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Maternal Mortality Rate Continues to Drop in Laos

Maternal Mortality LaosIt is hard to imagine how giving birth can be fatal to so many women around the world. However, even in 2021, maternal mortality remains a significant issue, especially in developing countries where modern medicine is scarce and medical facilities are not easily accessible. Fortunately, these maternal mortality rates have been dropping all over the world, especially in Laos.

Birth Complications in Laos

Laos, or Lao People’s Democratic Republic, is a landlocked nation between Thailand and Vietnam. With a population of 7.2 million, the country suffers from a declining fertility rate. In 2020, women in Laos had an average of 2.7 children, yet this rate was more than doubled just 30 years ago. In addition to infertility, women in Laos are at a greater risk for birth complications. According to the U.N., a mother’s risk of dying in Laos due to delivery and post-delivery complications is one in 150. This number is especially alarming when compared to statistics in Europe, where a woman’s risk of death is one in 3,400.

Declining Maternal Mortality Rates

Since the turn of the millennium, maternal mortality rates have dropped significantly all over the world due to the spread of modern medicine. According to the World Health Organization (WHO), the maternal mortality ratio dropped by approximately 38% worldwide in less than 20 years. Similar encouraging statistics are emerging from Laos. Eksavang Vongvichit, the nation’s former health minister, discusses Laos’s progress in tackling this issue: “We’re in third place worldwide in terms of bringing down the maternal mortality rate… We’ve brought down the number of maternal deaths from 450 out of 100,000 live births down to 220.”

The Ongoing Fight Against Maternal Mortality in Laos

Maternal mortality is a more frequent reality in developing countries. On average, women in low-to-middle-income countries more likely to die during or immediately after pregnancy than women in developed nations. This is largely because many birth-related deaths result from easily preventable causes, including severe bleeding, infections, high blood pressure, complications from delivery and unsafe abortions.

To prevent such avoidable deaths, numerous charities and NGOs are working on better educating reproductive healthcare workers in developing nations. The United Nations Population Fund (UNFPA) is a prime example of this work, being stationed in Laos and other developing nations all over the globe. In Laos, the program helped the Ministry of Health create better training programs for volunteers and midwives in reproductive care. This education includes bringing awareness to mothers about proper family planning, which covers how long to space out pregnancies and prevent undesired pregnancies. Not only will such education prevent unnecessary fatalities, but it will also aid families in properly planning for the future to break the cycle of poverty.

With the continued implementation of modern medicine and reproductive education in developing countries, there is great hope that the rate of maternal deaths will continue to decline in Laos.

– Amanda J. Godfrey
Photo: Unsplash

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WHO: Maternal Mortality Realities Worldwide

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According to a report by the World Health Organization (WHO), maternal mortality is a prominent issue in many developing countries, especially in sub-Saharan Africa and South Asia.

Deaths from childbirth disproportionately impact the poor as well as women living in rural areas. According to the WHO, “99 percent of all maternal deaths occur in developing countries.”

In addition, more than 50 percent of deaths during childbirth occur in sub-Saharan Africa.

The WHO also asserts that many complications that arise during pregnancy are treatable. The organization states that complications that present before birth may worsen during pregnancy and consequently become fatal.

Common complications accounting for deaths during pregnancy include severe bleeding (mostly after childbirth), infection, high blood pressure while pregnant, problems with the delivery and unsafe abortion.

According to the U.N., girls aged 15-19 are especially likely to experience fatal births.

The WHO explains that only 51 percent of women can afford skilled care by “a midwife, a doctor, or a trained nurse”. Therefore, millions of women face risks from unmonitored pregnancies. The WHO goes on to say that women need access to skilled care, not only during pregnancy, but also during childbirth and afterward.

A report from the U.N. shows that significant progress has been made in addressing the issue of maternal mortality. The organization states that Equatorial Guinea has achieved its Millennium Development Goals, reducing death during childbirth by 81 percent. Additionally, Eritrea reduced maternal mortality by 77 percent; Ethiopia saw a 69 percent decline and Rwanda reduced maternal mortality by 76 percent.

Moreover, U.N. Secretary Ban Ki-moon has launched a program named the Global Strategy for Women’s, Children’s and Adolescents’ Health, 2016-2030. The strategy “seeks to end all preventable death of women, children and adolescents and create an environment in which these groups not only survive, but thrive and see their environments, health and wellbeing transformed”.

– Mayra Vega

Sources: World Health Organization, United Nations 1, United Nations 2, Central Intelligence Agency
Photo: Flickr

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Fighting Maternal Mortality in Nepal with Misoprostol

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The earthquakes that shook Nepal in late April and early May were declared the country’s worst natural disaster on record. The quakes claimed the lives of 8,800 people and injured 22,000 others. The mass destruction and death toll continue to have devastating effects on all aspects of the country’s well-being. The Nepalese people are trying to rebuild and reclaim the sense of normalcy that existed before the quakes, but the earthquakes’ effects have presented new challenges.

Before the storm, increasing amounts of Nepalese women were choosing to have their babies in health facilities — a choice that helped Nepal meet the United Nations Millennium Development Goal in the reduction of maternal mortality rates by three-quarters. Another major factor in the massive reduction of such rates is a decade-old decision to distribute misoprostol to women who need it. Misoprostol is a drug designed to treat stomach ulcers, but is also capable of terminating a pregnancy when taken early on, and preventing postpartum hemorrhage — the leading cause of maternal death — when taken after giving birth.

The decision to distribute the powerful drug as a means to decrease maternal mortality lacked international support largely because the hegemonic ideology is that the best way to improve maternal mortality rates is to invest in making health facilities more accessible. While the idea of creating hundreds of well-stocked and adequately staffed health centers that are available to all mothers is a good one and would certainly reduce maternal mortality rates, overall it is unrealistic for many developing countries. The reality is that in developing countries where there have been large government expenditures on improving facilities, maternal mortality rates have not improved as significantly as they have in Nepal.

Since the massive earthquake struck, expectant mothers face additional challenges and there is concern that the mortality rates could increase again. With the destruction of roads and many healthcare facilities, giving expectant mothers misoprostol makes even more sense.

Currently, distributing the misoprostol amidst the widespread destruction is a major issue in Nepal. Aid groups, such as Direct Relief, have been working with the International Confederation of Midwives (ICM) and the Midwifery Society of Nepal (MIDSON), to deliver midwife kits, tents and funds. The intervention program focuses on providing midwives and the tools that they require, including misoprostol, to give Nepalese mothers the best chance at having a healthy delivery.

When access to midwives and trained professionals is as severely limited as it is in Nepal, there needs to be a backup plan. Few countries have followed in Nepal’s footsteps but if Nepal’s success has been any indication, misoprostol could be an intermittent solution that could work for many developing countries. In time, we will see how Nepalese maternal mortality rates fare in the aftermath of the horrific disaster. If the low rates are upheld, perhaps the international community will reconsider responsible use of misoprostol to get countries maternal mortality rates down, until the large scale investments in facilities and infrastructure can be made.

– Emma Dowd

Sources: Economist, Foreign Policy, Military Technologies, Reuters
Photo: Women News Network