustrate the grim realities that expectant mothers face. I left my comments and questions on each of these blogs as well as posted them below.

RH Reality Check: On Maternal Mortality, Why Africa Falls So Far Behind

Hi Edna,

Thank you for providing information and stories from the perspective of an educated woman in Africa's medical field. We often hear reports of such circumstances through journalists or media, but not directly from the people involved such as yourself; and in this manner your account provides sincerity and authenticity unmatched by reporters. Your explanation of maternal morality and its causes presents deep insight and builds an emotional connection for your readers while also offering objective facts. I appreciate your work and these aspects of your blog. I do, however, have a few questions. You mentioned that the patient was able to be treated "free of charge," but as many women do not come to hospitals or clinics because of the cost, why this case was free? Is that option available at Edna Adan Maternity Hospital for others who cannot afford maternal health care, or was it done only for her situation? From what I have read in other reports, it seems very difficult for expectant mothers to pay for prenatal or delivery care throughout Africa. Do you know of any hospitals, clinics, nonprofits or governments attempting to fix this problem? If such offers are available, pregnant ladies and their families must be made aware of the option. Also, you stated that, "poverty is a strong factor that prevents women from seeking help" but even if they were to seek assistance, medical centers do not have adequate staffing or equipment. Furthermore, many articles I've come across such as the Washington Post's report "In Sierra Leone, Every Pregnancy is a 'Chance of Dying'" find that even where there are doctors or nurses, they are not properly trained or at least not trained in all fields for which their help is requested. (For example, the Post story mentions a trained ophthalmologist serving as a de-facto obstetrician.) Do you think this lack of education among medical staff (including midwives) is of serious consequence to the health of women who are with child? I fear it is a huge obstacle to overcome, and that educated doctors, nurses and midwives may be the key to preventing pregnancy complications. All in all, your reasons for why "Africa falls so far behind" are sound and logical, and lend good information to the cause, and I look forward to hearing from you at www.devonvdemars.blogspot.com.

Partners in Population and Development: MPs Want More Investment in Maternal Health

Hi Evelyn,

It is great to hear that so many African governments are actively addressing the issue of maternal health. Your post was very informative and professional, and I appreciated the addition of quotations and numbers (such as the facts on how many women die during childbirth, as portrayed in the picture to the left,) to enhance the report. I believe that if governments start recognizing the lack of care for pregnant women, positive changes will start to occur and create a safer maternal experience. Another blog I've commented on, called RH Reality Check with a post titled "On Maternal Mortality, Why Africa Falls So Far Behind" states that "In 1948, the constitution of the World Health Organization was passed, with its first article stating, 'Health is a fundamental Human Right.'" It is my opinion, and I presume yours, that governments must begin protecting this right and getting females the correct maternity care that they need. Some governments are taking steps toward progress, an example being the availability of the Misoprostol tablet you mentioned in your entry. In regards to the drug, how obtainable is it for women who need it? Will it be commonly found in health centers or only in a few? As many people who are pregnant do not realize their health options, I worry they might not be aware of this new development. Your post also stated that, "cases that necessitate a cesarean can significantly be reduced through access to prenatal care, skilled attendance at birth and emergency obstetric care," but is there any governmental plan to provide those things, or only talk of it? Additionally, I'd be interested to know what this "roadmap to accelerate the reduction of maternal mortality" includes. I'm glad to know governments are putting more priority on this issue, and I hope it will continue to be a topic of importance in the political conversation. Thank you for your entry. I've included a link to my blog at www.devonvdemars.blogspot.com.