The true cost of maternal death: individual tragedy impacts family, community and nations

Abstract

The death of a woman in pregnancy and childbirth is globally considered an individual tragedy and a human rights violation. Given the inequities in death that occur to marginalized, poor, and vulnerable women in low and middle income countries, there is no doubt that maternal death is a horrific injustice. However, the long term global burden of disease goes far beyond this tragedy. Recent research is demonstrating that there are disastrous consequences in infant and child mortality, loss of economic opportunities, spiraling cycles of poverty in the families and communities where women die giving birth. The journal Reproductive Health has published a supplement “The True Cost of Maternal Death,” which includes original research from two major study groups. Harvard’s Francois-Xavier Bagnoud (FXB) Center for Health and Human Rights conducted a multi-country, mixed methods study of the impact of maternal mortality on newborn health and survival, family functioning, interrupted education and economic degradation in four high maternal mortality countries, Tanzania, South Africa, Malawi, and Ethiopia. A collaborative group from Family Care International (FCI), the International Center of Research on Women (ICRW), and the Kenya Medical Research Institute (KEMRI)-Center for Disease Control (CDC)-Research Collaboration conducted research into true costs of maternal death in Kenya. These articles demonstrate the enormous costs that ripple out from the maternal death, and the intergenerational and multi-sectorial disruptions related to maternal mortality. It is important in this period of post-MDG strategy planning period that donors, governments, and NGOs be aware not only of the individual level tragedy of the loss of a mother’s life, but also the financial and health costs associated with maternal mortality, and to keep the focus on maternal health as a key issue in all aspects of development, not just health.

Frequency and Risk Factors Associated with Mortality in Pregnant Women in Tehran-Iran

“…Although publication of this report is considered a significant success, but to maintain and improve this index, it will be very difficult and require more effort and implementation of interventions beyond the existing programs (Alkema et al, 2014). Also, the evaluation of index process based on the ratio of maternal mortality data showed lower maternal mortality or relative stability in this indicator, particularly in recent years (Miller et al, 2015).…”

Unsafe abortion and unsupervised births: understanding the challenges of pregnancy and childbirth in the rural highlands of Papua New Guinea

“…In addition to the estimated 290,000 maternal deaths every year [10, 19], a further 20 million women suffer pregnancy-related illness or complications and 1.4 million face near-miss events, that is a life threatening complications that the woman survives [33,34]. Both pregnancy-related illnesses and complications during pregnancy and childbirth are associated with a significant impact on the health of the newborn infant [15,35].…”

“…As already mentioned, sepsis is a leading cause of maternal mortality [34]; it is also a leading cause of neonatal mortality and morbidity [82, 83]. While a number of factors may contribute towards the development of sepsis, poor hygiene during the intrapartum period is a critical risk …”

“…Factors relating to access, economics, cultural beliefs, social support, knowledge of and attitude towards antenatal care, including women's personal experiences are all described [33][34][35][36][37][38][39]. A recent study conducted in Wosera, Eastern Sepik, identified that primary level education and marriage are significantly associated with attendance at antenatal clinic [40].…”

“…Despite the low level of supervised births, admissions to hospital for normal births did increase for the period 1998-2008 from 25%-30% [7]. But women living in rural areas are more likely to give birth in the village, than those living in urban areas [9, 13], with assistance frequently provided by a female relative; 4% are cared for by a traditional birth attendant and 7% of women giving birth alone [16].While documented evidence for the poor uptake of supervised births in PNG is limited, reasons identified are similar to those for poor uptake of antenatal care (access, staff attitude, economical, decision making) [29,[33][34][35][36][37][38]47]. Beliefs in, and fear of sorcerers, has been reported as a determinant for not attending for a health facility birth, with women afraid of meeting witches or sorcerers either at or on the way to the health facility [5, 19].…”