Pregnancy is special let’s make it safe

28/02/08

Article: Salome Donkor
A woman’s health is critical to the well-being of her family and to the economy of her community and her country.
The health of a pregnant woman is even more special because she needs access to essential health services to save her life from death resulting from obstetric complication that cannot be predicted and are difficult to prevent.
That is why the Millennium Development Goals (MDGs) give a central place to maternal health and gender equality.
MGD 5, improving maternal health, is often called “the heart of the MDGs” because if it fails, the other goals will also fail.
Evidence from 20 years of research and pilot interventions has identified five primary causes of deaths of pregnant women namely, haemorrhage (bleeding), eclampsia (high blood pressure), unsafe abortion, sepsis (infection), obstructed labour and obstetric fistula.
Maternal mortality is a global issue and the concern for reducing maternal mortality stems from the fact that at least 583,000 women die each year from the complications of pregnancy and childbirth. The alarming situation is that almost 90 per cent of these deaths occur in sub-Saharan Africa and Asia.
According to the World Health Organisation (WHO), 2006, while women in northern Europe have a one in 4000 likelihood of dying from pregnancy-related causes, for those in sub-Saharan Africa, the chance is one in 16.
The Ghana Demographic Health Survey, 1993 puts the maternal mortality rate in Ghana at 214 per 100,000 live births with a life time risk of one in 35 and health experts say the situation may not change by 2015 if no drastic measures are taken to reverse the situation.
The commitment to fight maternal mortality led to a landmark ‘Global Women Deliver Conference’ held in London in October last year, during which participants charged themselves to address the high incidence of maternal mortality.
A high-level Ghanaian delegation participated in the conference and the Ministry of Women and Children’s Affairs, in collaboration with the Ministry of Health, recently organised a panel discussion in Accra on reducing maternal mortality in Ghana to ensure that achieving points four and five of the MDGs remains a high priority on the national agenda.
Ghana has committed itself to achieve MDG Five, which requires the country to “reduce the maternal mortality rate by 75 per cent between 1990 and 2015”.
Coming in the wake of this crusade is a disturbing news item published in the February 25, 2008 edition of the Daily Graphic that the high maternal and juvenile mortality in the Upper West Region is the result of incessant alcohol abuse among expectant mothers.
The Regional Director of Health, Dr Erasmus Agongo, was quoted as saying that: “Alcoholism is causing high maternal and under-five mortality in this region. This is because more women in the region are drinking higher volumes of alcohol and more frequently than men.”
When reached on the telephone for further clarification, Dr Agongo explained that there is a high level of alcoholism among people of the region and the worse aspect of the problem is that people who are already impoverished are spending their scarce resources on alcohol.
He said for that reason a number of people could not afford balanced diets leading to malnutrition and anaemia and that is one of the underlying factors of maternal and under-five mortality in the region.
Dr Agongo explained that alcohol consumption was not good for anybody and it posed more risk to expectant mothers and children under five, because of the severe damage it caused to them.
Figures from the health directorate indicate that although accelerated child survival and maternal mortality reduction were some of the major priorities of the sector last year, 30 maternal deaths were recorded in the region last year as against 24 and 21 maternal deaths recorded in 2006 and 2005, respectively.
The question that keeps boggling my mind is whether the expectant mothers who join the “alcoholics” and devote their energies to consume volumes of alcohol are aware of the effects of alcohol abuse among pregnant women: Or do they do so out of some frustrations and social problems?
A medical reference from Healthwise, a health magazine, indicates that when a pregnant woman drinks alcohol, so does her baby, and a woman who drinks alcohol while she is pregnant may harm her unborn baby (foetus).
Alcohol can pass from the mother’s blood into the baby’s blood. It can damage and affect the growth of the baby’s cells and the brain and spinal cord cells are most likely to have damage.
The term "foetal alcohol spectrum disorder" (FASD) describes the range of alcohol effects on an unborn child.
The problems range from mild to severe. Alcohol can cause a child to have physical or mental problems that may last all of his or her life.
The effects of alcohol can include odd facial features, growth problems, learning and behaviour problems, birth defects, such as the eyes, ears, heart, bones, or urinary tract, and birth defects which involve parts of the body such as the eyes, ears, heart, bones, or urinary tract.
The Healthwise also mentions low birth weight and growth retardation and central nervous system problems as some of the effects of alcohol consumption among expectant mothers, indicating that new-borns with severe effects may be irritable and have problems with sucking.
During their school years, they also have problems with attention and learning.
Alcohol is the most commonly used addictive substance in the United States. One study estimated that of the approximately four million women who give birth each year in the United States, 2.6 million use some amount of alcohol during their pregnancy and another study has estimated that up to 22,000 children per year (approximately one-half of one per cent of all births) experience mild, moderate or severe adverse effects as a result of their mothers' alcohol ingestion.
The disastrous effects of alcohol intake, especially on expectant mothers, cannot be overemphasised.
Dr Agongo explained that there is a high level of alcoholism among people of the Upper West Region and since alcohol intake is not good for anybody, especially expectant mothers, it is important for them to be counselled to stay away from drinking.
As was pointed out in a Daily Graphic Editorial following the publication of the story, the Public Health Unit of the Upper West Regional Directorate of the Ghana Health Service has a crisis on its hands that must be addressed with all the seriousness it deserves and this should be done with support from related agencies.
Apart from the fact that health officials need to mount sustained public education on the need for proper ante-natal care or services and also encourage patronage by the expectant mothers, the Department of Women in the Upper West Region and women advocacy groups need to mount a vigorous campaign against alcoholism among expectant mothers.
In addressing this, the Public Health Directorate, with other relevant stakeholders, including the Department of Social Welfare, also need to identify social factors that drive the people, including pregnant mothers, into alcoholism and find effective solutions through counselling and the initiation of poverty alleviation programmes.
The 2008 State of the World’s Children report, released by United Nations Children Fund (UNICEF) late last month, has shown that up to half of the world’s under five deaths are caused by undernutrition. The report described the impact of simple and affordable, life-saving measures — such as exclusive breastfeeding, immunisation, insecticide treated bed nets and vitamin A supplementation — as key to achieving child survival across the world.
It noted that 26,000 children under five, the world over, died mostly from preventable causes and nearly all of these children lived in the developing world, of which 60 countries, including Ghana, were the worse affected.
Undoubtedly, parents need resources to take care of their children while pregnant women need energy and resources to safeguard their lives and that of the unborn baby, but this could not be done. We definitely need to make pregnancy safe.