…In Britain ii, the maternal mortality rate is 8.3 per 100,000 live births — and incidentally, Britain does not have the lowest maternal mortality rate by any means.
Ireland and Malta have a rather better record.
In Malawi, the maternal mortality rate is 1,140.1 per 100,000.
The two biggest causes of maternal death iii (and this is very well established) are:
— Haemorrhage
— Sepsis
Haemorrhage is the single biggest cause of maternal death anywhere in the world. It accounts for around one quarter of all cases, and around a third of cases in sub-Saharan Africa iv, followed by sepsis at around 10%.
A less common but particularly horrific cause of death is obstructed labour, where the baby becomes stuck in the birth canal and the mother may be maimed for life or killed having spent days in appalling pain trying to deliver a baby who may also die in the process.
This is common among very young or malnourished mothers whose pelvises are too small for them to deliver naturally.
What is particularly dangerous about haemorrhage is that there is very little time to treat it.
If a woman starts bleeding during labour, she has around 12 hours, but if she has a postpartum bleed, she has more like two hours before she bleeds to death.
So, if a woman is giving birth in a remote area, miles away from the nearest hospital, without easy access to affordable or suitable transport, she is highly unlikely to receive help in time, or if the hospital has just one doctor on duty or no blood bank and relatives have to be rounded up as donors, it will be very touch and go.
Beyond the clinical causes of death, there are a whole raft of reasons why women die in childbirth, all of which need to be addressed.
These include, of course, lack of accessible antenatal care where certain health problems could be picked up in good time, lack of good obstetric care and trained birth attendants and facilities such as equipped operating theatres and cheap antibiotics, but also broader issues such as poor infrastructure.
A study published in the Journal of Sustainable Development in Africa in 2010 found:
Despite the recognition of the role of transport to development and the livelihoods of poor people, rural transport networks, in most developing countries, are underdeveloped and of poor quality.
It is estimated that about 900 million rural dwellers in developing countries do not have reliable, all season access to main road networks and about 300 million do not have motorised access at all.
…Then, perhaps most significantly of all, there is the poor status of women in many cultures which renders it difficult for women to access medical care in time even if it is readily available.
I have come across stories of women living opposite maternity hospitals whose families would not allow them to access help until it was too late.
Neglect can also be seen as a form of violence against women.
As MaterCare International states:
“Violence to women may be done by commission, for example, by abortion, genital mutilation, and sexual assault, especially during times of war, or by trafficking, or domestic abuse, all of which have received considerable attention by civil societies.
“Violence, however, may also be perpetrated by omission as in the case of neglect during pregnancy and childbirth.
“If the lives of women are not valued, they will not receive the care they need.
“And what we must always remain acutely aware of as campaigners, when we look at figures and statistics, is that these numbers and categories alone cannot convey the full horror of young women dying unattended, in terrible fear and agony, leaving behind devastated families and other children whose own survival may well be jeopardized by the loss of a mother.
“In many cultures around the world, the mother is the lynchpin of the family and if she goes, the entire family is shattered. We need always to be aware of the human face of this tragedy…”
…The tragedy of maternal mortality needs to be faced and it requires a courageous and honest response.
Abortion is not the sad necessity, nor the empowering procedure presented by groups like Marie Stopes International and the International Planned Parenthood Federation: it needs to be recognised as part of the problem.
As Dr. Robert Walley has stated:
“Unfortunately, the international safe motherhood initiative has accepted the current culture of death prevalent in obstetrics and gynaecology, as abortion is included as the solution to maternal health problems. All of this points to a real poverty -the lack of love and compassion.
The staff and volunteers at MaterCare International know something about love and compassion for the forgotten mothers of the developing world. They provide life-saving assistance to women and babies in Kenya and Ghana and are providing emergency help in Haiti since an earthquake devastated that country…
[September 2011, https://www.spuc.org.uk/campaigns/motherhood_campaign/fiorella_matmort ]