Birth-related deaths belong to the bad past 

Once more, the media is drawn to a harrowing incident of a mother losing her life after delivery, allegedly due to negligence by medics.

The victim is reported to have bled to death after delivering twins at Mama Lucy Kibaki Hospital, in Nairobi.

The pain of the father watches helplessly as his wife’s life ebbs away yet she could have been saved had his 12-hour plea been heeded by the medics on duty.

To be fair, most of our hospitals are ill-equipped to handle emergencies. On this, medics have no recourse.

But, however, deprived, they need not act inhumanly by failing to offer timely assistance where they can, including advising on referrals.

The World Health Organization cites postpartum haemorrhage (PPH)—whereby a mother loses 500 millilitres of blood (normal delivery) or 1,000 ml (for caesarean section)—as a leading cause of maternal deaths.

In 2017 alone, WHO says, 295,000 women died during or after childbirth. Strangely, most of the causes are preventable through vigilance, preparedness and timely intervention.

There is a need for more widespread awareness of PPH to enhance proactiveness. Besides, the women at risk ought to be identified during their prenatal visits and their hospital cards annotated accordingly.

The alerts should subsequently be referred to when the mothers are due and appropriate measures taken in readiness for PPH.

Increases preparedness

A research report published in the Reproductive Health Journal says, among several others, that PPH is increased by conditions including hypertension, multiple pregnancies, anaemia, obesity, advanced maternal age, HIV-positive status, caesarean delivery and foetal microsomia (larger babies).

Whereas there are other intervening factors, knowledge of such risk increases the preparedness of patients and medics.

There is a need for hospitals to institute a policy specific to handling delivery cases. Birthing is a special, God-given responsibility.

It’s not only the beginning of life but a matter of life and death. All hospitals ought to give an account of how they handle every case.

Incidents of negligence should be criminalised and culprits handed deterrent sentences.

Secondly, community health workers (CHWs) should be empowered to follow up on pregnancy cases that fall under the risk bracket.

Instructively, most victims are from low-income groups, which attend mostly ill-equipped public health facilities.

CHWs can advise them on what to do, including reporting negligence. A timely distress call is critical.

Thirdly, establish a toll-free line to serve reports of birth complications. With most victims of negligence low-income earners, this lot is often ignored upon the misconception that they are ignorant of their rights and incapable of holding medics to account.

Lastly, medics ought to be trained in human ethics. Intelligence without humanity is dangerous. Medics should remain loyal to the Hippocratic Oath, whereupon they are called to preserve life.

Mr Osabwa is a lecturer at Alupe University, Busia. [email protected].