Senseless maternal deaths

Despite the millions of dollars in foreign aid as well as pesos from the government coffers spent on maternal health in the Philippines during the last decade, why are we seeing a rise in the numbers of mothers dying from giving birth?

The latest results issued by the Family Health Survey citing 2011 data revealed that maternal mortality rates (MMR) had increased to 221 from 162 between 2006 and 2011. That’s a 36.42- percent jump that just caught us by surprise.

MMR is the number of maternal deaths measured by 100,000 live births. A maternal death is defined by the World Health Organization as the death of a woman while pregnant or within 42 days of termination of pregnancy.

The Philippines is committed to bring down its MMR to 70 by 2015, and the recent uptrend has made the task even more insurmountable. In fact, our figures are back to where it was about a decade ago.

So where have we been remiss?

Reproductive health (RH) advocates, including those who support the passage of a bill currently languishing in Congress, are quick to point out the root cause being the lack of a national policy that will provide comprehensive services on RH and family planning.

And perhaps rightly so since the RH bill or HB 4244 (The Responsible Parenthood, Reproductive Health and Population and Development Act of 2011) that has been subjected to so much politicking by anti-abortion and anti-population control advocates as well as the Church, so much so that the bill has failed to pass despite so many revisions since its first introduction.

It’s a shame that maternal health reforms in the proposed RH bill are held hostage to the hard-core position taken by its detractors who have even warned of a possible rise in immoral behavior among the youth if reproductive health were to be included in the education curriculum.

It’s true that abortion, teenage pregnancies, and one-child state policies are real problems. But to oppose and not present solutions is going overboard especially if other equally important issues like HIV, extreme number of children in a family, male violence against women, and maternal deaths are left unattended.

Preventable maternal deaths

HB 4244 presents a package of solutions that aims to prevent the numbers of Filipino mothers from dying. At present, the Philippines has one of the highest MMR in Southeast Asia.

The National Statistics Office (NSO) puts maternal deaths at 10 per day, leaving more than 30 children to grow up without their biological mother. Sadly, these deaths are preventable based on investigative researches on the issue.

Even in this modern age, many women still deliver without medical assistance. Many women in rural areas call for hilots or traditional birth attendants (TBAs) because of convenience and lower cost, but often put at risk their own lives.

Yet this same preference is also happening in poor urban areas even when there is proximity to medical institutions (lying in clinics and hospitals) and professionally trained doctors, nurses and midwives.

Poor women are said to be at higher risk of dying from pregnancy and pregnancy-related complications. They often do not have prenatal check-ups which are essential in preparing pregnant but often undernourished or unhealthy women for the task of birthing.

The RH bill is supposed to address the delivery of services that will ensure safe and healthy motherhood that includes access to health facilities and more medically trained care providers not otherwise available in the current public health set-up.

Poor public health care access

According to UNICEF, maternal deaths happen for two reasons: a direct obstetric death which is caused by complication that develops directly as a result of pregnancy, delivery or the postpartum period; or an indirect obstetric death which is due to existing medical conditions that are made worse by delivery or pregnancy.

In finding a solution to this problem, and therefore lessening (if not preventing) maternal and newborn mortality, local services delivery networks for maternal and newborn care should include facilities for emergency obstetric care service.

In the country, each province and city, with the assistance of the Department of Health, needs to establish or upgrade its hospitals with adequate and qualified personnel, equipment and supplies to be able to provide emergency obstetric care.

For every 500,000 population, there should be at least one hospital with comprehensive emergency obstetric care and four hospitals or other health facilities with basic emergency obstetric care. This is all the more appropriate for people in geographically isolated and depressed areas.

Corollary to this, the local and national government should ensure that there is a capable provider of emergency obstetric care in at least each municipality, and not just a midwife.

Up to when do we wait?

Congress will open next month. Will this nation waste again another year trying to pass a bill that aims to provide better care for our pregnant women? Will we see more of our mothers dying in child birth?

Ironically, maternal deaths are so very preventable. Every mother who dies while giving birth to her child should not be chalked down as a statistic, but rather as a tragedy arising from poverty, ignorance, and even from self-righteousness.

At this point in time, and given the unfortunate circumstances stated, the country may be far from meeting its 2015 Millennium Development Goal of reducing its maternal death ratio by three-fourths to 70 from the 1990 level of 280. There is urgency is crafting a legislative act to put in place a relevant, timely and effective reproductive health policy.

When will our congressmen and senators act? When maternal deaths double and reach 20 a day? Have a conscience and do your part to stop the senseless deaths of mothers. -Rey Gamboa (The Philippine Star)