Maternal death; a cause for concern

I was in a hospital somewhere in Africa for some days and the rate of maternal/obstetric emergency was alarming, not due to the hospital's negligence but due to clients negligence!

I felt so sad and I got the inspiration to write about this topic.

Every single day approximately 830 women die from causes related to child birth, and these can be highly prevented.


In a very brief definition, maternal death is a death of a woman pregnant or within 42days of termination of pregnancy due to medical or any cause.

Cause of maternal death could be direct or indirect.

Direct causes

 • Post partum hemorrhage

• Placenta previa
• Obstructed labour 
• Eclampsia
• Complications of labour
• Sepsis
• Unsafe abortion

Indirect causes

• Anaemia
• Malaria
• Eclampsia and hypertension related cases
• Heart diseases
• Infections
• Ectopic pregnancies
• Embolism
• Unsafe abortion
• Anaesthetic complications

Also there are 3 delays that may be responsible for maternal death.

1. Delay in seeking care; this happens during the state of confusion by the woman, contemplation by the family on which facility to go to, the finances and resources available, perception of ailment, values and societal norms play a major role. 

2. Delay in reaching care in time; here bad roads, poor security level, public transportation (which will delay the arrival at the hospital).

3. Delay in receiving care or delay in treatment; poor facilities and resources, too many protocols, unskilled professionals and personnel,negligence and ommision of care,stigmatization. 

How can we prevent this mortality?

First  phase of prevention is done during preconception care;

A lot of people are not aware that there is something like  preconception care, that is why child bearing should be by choice not by chance.

It is not advisable to just get pregnant without necessary check up and medical advise.

Here  a woman is assessed properly before conception ( pregnancy). A lot is entailed but I will mention just few

1. A lot of history will be obtained to guide the care.
2. General assessment
3.Laboratory investigation / screening,including rheusus factor (which causes a lot of post partum death
4. Psychological preparation
5. General advise will be given based on outcome of test.


Second phase of prevention is done antenatally

1. This should be done in a good facility
2. Booking is the first step
3. Laboratory test will be done to asses the growth and well-being of fetus and mother.
4. Medical advise and teaching will be done, simply adhere to and ask questions where necessary
5. Comply with all medications administered and avoid self medication or drugs not prescribed by your physician
6. Take good care of your health and maintain good personal and environmental hygiene while being conscious of your environment.
7. Male partners should also be involved in care of their female partners
8. There should be birth preparedness and complication readiness.
9. Seek medical care immediately symptoms you perceive any deviation from minor pregnancy symptoms.

Third phase of prevention is observed with care during  Intra partum care:

1. Delivery should be in the hospital and must be conducted by a skill attendant.

2. Health care facilities have improved in the prevention of post partum hemorrhage by the use of oxytocics,antibiotics. Most times manual delivery of placenter, blood transfusion,or hysterectomy if  need arises.

3. Prevention of eclampsia and eclamptic fits is done by the use of anticonvulsants in most facilities.

4. Instrumental  deliveries are encouraged and basic surgical equipments for ceaserean section is required.

The last phase is done during post partum care.

1. Close monitoring and observation.
2. Bonding and establishment of lactation is ensured.
3. Laboratory investigations to ascertain any deviation from normal.
4. Advise on discharge and take home drugs with stress on compliance to medication.

Six weeks post partum Family planning is introduced to avoid unwanted pregnancy and aid better recovery.

Political commitment is very important. Government should be highly involved in prevention of maternal mortality by making no 5 of mellenium development goals a priority.


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