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  • Title: [Toward safe motherhood: a call for action].
    Author: Mahler H.
    Journal: Profamilia; 1987 Dec; 3(11):20-3. PubMed ID: 12341914.
    Abstract:
    The most shocking fact about maternal health today is the difference between maternal mortality rates in developed and developing countries. In developed countries, mortality risks range from 1/4000 to 1/10,000, but in developing countries the risk may be 1/15 to 1/50. Most countries with high maternal mortality rates have inadequate vital registration systems. The magnitude of the maternal mortality problem was unknown until recently, when reliable statistics from Asia, Africa, and Latin America became available. Discrimination against females in education, nutrition, and other aspects of life is a more or less direct cause of maternal mortality. Maternal deaths often have their roots in the life of the woman before the pregnancy or even before the woman's birth. Persistent deficiencies of calcium, vitamin D, or iron may result in a constricted pelvis, eventually leading to death during labor. Chronic anemia may lead to death from hemorrhage. Risks resulting from adolescent pregnancy, maternal exhaustion due to closely spaced births and heavy physical labor during the reproductive years, procreation after age 35 and especially after age 40, and illegal induced abortion are all factors in high maternal mortality rates in developing countries. The only hope of providing access to essential maternal health services, family planning, and especially obstetrical services for life threatening emergencies to poor women living in remote areas is through primary health care. Local health care cannot exist in a vacuum; technical and administrative help is required from municipal centers. Fewer than 50% of the world's women receive trained care during deliveries. The consequences of unregulated fertility are particularly important as a determinant of maternal mortality. The World Health Organization family planning policy is based on recognition of family planning as an inseparable part of maternal and child health care. Longterm economic and social development and elimination of female illiteracy are other parts of the multiple strategy of controlling maternal mortality. 4 steps are essential in strategies to control maternal mortality: 1) providing adequate health and nutrition services for girls and family planning services for women 2) providing good prenatal nutrition and health care and identifying high risk women early in the pregnancy 3) assuring professional attention for all deliveries, and 4) providing access to obstetrical care for high risk deliveries and obstetrical emergencies. Some of the needed resources to make childbearing safer already exist in each country and can be strengthened by cooperative efforts between national and local governments, international assistance agencies, nongovernmental organizations, and families and communities of each region.
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