Hypertensive states of pregnancy were the current leading cause of maternal mortality. Adopting a multi-pronged approach through reducing delays in access to emergency obstetric care, promoting contraceptive use, encouraging early, regular antenatal attendance and shared antenatal care with the medical team is essential to tackle the situation.

BackgroundData pertaining to risk factors associated with stillbirths and very low Apgar scores is very sparse. This study was conducted to determine the prevalence of, and examine the socio-demographic and obstetric factors associated with stillbirths and very low Apgar scores among vaginal births in a tertiary health facility, Ghana.MethodsA retrospective cross-sectional review of vaginal deliveries conducted at a teaching hospital in Ghana from 1st January to 31st December, 2009. Background characteristics and obstetric history of the mother as well as the vital status of the baby at birth were extracted. Risk factors associated with stillbirths and very low Apgar scores were examined using binomial regression with a log-link function, and population attributable fractions calculated for significant risk factors.ResultsOf the 8,758 deliveries which met the inclusion criteria, 5.9% of the babies were stillbirths, and 6.5% and 1.9% of live births had very low Apgar scores in the first and fifth minutes respectively. Preterm delivery, hypertensive disorders in pregnancy, breech delivery and vacuum extraction were significant risk factors for stillbirths and very low Apgar scores in the fifth minute of life. Low birth weight was also a significant risk factor for very low Apgar scores.ConclusionThe prevalence of stillbirths and very low Apgar scores were high. Improving the quality of obstetric care during labour and delivery may help improve these adverse vaginal birth outcomes.

Awareness of the current legal status of abortion was lacking among women with abortion-related complications attending a tertiary center in Kumasi. However, the provision of safe abortion services was much needed in this population.