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The Best Time Of Your Life?

by Captain Diana Macdonald, Pakistan Territory

Captain Diana Macdonald, Pakistan Territory

Pregnancy should be a time of eager anticipation and joy for a woman and her family. Yet, some women are not so worry-free. Many women have unforeseen pregnancy and childbirth complications. Haemorrhaging, convulsions, obstructed labour, and severe infections after delivery or unsafe abortions are just some of the problems. In developing countries, the complications are more prevalent. Although improving all over the world, the health of mothers is still seen as a very low priority in public health.

In both Western cultures and developing countries, pregnant women are under physical and psychological pressures. However, the challenges women face in developing countries are of a different nature. Health care is poor in comparison to Western cultures.?Many women suffer from reproductive tract infections, cancers, sexually transmitted diseases, domestic violence and mental illnesses.

The major causes are lack of adequate medical facilities, poverty, inadequate diet, problems caused by having a large number of children or from having children at a young age. Ignorance also contributes to this problem. Among the poor, maternal health problems are amplified. Poor people do not have access to private health care. In urban slums and rural areas there are meagre health services provided.

In Pakistan, contraceptive use is one of the lowest in the region. Thirty-three per cent of mothers with fewer than three children who have admitted they do not wish to have more children still do not protect themselves against unwanted pregnancies. This is largely due to the lack of sex education services. Also, the vast number of home deliveries with untrained personnel means that women are not taking the health precautions they should.

It is not uncommon for a woman to lose her life during or after pregnancy. As a result of pregnancy-related complications, more than 20,000 women die each year. The statistics for maternal mortality remain steady at 300-700 mothers dying for every 100,000 live births.

A mother's death brings great turmoil to her family. Sadly, children under the age of five who lose their mother have little protection in harsh surroundings and therefore have a decreased chance of survival. The risk of death for these children is at least doubled, possibly tripled after the death of their mother. Mothers who do survive childbearing often suffer from serious disease, disability, or physical damage caused by pregnancy-related complications. A prolapsed uterus, pelvic inflammatory disease, fistula, incontinence, infertility and dyspareunia (painful sexual intercourse) are among the post-pregnancy complications.

Protecting a mother from such undesirable outcomes should begin long before she becomes pregnant. This requires a joint effort between the woman, her family, the health care system in the community and the government. In developing countries, a women's maternal health will improve only when she is offered the opportunity to participate fully in community social and educational programmes, and when community-based actions ensure adequate health care. Additional intervention and rigorous assessment is urgently required in order to decrease the number of maternal deaths.

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