Absence of trained midwives behind high MMR

KANPUR: The high percentage of maternal mortality rate (MMR) has been a concerning issue for the health department.
The MMR also reflects the overall effectiveness of maternal and child healthcare programmes running in the state.
According to the sample registration survey conducted in 2006, the MMR was 440 per 1,00,000 live births in the state. Comparatively, it was much higher than the MMR in Kerala (95) and Tamil Nadu (111).
The survey revealed the major causes of high maternal mortality as haemorrhage, sepsis, hypertension, obstructed labour and abortion etc.
Even illegal abortion was found to be a leading cause of death.
"Maternal death usually occurs between the third trimester of pregnancy and first week after delivery. There are more chances of a woman's death within first two days after the delivery. A large number of deliveries are conducted by untrained personnel. Deaths are mostly related to obstetric complications including post partum haemorrhage, infections and prolonged or obstructed labour. Also, a prime reason has been the lack of institutional deliveries," said chief medical officer Ashok Mishra.
Revealing anaemia as the major cause of maternal deaths, he said, "Low percentage of haemoglobin at the time of delivery affects about half of the pregnant women. Pregnant adolescents who are married at a very early age are more prone to anaemia than older women. Besides, undernourishment and lack of care only enhance the chances of death."
However, various programmes like Janani Suraksha Yojana and Sambhav are being run to improve the health status of pregnant women by giving iron-folic acid tablets and by promoting institutional deliveries.
Certain social factors only aggravate the situation.
The optimum child-bearing age and short birth intervals, other variables like economic circumstances, cultural practices and beliefs, nutritional status, environmental conditions and violence against women affect the maternal mortality rate.
The ante-natal care which plays a key role in lowering the maternal death rate has been widely affected due to low literacy and awareness among women. Most deliveries take place at home without the service of the midwife. Health experts say that the risk of a mother's death and the availability of trained midwives at the time of delivery share an inverse relationship.
"The maternal deaths are not caused by diseases. Most women die due to absence of trained professions at the time of delivery. The danger lurks from the time of conception till six weeks after delivery," said the head of department, gynaecology, Lala Lajpat Rai (LLR) Hospital, Dr Kiran Pandey.
"The maternal deaths and pregnancy complications can be prevented if women have access to better quality ante-natal, natal and post-natal care," she added.