Maternal mortality during or after childbirth: causes and prevention efforts & bull; hello healthy

Every family wants the mother and baby to be safe after going through the delivery process. However, sometimes the mother can experience a critical condition during childbirth which is fatal to the point where she dies. The cause of death or the mother dying during or after childbirth can be due to various things.

The condition of the mother during pregnancy, during childbirth, or within 42 days after giving birth (childbirth) is often the cause of the high maternal mortality rate (AKI).

Actually, why can a mother die during or after giving birth? Can this be prevented?

The cause of the mother's death during and after childbirth

The maternal mortality rate (MMR) in Indonesia is still quite high and far from the target to be achieved.

Launching from the Social Welfare Sector, Brief Information, MMR in Indonesia until 2019 still reaches 305 per 100,000 live births.

This means that there are about 305 mothers who died in 100,000 live births.

The presence of various problems related to pregnancy and childbirth, including maternal mortality, cannot be separated from various causes.

The cause of the mother's death during and after childbirth can be due to health conditions, readiness to become pregnant, and examinations during pregnancy.

In addition, assistance and care after childbirth also contributes to the increase in maternal mortality.

To be clearer, here are some common causes of mothers dying during and after childbirth:

1. Postpartum hemorrhage

Bleeding is actually common during childbirth, but if not handled properly it can get worse and risk causing the mother to die after giving birth.

Bleeding that is not treated as soon as possible after delivery and can have a fatal risk, namely postpartum hemorrhage.

Postpartum hemorrhage can occur when the mother chooses to give birth normally or by caesarean section.

Bleeding after childbirth can occur because the vagina or cervix is ​​torn or the uterus does not contract after giving birth.

However, usually heavy bleeding is also caused by placental problems during pregnancy.

Placenta-related delivery complications include uterine atony, placenta accreta, and retained placenta.

2. Postpartum infection

Postpartum infection can occur when bacteria enter the body and the body cannot fight back.

Some infections can cause the mother to die during or after childbirth.

Pregnant women infected with the Streptococcal B bacteria group can experience sepsis (blood infection).

Sepsis can attack the immune system and cause severe problems or even death.

Sometimes, sepsis can cause blood clots in pregnant women so that it blocks blood flow to important organs of the mother, such as the brain and heart.

This in turn can lead to organ failure and even death.

In general, postpartum infections usually begin to appear after delivery when the uterus is infected with bacteria.

Usually, the cause of infection in the uterus is because the amniotic sac is infected first.

The amniotic sac is a thin sac that covers the baby during pregnancy and contains amniotic fluid and placenta.

3. Pulmonary embolism

Pulmonary embolism is a blood clot that blocks a blood vessel in the lung.

This usually occurs when a blood clot in the leg or thigh (deep vein thrombosis or DVT) breaks and flows into the lungs.

Pulmonary embolism can cause oxygen levels in the blood to be low, so symptoms that usually appear are shortness of breath and chest pain.

Organs that don't get enough oxygen can become damaged, and this can then lead to death.

To prevent pulmonary embolism and DVT, it's a good idea to get up and walking as soon as possible after giving birth.

This method can help make blood flow smoothly while preventing blood clots from forming.

4. Cardiomyopathy

During pregnancy, a woman's heart function changes quite a lot.

This makes pregnant women who have heart disease at high risk of dying.

Cardiomyopathy is one of the heart diseases that can cause the death of pregnant women.

Cardiomyopathy is a disease of the heart muscle that makes the heart bigger, thicker, or stiffer.

Cardiomyopathy can make the heart weak so it can't pump blood properly around the body.

Ultimately, cardiomyopathy can cause problems, such as heart failure or fluid buildup in the lungs.

5. Mother dies during childbirth due to limited health facilities

Access to good health facilities or services, especially for mothers in underdeveloped, remote, border and island areas (DTPK) is one of the causes of maternal death.

The unequal provision of comprehensive obstetric neonatal emergency services (PONEK) and basic emergency obstetric neonatal services (PONED) also needs attention.

This is because the limited facilities for PONEK, PONED, integrated service posts (posyandu), and blood transfusion units, which have not reached all regions, can have fatal consequences for the mother's condition during childbirth and after.

Another cause that contributes to the high maternal mortality rate is poor road access to health services, especially in remote areas.

This makes it difficult for mothers to reach these health facilities so that it is too late to get help when experiencing complications during pregnancy and childbirth.

6. Other causes of maternal death

According to the Mayo Clinic, there are still various other causes of mothers dying during and after giving birth.

The following are causes of maternal death that can occur during or after childbirth:

• Experiencing cardiovascular disease
• Have had a stroke
• Experiencing high blood pressure (hypertension) during pregnancy
• Have a pre-pregnancy medical condition and childbirth
• Experiencing complications of anesthesia (anesthesia)
• Experiencing amniotic fluid embolism, which is when amniotic fluid enters the mother's bloodstream

But sometimes, the cause of the mother's death during or after childbirth is also not known with certainty.

In addition to understanding the various causes of mothers dying during or after childbirth in order to prevent the risks, don't forget to prepare well for labor.

Not to forget, childbirth supplies for mothers, babies and fathers who are waiting for delivery should also be provided in advance.

So, when the signs of childbirth begin to appear, the mother can immediately go to the hospital accompanied by a partner or a doula if there is one.

Signs of labor include labor contractions, the opening of the delivery, and the water breaking.

To avoid being mistaken, distinguish between real labor contractions and false contractions near the time of birth.

Can you prevent the mother from dying during or after giving birth?

In fact, the causes of maternal death during or after childbirth can be minimized as early as possible.

This can be done, for example, if there are health facilities that are easily accessible to all mothers in various remote areas plus relatively low costs.

The Centers for Disease Control and Prevention (CDC) explains that it is important for all women of childbearing age to adopt a healthy lifestyle.

This healthy lifestyle can be done by maintaining a diet, maintaining an ideal body weight, being physically active, and avoiding consuming illegal drugs.

Also, make sure that the mother handles any health problems before becoming pregnant so that the pregnancy and childbirth can run smoothly.

Mothers can also try to check their health conditions to the doctor when planning a pregnancy and regularly consult according to the schedule during pregnancy.

Efforts to prevent mothers from dying during and after childbirth

Key measures that have been shown to help reduce maternal mortality include:

• Ensure every woman has easy, fast, and high-quality access to prenatal care ahead of delivery.
  
• Ensure every woman has access to skilled health personnel at delivery and care a few weeks after delivery is over.
  
• Ensure easy access to a quality hospital or birthing clinic.
  
• Access to and empowerment of family planning programs.
  

The risk of the mother dying during or after childbirth can be significantly reduced if problems with pregnancy are treated early.

Also try to undergo the birth process in a trusted hospital or clinic if the mother has certain health conditions rather than giving birth at home.

This is because if certain complications occur during labor in the hospital, treatment can be given immediately.

Meanwhile, when the mother gives birth at home, the existing equipment may not be as adequate as in a hospital or clinic.

Heavy bleeding after birth can kill a healthy mother within hours if left unattended.

Injecting oxytocin immediately after delivery also effectively reduces the risk of bleeding.

The problem of postnatal infections can be reduced if good hygiene is maintained during the birth process.

In addition, early signs of infection can be detected and treated in a timely manner.

In order to avoid maternal death, it is also important to prevent unwanted and premature pregnancies.

The health of mother and baby are two things that are mutually related.

It is very important to ensure that all births can be assisted by a skilled health professional.

The goal is that if problems are found related to pregnancy and childbirth, they can be overcome on time.

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