WUNRN

http://www.wunrn.com

 

Doctors Without Borders

http://www.doctorswithoutborders.org/our-work/medical-issues/womens-health

 

WOMEN’S HEALTH – MATERNAL MORTALITY – CARE INEQUALITIES: GLOBAL REALITIES

 

http://www.doctorswithoutborders.org/sites/usa/files/styles/detail_page_header_left_sidebar/http/media.msf.org/Docs/MSF/Media/TR1/6/d/d/9/MSB1780.jpg

Wendy Marijnissen

Facts

99% of maternal deaths occur in developing countries.

The main causes of maternal mortality are hemorrhage, sepsis, eclampsia, unsafe abortion, and obstructed labor.

One woman dies every six minutes from unsafe abortion.

Wealthy countries have reduced mother-to-child transmission of HIV to under 1%. The transmission rate is 25 to 45% in poor countries.

Women's Health

Every minute, one woman around the world dies from pregnancy or childbirth complications.

 

The pathologies that kill women during their pregnancies, deliveries, or just after giving birth are the same throughout the world. What makes the difference is access to quality health care. The vast majority of maternal deaths, 99 percent, occur in developing countries. More than half of these deaths occur in sub-Saharan Africa, and one third in South Asia. In wealthier countries, the availability of affordable and effective treatment prevents the conditions that continue to kill pregnant women in developing settings.

 

In more than 20 countries, MSF focuses on reducing maternal and infant mortality through care during pregnancy and prenatal consultations, emergency obstetric care, postnatal care, and access to contraception and family planning services.

 

Likewise, obstetric fistulas—a condition that affects women who have experienced prolonged obstructed labor—were eradicated in more developed countries at the end of the 19th century, when Caesarean section became widely available. However in poor and conflict-affected areas, women are unable to access emergency obstetric services and continue to suffer from prolonged obstetric labor which causes fistulas to occur. MSF provides treatment for fistula in some countries where obstetric services are absent, inadequate, or in need of support.

Maternal Health

The percentage of deliveries assisted by qualified medical staff is 61 percent worldwide, but this drops to 34 percent in developing countries. In Somalia and Ethiopia, only 23 percent of deliveries involve qualified staff; in Haiti, it’s 5.6 percent. Without medical care, pregnant women are far more likely to die from obstructed labor, eclampsia, the effects of malaria, or other conditions.

 

In many countries and for a multitude of reasons, women deliver at home. In fact, only 40 percent of deliveries worldwide take place in medical structures. And in the countries where home-births are most common, maternal mortality is the highest.

 

As MSF is often the only health provider in a region, women frequently have to travel long distances to reach us, and they may not begin this journey until complications have already developed. In Ituri, for example, in eastern Democratic Republic of Congo, more than one third of the 200 deliveries taking place each month in the maternity ward of the Bon Marché Hospital present with complications such as hemorrhage or eclampsia. In many countries where MSF works, it provides care during pregnancy and prenatal consultations, emergency obstetrics, and post-natal care. MSF also helps pregnant women identify a nearby hospital so, as soon as labor begins, they know where to go.

Main Causes of Maternal Mortality

The main causes of maternal mortality are hemorrhage, sepsis, eclampsia, unsafe abortion, and obstructed labor.

 

Hemorrhage, or severe bleeding, accounts for a quarter of all maternal deaths. A woman, even one in good health, who hemorrhages just after giving birth can die within two hours, especially if she is left without obstetric care. Sepsis, or general infection, is the main cause of death after delivery. One in 20 women giving birth develops an infection requiring antibiotics to avoid potential fatalities. Eclampsia is the world’s third most common cause of maternal mortality. Eclampsia is linked to hypertension and is characterized by the appearance of seizures that may lead to coma and death. According to the WHO, there are approximately 70,000 cases of eclampsia each year in the 143 least-developed countries in the world. Convulsions related to eclampsia can be prevented and treated using the drug magnesium sulfate.

 

Unsafe abortion refers to the termination of an unintended pregnancy by persons lacking the necessary skills, in an unhygienic environment, or both. One woman dies every six minutes from unsafe abortion. Of those who live, many suffer serious consequences such as infertility, or complications with future pregnancies. Comprehensive sexual and reproductive health care services can greatly reduce the number of unsafe abortions, by offering safer alternatives through family planning and by identifying and treating complications during pregnancy early on. Obstructed labor is another leading cause of death and infirmity, particularly in sub-Saharan Africa and southeast Asia. It can also cause rupture between the vagina-bladder wall and/or the vagina-rectum wall, a condition known as obstetric fistula. Obstructed labor can be managed if it is identified early, by following a woman in labor and intervening with medication at the appropriate moment.