Midwives playing vital role in reducing maternal mortality

Speakers at a function held in connection with International Day of Midwives said that midwives were playing an important role in reducing maternal mortality but there was great need to train community midwives. Afghanistan ranks among the top countries with the highest maternal mortality rates in the world. They said that according to an estimates, every day, 1500 women die from pregnancy or childbirth related complications across the world.
Most of these deaths occur in developing countries, and most were avoidable by improving state of maternal health in line with the eight Millennium Development Goals adopted by the international community at the United Nations Millennium Summit in 2000. In Millennium Development Goal 5 (MDG5), countries have committed to reduce the maternal mortality rate between 1990 and 2015. However, between 1990 and 2005 the maternal mortality rate declined by only 5%. Achieving Millennium Development Goal 5 requires accelerating progress particularly in developing countries.
They said that high incidence of maternal death is one of the signs of major inequity and it reflects gap between rich and poor. A total of 99% of all maternal deaths occur in developing countries, where 85% of the population lives. More than half of these deaths occurred in sub-Saharan Africa and one third in South Asia.
Parliamentary Secretary Health Punjab, Dr Saeed Elahi has said that uplift of health sector and welfare of the people associated with it is the top priority of Punjab Chief Minister, Shahbaz Sharif. In order to reduce mortality rate among pregnant women and newborn babies it is necessary that midwives or trained birth attendants should be present at the time of delivery, he said. "The government is paying special attention to the health of women and children and on the instructions of Punjab Chief Minister, mobile health units have been provided in rural areas for extending healthcare facilities." He disclosed that 50 more mobile hospitals are being purchased and the scope of the programme is being extended to tehsil level.
Special Secretary Health, Wasim Mukhtar appreciated the services of midwives and said that other staff in the health department should also follow their example. DG Health, Aslam Chaudhary said that the target of deputing one midwife for every 5,000 women would be achieved by 2015. He informed that 4600 midwives have been trained. He further said that more refresher course and quality training programme should be introduced for midwives.
Other experts believed that most maternal deaths are avoidable, as the solutions to prevent or manage the complications are well known. Since complications are not predictable, all women need care from skilled health professionals, especially during birth time, when rapid treatment can make the difference between life and death. For instance, severe bleeding after birth can kill even a healthy woman within two hours if the woman is unattended. Injecting the drug oxytocin immediately after childbirth reduces the risk of bleeding very effectively, they added.
It may be noted that the WHO defines a skilled attendant as "an accredited health professional - such as a midwife, doctor or nurse - who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and new-borns."
In Pakistan, experts say over 60 percent of deliveries are handled at home while only 5 percent are attended by qualified doctors in hospitals. This is one of the contributing factors of high rates of maternal mortality and morbidity in Pakistan.