Episode #136 – Healthy births, saving mothers

VSG According to a new WHO report, more women are surviving pregnancy and childbirth than ever before. In just the last twenty-three years, we’ve seen a decline of forty percent in maternal deaths. However, as unprecedented aid cuts take effect around the world, UN agencies are warning of a threat of major backsliding. We all know someone who’s expecting a baby, right? Our maternal health expert, Dr Femi Oladapo, is our expert on this show today. Welcome, Dr Femi. You’ve had years of experience in the field, delivering babies. Talk to us about what a mother needs to know about how she can have a safe pregnancy and delivery.

FO Thank you, Vismita. The birth of a child is a major life event. Potentially a time of hope, new beginnings and joy. But it can also be a time of fear and complications. For a woman to have a healthy pregnancy, for starters, access to routine medical checkups and good nutrition are essential to prevent complications during pregnancy.

VGS What kind of tests are included in these antenatal checkups?

FO During these checkups a woman should expect to have tests like urine tests, blood tests, ultrasounds, glucose screening, blood pressure checks, as well as monitoring of her baby’s growth.

VGS And then, in addition to these tests, what are the other things she should keep in mind during pregnancy?

FO There are some warning signs that might indicate that a complication is about to set in. Women should watch out for things like vaginal bleeding, severe headache, or swelling of the legs. And if any of these emerge, a woman should contact her health-care provider.

VSG Dr Femi, let’s talk about a major killer for women during childbirth, haemorrhage. Why are so many women still dying of haemorrhage in this day and age?

FO It’s a reality that maternal death is still a major issue worldwide. In 2023, two hundred and sixty thousand women died as a result of complications of pregnancy or childbirth. Haemorrhage is the leading cause of maternal death and it accounts for over twenty five percent of maternal deaths that occurred in 2023. If you look at that number, that is roughly seven hundred maternal deaths in a day, about one in every two minutes. That’s like a jumbo jet crashing every day. High blood pressure disorders, known as pre-eclampsia, is another major cause. But the real tragedy, is that many of these deaths are preventable.

VSG So clearly haemorrhage is a big killer, but WHO has a solution that’s turning the tide, right?

FO Yes, exactly. The complications and serious health outcomes that are associated with postpartum haemorrhage, are preventable if it’s identified early. The key to this is rapid detection and effective treatment. Unlike in the past, where doctors and nurses, you know, guessed the amount of blood that a woman is losing, WHO has come up with a powerful solution, a special plastic sheet that is called a calibrated drape, whereby the blood loss of a woman is measured more accurately. So, immediately after the birth of the baby, the health-care providers would slip this beneath the buttocks of the woman. The blood loss is then collected here. As soon as the blood loss reaches a certain point, in this case 500 milliliters, a set of treatments are provided to the woman almost at the same time, within fifteen minutes. From the study that was conducted, over two hundred thousand women were involved, this approach was shown to reduce severe blood loss of more than a litre, surgery to stop bleeding or death by as much as 60%.

VSG So, Dr Femi, I remember when I was expecting my child there were so many people to advise, my mother, my relatives. But nowadays, it’s even more, right? There’s digital media, there’s misinformation, there’s good information, there’s too much information. What is it that a woman needs to know about her rights while going through pregnancy and delivery?

FO Very important question. A woman who is pregnant, has the right to a safe, positive pregnancy, childbirth and postnatal experience where they are treated with dignity and respect. They have the right to have a companion of their choice, to be with them throughout the pregnancy journey, including during labour and childbirth. They have the right to move around when they’re in labour and they have the right to choose the birth position. And she has the right to have pain relief. In terms of advice, I would advise women to consult their health-care providers much earlier in pregnancy, so that they can work out a plan what we call a birth plan, to ensure that they have a safe pregnancy and childbirth outcome. When women have control of their health and lives, we see healthy mothers and healthy babies.

VSG Thank you, Dr Femi. That was Science in 5 today, until next time then, stay safe, stay healthy and stick with science.