By Dr Nahitun Naher
There are so many special days we celebrate throughout the year that nowadays they do not create enough excitement. But among these plethora of special days, Mother’s Day is unique as it is a reminder to all to acknowledge and honour one’s mother. This should not only be a one day celebration, rather a mantra in our lives. Mother’s Day is the perfect time to talk about motherhood and maternal health and to express love and gratitude to the most unconditional bond between two human beings.
From my personal experience, the day when my son was born there was an overnight shift in all the equations and dimensions of my life. However, the journey towards motherhood is not an easy one to trail; motherhood is difficult and the amount of physical and emotional stress it places on a woman is not an easy one to endure despite that fulfilling experience of bringing a life into the world.
According to the World Health Organization (WHO), more than 135 million women experience pregnancy and childbirth each year. One of the lesser discussed topic are the issues a woman will face during this experience.
Maternal health refers to a woman’s health during the period of pregnancy, childbirth and postpartum. For many women around the world, it is also associated with ill health and sometimes even life threating complications. Although the global maternal mortality ratio declined 44 per cent from 1990 to 2015 (as per UN inter-agency estimates), 830 women will die every day from pregnancy and child birth related complications. Unsurprisingly, 99 per cent of these deaths take place in developing countries, with a higher rate in rural areas and with an even higher rate among young adolescent mothers.
The five main causes of maternal mortality are severe bleeding, infection, unsafe abortion, hypertensive, and medical complication in pregnancy. Out of the 135 million women who give birth per year, nearly 20 million of them suffer from various complications even after birth.
Many of these mortalities and morbidities can be prevented through skilled care and delivery, however shortage of qualified health workers to provide these services remains a major obstacle in ensuring safe motherhood (WHO).
Bangladesh has made significant improvements in maternal health in terms of achieving Goal 5 of the Millennium Development Goals (MDG). As per the United Nations and WHO, the maternal mortality rate in Bangladesh is 176 per 100,000 live births (2015) with an annual rate of 5.9 per cent reduction from 2005 to 2015. Multiple factors contributed to this achievement, primarily the government’s strong commitment to highlight maternal health as a national priority.
Despite the achievement, the number of skilled birth attendants present during delivery is still below the national goal of 55 per cent (it is currently 42 per cent). On the other hand, the high rate of unnecessary Caesarean sections (23 per cent in 2014 despite the WHO recommendation of 10 to 15 per cent) reflects an imbalance in terms of utilisation of maternal health services. The government institutions, private organisations, and NGO’s including BRAC, are producing midwives towards so as to bolster the maternal and new born healthcare services available in Bangladesh.
However, while the country is making strides in promoting better maternal healthcare services, it is also hampering progress due to the high rate of child marriage and adolescent pregnancy – a new law was recently passed which allowed a marriage to take place between parties under the age of 16 due to “special circumstances”.
Because every single mother matters and deserves care, safe delivery through the presence of skilled birth attendants and ensuring equitable provision of comprehensive reproductive healthcare services, while at the same time working on issues of child marriage and adolescent pregnancy are crucial to accelerate the progress of maternal health in Bangladesh in the coming years.
The author is a senior research associate at BRAC School of Public Health.