Three Per Hour: Exploring the Stark Realities of Maternal Mortality
In 2015, the Millennium Development Goals were drafted as eight international targets for the time-bound eradication of poverty in all its dimensions. Pakistan happens to be one of the unfortunate countries that have failed to achieve two of the most important MDGs in present time i.e. number 4—to reduce child mortality—and number 5—to ensure maternal health.
When we think about the growing monster of maternal mortality in Pakistan, we often question ourselves, ‘Are there not women in other parts of the world who may suffer from pregnancy related complications?’ As a matter of fact, women all across the world go through pregnancy related issues, including septicemia, postpartum hemorrhage and anemia. But these issues can be prevented in their initial stages elsewhere. Unfortunately, maternal health in Pakistan is a staggeringly underestimated problem. Although women from the elite backgrounds can access healthcare facilities, women from marginalized classes suffer immensely during their pregnancy, which is why a majority of deceased mothers belong to the lower-income circles.
UNICEF Pakistan claims that almost 100,000 women die each year in Pakistan, which equates to three dead mothers per hour. If we analyze the causes of increasing maternal deaths in Pakistan, it becomes clear that postpartum hemorrhage, septic shock, unsafe abortions, untrained birth attendants, undernourishment and anemia stand at the top of the list. We cannot look into these causes superficially; often, they stem from some indirect entities as well, such as lack of awareness, religious and cultural fundamentalism, gender-based discrimination and non-involvement of women in decision-making.
In my opinion, women suffer mostly because they cannot make decisions for themselves. They are not allowed to decide whether or not to get an education, to choose a life-partner or to have children. A research result shows that in Pakistan, ‘females having undertaken post-graduate education have a probability of 25.29% of making uninfluenced decisions’. This implies that if women do not have the power to assess their own basic needs, then they cannot assess their sexual and reproductive rights, which are the direct causes of maternal mortality.
Being part of an occupied rural territory of Pakistan, I have closely observed the conditions of women in my area. Women are not allowed to make decisions for themselves and for their families. I have witnessed many mothers giving birth to their children in washrooms, in open fields and in cattle houses. They are unaware of the complications of unhygienic deliveries, thus inadvertently choosing death for themselves.
I have witnessed the case of a friend which I share here with her consent. Her sister was pregnant. It was her first pregnancy at 20 years of age. She used to be verbally abused within the family and was forced to shoulder the burden of all the home chores by herself, from lifting heavy loads to sweeping floors. She never went to hospital from conception till the day of delivery. At the time of delivery, she asked her family for a doctor but they refused to take her to the hospital. The family instead called upon the traditional birth attendant for delivering the baby. Shockingly, the child was delivered in the washroom under highly unhygienic and unsafe conditions. This was a greater risk for the mother and child both and unfortunately the mother could not survive due to pregnancy-induced septicemia.
Many women are not aware of the complications related to pregnancy and much of this unawareness is rooted in illiteracy. They have been kept inside the boundaries of religious and cultural fundamentalism. For example, women are often denied education in accordance with our culture. Moreover, they are held responsible for all the house chores in addition to feeding their children and husbands. Cultural taboos have created a large gap between males and females within the same family. Furthermore, women cannot dare to share their health problems with men or with the heads of the families, so they prefer to treat these issues through unhealthy means.
Let me share with you a very disappointing scenario: a pregnant mother was in her last trimester and had never been taken to the hospital before. While delivering the baby, her mother in-law used a knife to cut the umbilical cord which is normally attached to the mother and the baby. This resulted in heavy bleeding, and due to negligence of the family, the new mother died within 24 hours due to an issue which could have easily been prevented.
It is very disappointing to know that an average of three mothers die every hour in Pakistan due to maternal health complications. This is a matter of shame for all the active stakeholders of this country. It is the responsibility of the state to prioritize pro-motherhood policies and enhance awareness about pregnancy-related emergencies and their management. Mothers are the producers of the next generation. If safe motherhood policies are introduced and implemented, mothers will be raised and nourished in healthier environments in order to create a healthier next generation.
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