Saving the Lives of Mothers and Babies

Two babies in the MSF primary health care clinic in Mogadishu, Somalia. (2008)
Two babies in the MSF primary health care clinic in Mogadishu, Somalia. (2008)
Joe DeCapua

A medical aid group says every day about one thousand women worldwide die in childbirth or from complications related to pregnancy. Doctors Without Borders says most of those deaths can be prevented. It’s released a new report on the problem to coincide with International Women’s Day, March 8.

The report is called Maternal Death: The Avoidable Crisis. Doctors Without Borders, also known as MSF, says at least 15 percent of all pregnant women worldwide encounter a life-threatening complication. It says pregnant women are even more vulnerable during conflicts or crises.

Critical moment

Catrin Shulte-Hillen is the head of MSF’s Sexual and Reproductive Health International Working Group. She’s also a midwife. She said delivery is the most critical moment for saving the lives of both mother and child.

“When it goes right it’s beautiful. It’s a wonderful event. It brings you to tears because it’s such a beautiful event. When it’s wrong it’s chaotic,” she said.

Chaos comes from complications.

“They have such a symbiotic situation. If the mom is bad, the mom is exhausted; the baby doesn’t get enough oxygen. The baby suffers also. So the problem is as soon as you have a delivery that doesn’t go very spontaneously, very easily. The uterus doesn’t want to contract. She starts bleeding. You concentrate on the mother. The baby doesn’t breathe. That’s where it all accumulates,” she said.

Five main reasons are given for potentially deadly complications: hemorrhaging, sepsis or infection, unsafe abortions, eclampsia or hypertension and obstructed labor.

High standards

Shulte-Hillen says it’s uncommon for a woman to die in childbirth in developed nations. But when it does happen, health officials want to know why.

“Today in any hospital if there’s a maternal death there’s a commission that’s put up to investigate exactly what went wrong. That’s how seriously we take the fact that a woman dies in childbirth. And if you look at that in comparison to what happens in a large part of the world where it just gets completely unaccounted for,” she said.

Shulte-Hillen said MSF has high standards for maternal care, even in conflict zones or areas hit by natural disasters.

“We expect that in an MSF hospital you do not lose mothers. And we do the same thing we do in Europe. We have a commission. We get the whole staff together and do an analysis (on) why did this happen,” she said.

The Doctors Without Border’s report stated the solution is straightforward: skilled medical staff, drugs and equipment. It’s based on the group’s programs in 12 countries, including South Sudan, Haiti, Pakistan and Somalia.

In conflict zones like Somalia, health care infrastructure has been destroyed. Little medicine is available and trained medical professionals are often forced to flee. Similar conditions existed in Ivory Coast in early 2011, when political violence spread across the country. MSF describes Afghanistan as one of the most dangerous places in the world for a woman to give birth.

First things first

Shulte-Hillen said if or when the situation stabilizes, then comprehensive post-natal care, family planning and health education can be provided.

“The best that we can do as a medical organization is to be there today with assistance that is lifesaving,” she said.

Doctors Without Borders provides obstetric care in about 30 countries. It says in 2010, its medical teams delivered more than 150,000 babies.

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