Tuesday, 13 December 2016 22:51

Maternal Mortality : The Lock & The Keys.

Written by 
Rate this item
(0 votes)

Subhadip Chakraborty

India is designated as 'Mother' by her 'Children'. The dignity bestowed upon mother is a hallmark of the Country's culture. Unfortunately the situation does not look the same when we shift our focus to the healthcare sector. Throughout the Nation, the status of maternal death raises frowns on the forehead of every healthcare provider.

'Maternal Mortality' is defined by WHO as the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. The maternal mortality rate of India is a staggering 178 deaths per 100000 pregnant women.

The situation is worse in certain socioeconomically backward tribes. The Northeastern States are highly affected by this with Assam recording the highest maternal mortality in the country (358/100000 pregnant women). In the era of laparoscopy and robotics surgery, maternal death is still giving nightmares to our mothers.

Without stepping more into statistical details, let me dig into the problem and its management.

CAUSES:
WHO has enlisted certain factors responsible for maternal mortality. They are:
1. Severe bleeding
2. Infection
3. Complications from pregnancy
4. High blood pressure during pregnancy
5.. Unsafe abortion

Other factors responsible are - Poverty, distance, lack of information and inadequate services and cultural practice.

Among all these, bleeding (usually after childbirth) stands to be the lone greatest factor for maternal death particularly in the Indian setup. And the cause behind this havoc is Anaemia among the women of reproductive age group. Though iron deficiency anemia is most common but anemia resulting from bleeding due to worm infestation also dominates among population who have low socioeconomic profile with inadequate living space and sanitation. In my limited experience in the process of gaining clinical knowledge, I have witnessed hundreds of female patients at Assam Medical College with haemoglobin levels ranging from 2-6 gm/dl. This gives an idea about the intensity of the crisis.

REMEDY:
To eliminate this peril from the fate of civilisation, we need efforts at all levels. As per NRHM and NHM , Primary Healthcare Centres(PHC) and Community Healthcare Centres (CHC) are working with basic goal of taking maternal mortality out of the equation in their designated population.
• Mass awareness regarding pregnancy registration followed by three compulsory antenatal visits is a must.
• Pregnant mother should take Iron tablets, Folic acid tablets or IFA tablets as per requirement and as directed by concerned physician.
The required dosage is beyond the scope of the context. For the interested reader, I am hereby attaching a hyperlink to RGPMA guidelines:

http://www.nrhmtn.gov.in/guideline/RGPMA.pdf

• On part of doctors and ANMs, regular check up and maintenance of records regarding urine albumin, blood pressure, etc are a must.
• Institutional deliveries will show the pathway towards a healthy maternal health.
• All abortions should be done at registered medical centres only.

These among several others can promise to bring maternal mortality down to null.

Mother's health should be a prime issue as we speak of a developed society. It is a positive indication that in certain states under the likes of Mizoram and Tripura, maternal mortality rates have gone down as compared to the records of SRS-1997. But cases are still prevalent. Our goal should be to ensure a healthcare system where maternal mortality will be an old forgotten past. Let us all hold hands and work towards this goal.

Read 855552 times Last modified on Friday, 16 December 2016 12:54

56512 comments

Leave a comment

Make sure you enter the (*) required information where indicated. HTML code is not allowed.