African Birth Training in the News

Tammy Ryan was interviewed by a local reporter with the Quad City Times. You can read the full article here: Quad City Times.

But I just want to say that I can’t believe I would have told the reporter that getting pregnant was a death sentence for these women. Pregnancy is NOT dangerous anywhere in the world. Let me explain this a little.

The highest maternal mortality rates we have are between 1 and 2%, which means for every 100 live births, 1 or 2 women will die. Combining these statistics with the average number of children each woman has gives you the lifetime risk of maternal death. This is the number of women who are expected to die during pregnancy or the immediate postpartum. In the worst part of central Africa it is 1 in 10, the rest of the area is between 1 in 12 to 1 in 16.

These numbers are way too high, I don’t disagree there. But where there is no healthcare, poor nutrition, poor sanitation and any other problem you can imagine we only loose 1-2% of the mothers. In other words, where the conditions are prime for bad outcomes, almost every mother and baby comes out of pregnancy and birth safe. By sharing a small amount of information and skills we will reduce this number even more. Before we jump to saying pregnancy is a death sentence we need to understand what causes these deaths.

By far the most common cause of maternal death is hemorrhage, which is responsible for 25% of the maternal deaths around the world. Good nutrition and an understanding of ways to help stop postpartum bleeding will help with this problem.

Moving on, 20% of deaths are indirectly caused by infections like malaria or HIV which become more dangerous when you are pregnant. In these cases it isn’t really the pregnancy that is the problem, but the rampant disease and spread of infection. Other issues are cardiovascular disease and anaemia. These issues are going to cause problems anyway, and the issue is NOT pregnancy but a lack of basic health care.

15% of maternal deaths are caused by infection. 1 in 20 women giving birth in a developing nation develops an infection and needs prompt treatment. Unfortunately the women in developing nations do not have access to treatments. The “lucky” women recover from the infection with infertility. The “unlucky” die. What is most distressing about infection is that we know how to prevent the spread of infection. The solutions are simple and low-cost. It is an entirely preventable cause of maternal death.

13% of the maternal deaths world-wide are the result of unsafe abortions. Women in developing countries are not likely to have access to “safe” abortions any time soon. The issue of planning pregnancies is as real for them as it is for women in developed nations. However, unlike us they do not have access to pharmaceuticals or barrier methods of birth control. Part of our training of the midwives will be an understanding of a woman’s fertility cycles and how to work with her body to space her pregnancies.

12% of maternal deaths world-wide are the result of eclampsia. Officially, the jury is still out on the causes of eclampsia. Unofficially, Dr. Tom Brewer learned eclampsia could be prevented with proper nutrition. So many issues in pregnancy can be prevented with good nutrition, from anemia to gestational diabetes. Part of the training will focus on helping the midwives understand proper nutrition and how to apply the principles of good nutrition to the food available to them.

8% of maternal deaths are the result of obstructed labor. This means the baby did not line up correctly to be born. Rates of obstructed labor vary from 1% to 20% around the world. When labor is obstructed, the baby may be stillborn, suffer brain damage or die soon after birth. Having skilled birth attendants available to help women in labor will work to prevent obstructed labor because the skilled birth attendants will be able to identify the baby’s position, using good positioning for the mother and identify early signs of an obstructed labor.

What I hope you see from this is that pregnancy and giving birth are not inherently dangerous. What makes pregnancy dangerous is poor nutrition, unsanitary conditions, lack of accurate information and a lack of basic health care. But this is true for any part of life, not just during pregnancy.