World’s Apart
By Dr. George Mulcaire-Jones
This Mother’s Day, we offer reflections on what it means to become a mother from a global perspective.
There are two worlds in which women give birth.
In well-resourced countries, women have access to skilled obstetrical and perinatal care. High-risk conditions such as twins, placenta previa or severe intrauterine growth restriction have been identified by ultrasound prior to labor. If a woman develops a complication such as severe preeclampsia or postpartum hemorrhage, there are midwives, nurses and obstetricians trained to recognize and manage it. Medications to arrest bleeding and control blood pressure are readily available. Blood transfusions or a Cesarean section can be performed. With such skilled care, we expect mothers and babies to leave the hospital in good health. They have had a safe pregnancy and birth.
In many regions in Africa, pregnant women encounter a different world. They may have received no prenatal care. Without an ultrasound, they may have twins, a placenta previa or some other complication – and neither they nor their birth attendants are aware of it. They may deliver in the village with a traditional birth attendant who does not have the training or basic equipment to manage a complication. They may die from a hypertensive crisis or a postpartum hemorrhage without ever reaching a hospital. They may die en route from a ruptured uterus after hours of obstructed labor. They may reach a health facility and find there is no staff, no utero-tonic medications, no capacity for a blood transfusion or Cesarean section.
Lira, Uganda – A pregnant woman receives an ultrasound from a MLI donated device.
The difference in these worlds is reflected in the maternal mortality disparities between well-resourced countries and least developed countries. Maternal mortality is expressed as the maternal mortality ratio (MMR), the number of maternal deaths per 100,000 live births during a given period.
In Sub-Saharan Africa, the MMR is 531 maternal deaths per 100, 000 live births. This is 133 times higher than in Australia and New Zealand where MMR is lowest (4) and compares to 13 in Europe and North America.
Differences in maternal mortality are also reflected in the lifetime risk of women dying from complications of pregnancy and childbirth during their reproductive life (age 15 to 49).
· In Africa as a whole, the lifetime risk is 1 in 40.
· North America has a lifetime risk of 1 in 2,900.
· The lowest risk countries have a lifetime risk of 1 in 16,000.
Both maternal mortality ratios and lifetime risk of dying from pregnancy and childbirth are higher in rural areas. Women who live more than 35 kilometers from a hospital have nearly 4 times the risk of maternal mortality compared to women living within 5 km of a hospital.
This Mother’s Day we remember and honor in a special way all those mothers who have suffered the tragedy of death or neonatal loss.
Speaking of long walks---This summer, 9 MLI supporters embark on an epic 120-mile walk across Kenya in solidarity with those mothers in Africa who live long distances from health centers. With your support, we walk to make their birth experiences safer, and their journeys to adequate health care more secure. We begin this first annual 7-day Walk for Mothers on June 25. We will be traversing some of the most pristine geography in the world, tent camping among God’s creation, with camels walking alongside to carry our gear. Please visit our website (link below) to meet and sponsor these adventurous and giving souls. We are comprised of 3 groups of families, parents and children, a fitting entourage for an NGO focused on families.
The process of walking continuously for 7 days has great significance. We walk in solidarity with those pregnant mothers who struggle to reach a safe facility to give birth. We walk in solidarity with all those children who walk miles to fetch water and find firewood for their families. We walk in solidarity with those fathers who awake before sunrise to find work with a sustainable wage. May the steady rhythm of our steps mirror the steady steps of all those families in Africa who are healthier, more secure and more prosperous because of our walking. Our goal is to raise $50,000 through our communal efforts, so that MLI can take our programs to new locales where marriage, birth and family suffer from the hardships of extreme poverty. Please help make our walk a success! We will carry our supporters with us every step of the journey.
Please donate in honor of a mother in your life. Your contributions save lives.