Hussan Bibi, a 35-year-old resident of Badaber in Peshawar, shared her troubling experience after giving birth to her third child. All three of her children were delivered by a nearby midwife, but after the birth of her third child, she experienced continuous bleeding.
Initially, she brushed it off as a common post-pregnancy issue, as advised by the midwife, but the bleeding persisted for 10 to 15 days beyond the normal period. Concerned, her husband took her to a government hospital where a lady doctor diagnosed a serious internal injury that required surgery.
Gynecologist Afroz Khattak from Lady Reading Hospital in Peshawar emphasized that many women dismiss persistent back pain and prolonged bleeding as typical postpartum symptoms. However, such symptoms can indicate internal injuries caused by inexperienced midwives during childbirth.
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According to the World Health Organization (WHO), maternal mortality remains a significant global concern, with 200 out of 100,000 women dying annually from childbirth-related complications. Khyber Pakhtunkhwa has the highest maternal mortality rate among Pakistani provinces, with traditional practices often cited as contributing factors. Aggregate data underscores the urgency of addressing preventable maternal deaths, with one life lost every 7 seconds due to treatable causes.
How Dangerous Can Midwives Be?
Nazia, a resident of a village in Charsadda, sought medical assistance at a government hospital after enduring three miscarriages. Married for two years, she recounted her experience of getting pregnant three times and relying on midwives for childbirth, as per the village tradition. Despite familial disapproval, Nazia's husband brought her to the hospital for examination, where she received medication and was advised to return for a follow-up after a month.
Meanwhile, Nasreen (pseudonym), a 65-year-old midwife with 35 years of experience, reflected on the changing childbirth practices. She noted a shift from home births, once a common preference, to a trend where more women opt for hospital deliveries.
However, gynecologists challenge this trend, attributing maternal deaths in developing nations like Pakistan to the negligence of traditional birth attendants. Dr. Afroz emphasized that many complications during childbirth arise from the practices of midwives, warning against overlooking these issues as they can lead to fatal outcomes. She highlighted that a significant portion, up to 90%, of maternal deaths in Khyber Pakhtunkhwa result from such complications.
Causes of Death During Pregnancy
Assistant Professor Saida Abrar shed light on the prevalent causes of death during pregnancy, emphasizing that a significant number of pregnant women fail to complete even four out of the recommended eight weeks of prenatal check-ups. When women opt for midwives or traditional birth attendants for delivery, they may encounter complications due to the lack of medical treatments and facilities available in hospitals.
Abrar outlined potential complications, including profuse bleeding, infections, high blood pressure, obstructed labor, and the need for emergency surgical interventions. She underscored the critical role of specialist doctors in managing such complications, stressing the inadequacy of midwives in handling these medical emergencies effectively.
Despite advancements in medical care, Abrar highlighted the continued reliance on midwives, often resulting in cases of negligence and endangering both the mother and the unborn child. She lamented that pregnant women still entrust their lives to traditional birth attendants who lack the necessary skills and resources to mitigate risks, leading to tragic outcomes.
Statistics reveal a grim reality, with 40.7 out of 1,000 children in Pakistan either stillborn or dying on the day of birth. Pakistan holds the dubious distinction of having the highest child mortality rate globally, underscoring the urgent need for improved maternal healthcare services and greater awareness about the risks associated with traditional birthing practices.
Gynecologist Afroz Khattak, affiliated with Lady Reading Hospital, highlighted specific factors contributing to infant deaths, emphasizing the importance of antenatal care for expectant mothers. She underscored that prenatal check-ups play a crucial role in assessing the health of both the mother and the baby, detecting potential complications such as anemia, abnormal blood pressure levels, and inadequate weight gain during pregnancy.
Khattak emphasized the significance of monitoring the baby's growth and position in the womb to ensure optimal fetal development and movement. Timely diagnosis of these factors is vital to mitigate risks and safeguard the lives of both the mother and the child. However, she lamented that inadequate healthcare services and reliance on inexperienced midwives often exacerbate these risks, making it challenging even for well-equipped hospitals to address emergencies effectively.
According to the World Health Organization (WHO), maternal deaths encompass women aged 15 to 49 years, with progress in reducing maternal and infant mortality stagnating over the past eight years. A recent report by the WHO indicates that more than sixty countries are at risk of missing their targets for reducing these deaths by 2030, highlighting the urgent need for enhanced maternal healthcare services and global efforts to address this concerning trend.
What diseases can occur during and after pregnancy?
Gynecologist Afroz Khattak from Lady Reading Hospital highlighted potential health concerns during and after pregnancy, including high blood pressure, infections, back pain, and mental disorders. These conditions not only pose risks to the woman's health but also increase the likelihood of complications in subsequent pregnancies.
What foods should pregnant women eat that can be beneficial during pregnancy?
Nutritionist Aimal Khan, affiliated with Lady Reading Hospital Peshawar, emphasized the significance of a balanced diet for maternal and fetal well-being during pregnancy. A diet rich in essential nutrients supports maternal health and fosters optimal fetal development. Khan recommended minimizing the intake of sugar, salt, and fat to promote overall health.
According to Khan, while weight gain is a natural aspect of pregnancy, excessive or insufficient weight gain can pose risks to both the mother and the baby. A balanced diet typically fulfills nutritional requirements during pregnancy. However, certain foods are particularly beneficial due to their high nutrient content, including folic acid, calcium, iron, iodine, and vitamin D, which are vital for the baby's health and can help prevent congenital disorders.
Khan advised women planning pregnancy to begin taking folic acid supplements at least one month before conception and continue for three months afterward. Folic acid supplementation reduces the risk of neural tube defects in newborns. However, Khan cautioned that supplement needs vary by individual, urging women to consult their healthcare provider before initiating any supplementation regimen.
Furthermore, Khan noted that pregnancy may increase cravings for processed foods high in sugar, salt, or fat. However, he advised pregnant women to avoid such foods as they can contribute to gestational diabetes and hypertension. Opting for a balanced diet supports maternal health, aids in maintaining a healthy weight, promotes optimal fetal development, ensures a healthy birth weight, and helps regulate blood pressure during pregnancy.
What should a pregnant woman take care of in her diet?
Assistant Professor and Nutritionist Bushra Khalil outlined two crucial dietary considerations for pregnant women. Firstly, she emphasized limiting daily salt intake to five grams or one teaspoon to reduce the risk of hypertension. Pregnant women should avoid canned or processed foods, which often contain high sodium levels.
Secondly, Khalil recommended reducing the consumption of foods with added sugars and unhealthy fats, such as fried foods, instant noodles, ice cream, candy, biscuits, and sugary beverages. These foods lack essential nutrients and can contribute to excessive weight gain and related complications during pregnancy.
Furthermore, Khalil cautioned against consuming certain foods that may harbor harmful bacteria or parasites, posing risks of infections and pregnancy complications. Pregnant women should avoid raw or undercooked meat and ensure thorough cooking to eliminate any potential pathogens.
Additionally, maintaining adequate hydration is vital during pregnancy, and expecting mothers are advised to drink water frequently to support maternal health and fetal development.
