Why do mothers die at childbirth?
Every 90 seconds, somewhere in the world a woman dies giving birth.
Multiply that by the days of the year and the number will undoubtedly
shock you out of your comfort zone: 358,000 - no less and probably much
more if the unofficial numbers are counted.
These figures which Amnesty International (AI) has painstakingly
chalked after years of research in many countries are meant to shock.
The initial reaction would be disbelief as readers try to understand how
a natural process like giving birth to a child could cause so many
premature deaths of women both married and unmarried.
But this sense of shock, soon gives way to resignation and acceptance
since the vast majority of women who die from childbirth (80 percent)
are from poor developing South Asian countries and Sub Sahara African
nations. They die for trivial preventable causes: Many die even before
they reach the nearest medical facility to which they have to walk
several miles, or hitch a ride from a cattle truck, or a wagon carrying
farm produce or even getting a ‘lift’ on a camel or pony. In
neighbouring India and Pakistan it would more likely by a three wheeler.
Fortunately for us in Sri Lanka, our free health care system has
provided mothers to be a hospital within every three or four miles from
their homes except in very remote areas, making such births while in
transit to a hospital extremely remote and unlikely, health sources
Impact of maternal deaths
Mothers who die prematurely in our part of the world are usually
young; in fact very young and that is largely one of the main reasons
why they die in the first place while giving birth. Many of them are
still in their teens, 18 and under and their bodies are still growing.
They are in fact, still children themselves totally unprepared for the
demanding challenges of motherhood.
It is the realisation that something should be done to prevent
mothers from dying prematurely, and leaving thousands of motherless
children likely to suffer from emotional loss, physical abuse and
neglect, that the Safe Motherhood concept was conceived and accepted by
several member countries of the United Nations including Sri Lanka..
The risk of becoming pregnant at too early an age not only poses
risks to the mother but the child as well. It is a proven fact that
babies born to women still in their teens are likely to be born too
early (prematurely) and weigh too little at birth. Health experts have
warned that underweight (less than 2.5 kgs) babies have little chance of
fighting off diseases and infections than children who are born with
normal weight. Repeated infections can easily lead to death in the first
year of their life.
The key then to child survival among other things is spacing a birth.
To quote a recent WHO report, the risk for young children is increased
by fifty percent if the interval between birth is less than two years.
Our own health officials, to whom this writer spoke, agreed.
“Children born too close together do not develop physically or
mentally as children birth 2-3 years apart,” a spokesperson from the
Family Health Bureau which is overlooks maternal welfare said. “Why?” we
asked. “How does timing make a difference in child survival and the
child’s quality of life?
“For one thing when a woman who is still breastfeeding her child gets
pregnant, she may decide to stop breastfeeding her child, and switch to
formula milk or commence complementary feeding early. This will prevent
the child from getting the optimum benefits of breast feeding.
In addition, the mother will also have less time to prepare
nutritionally balanced foods her child needs once the new baby arrives.
Since most of her attention will be on the needs of new baby, the
other child may not get the care and attention he/she needs especially
during illness. Hence the child will fail to grow and develop well,” the
health official explained.
“Breastfeeding is the key to child survival,” points out an expert on
the health of new born children. “Immediate skin to skin contact and
early initiation of breast feeding within an hour following birth, could
reduce neo natal mortality significantly”.
“By placing a new born directly to the mother’s bare chest (skin to
skin contact) it helps the new born to ‘adapt and adjust’ to the new
environment which is different to what he was used to while in his
mother’s womb. It regulates the new baby’s temperature, helps establish
breast feeding as a regular practice and forges mother and child bonding
which is important to both mother and child.”
Breast milk also helps new born babies to fight infections. A
nutritionist underlined this fact when she told us, “Colustrum (first
milk) that the new born receives from his mother, is rich in nutrients
and anti bodies and helps fight infections. It is all the baby requires
in the first few days of life.
Feeding colostrums also stimulates the mother to produce more milk”.
In countries, where the rate of infant mortality was high, and the rate
of literacy was low among women, wrong myths that this rich source of
nutrients is bad for the child, had led many mothers to throw away the
“Fortunately”, she adds, “in Sri Lanka, because of high literacy
among women and raised awareness about breast feeding benefits, the
majority of our mothers including working mothers now breast feed their
babies for at least the first three months prior to their returning to
Our studies show that nearly 80 percent of mothers now exclusively
breast feed their infants for 3-6 months. Our target is that all mothers
do this for the first six months of their child’s life, so that their
child can have the best possible start in life, and continue to breast
feed even when the child is receiving complementary foods, for as long
as is possible”.
To this end, a national campaign is being conducted islandwide with
the Health Ministry now banning all advertisements on formula milk foods
in hospitals, and encouraging mothers to initiate breastfeeding before
leaving the hospital after a delivery.
According to the WHO report of 2013, optimal breastfeeding of
children under two years, has the potential preventing 800,000 deaths of
children under five years who die of low weight, malnutrition and
diarrhoea every year, while thousands of under aged mothers will die of
anaemia and birth complications caused by illegal abortions.
Even in Sri Lanka which has one of the lowest if not the lowest
number of maternal and infant mortality rates in the South Asian region,
it is said that from 750 to 1,500 illegal abortions occur daily.
Ensuring safe motherhood for all pregnant women with improved
obstetric care, giving women more control over their reproductive
health, improving the quality of family planning services and preventing
illegal abortions by encouraging young women to make informed choices
before they assume the responsibilities of motherhood, can prevent these
In just three months it will be 2015. Before the dawn of the next
year, another 358,000 more women worldwide and in Sri Lanka will die
because of unplanned childbirth, and botched illegal abortions leaving
thousands of motherless children.
Are we ready to avert this looming crisis?