It is no longer news that maternal mortality is a major public health issue especially in developing countries like Nigeria.
Maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from incidental or accidental causes.
An estimated 358,000 women die each year throughout the world from complications of pregnancy and childbirth. The 10 countries with the highest maternal mortality ratio are in Africa and an estimated 14 per cent of maternal deaths globally occur in Nigeria (United Nations Economic Commissions for Africa, 2013).
Also, according to 2013 National Demographic Health Survey (NDHS), the maternal mortality ratio was 576 per 100,000 live births for the seven-year period preceding the survey. The lifetime risk of maternal death indicates that 1 in every 30 women in Nigeria will have a death related to pregnancy or child bearing.
According to Dr. O.A. Olamigoke from Lagos Island Maternity Hospital, the causes of maternal mortality are obstetrics haemorrhage, hypertensive disorders, unsafe abortion, obstructed labour, postpartum infections, anemia and others such as Malaria, HIV, Diabetes, etc.
Olamigoke said obstetrics haemorrhage causes 23 per cent of maternal mortality, hypertensive disorders 20 per cent, unsafe abortion 13 per cent, postpartum infections 12 per cent, obstructed labour 11 per cent, anaemia 11 per cent and others 10 per cent.
She said the core four effective ways to curb maternal mortality are family planning with related to reproductive health services, skilled care during pregnancy and childbirth, emergency obstetric care and immediate postnatal care.
Olamigoke defined family planning as a way of thinking and living that is adopted voluntarily upon the basis of the knowledge, attitude and responsible decision by the individual and couples in order to promote the health and welfare of the family group and thus contribute effectively to the social development of the country (WHO).
She said family planning could reduce maternal mortality directly by reducing exposure to incidence of pregnancy, reducing vulnerability to abortion risk, Postponement of pregnancy during prematurity of pelvis development by delaying the first birth
Reducing the hazard of frailty from high parity pregnancies, increasing contraceptive prevalence rate and reduce the risk of maternal death increase if a woman is too old or too young or has many children or closely spaced children (too early, too late; too many, too close).
“Family Planning reduces maternal mortality indirectly by Ensuring a woman’s body has sufficient time to recover before another pregnancy, increasing antenatal care coverage, Increasing proportion of births attended by skilled health personnel, preserving healthy status and improving economic well-being of the family,” she added.
According to Olamigoke with all these numerous benefits of family, the Contraceptive Prevalence Rate (CPR) is still low due to unnecessary fear of side effects, low female literacy rates, socio-cultural values, lack of spousal or partner approval, inaccessibility of health services and health workers’ attitude.
The way forward, according to Olamigoke is that there is need for more female education, targeted and sustained public health awareness campaigns, increased availability of family planning services and increased training for health care providers.
She however said maternal mortality is preventable. Thus to reduce maternal mortality, there must be improved access to quality of maternal health care, skilled birth attendance at birth, access to emergency obstetrics care and effective family planning and reproductive health services.