5 Rs to reduce maternal deaths

Compared with our neighboring countries, the Philippines has one of the highest numbers of mothers dying every day. From a high rate of 221 mothers dying for every 100,000 live births in 2010, the country is tasked to reduce this number to 52 maternal deaths for every 100,000 live births by 2015. This is part of our commitment to the United Nations Millennium Development Goals.

According to DOH statistics, the major cause of death is bleeding. Other causes include infections, unsafe abortions, high blood pressure (called pre-eclampsia), and abnormalities in the womb itself. From a public health standpoint, here are the five strategies we can use.

For easy recall, these form the code word of five Rs.

•Ready facilities. The DOH has started to improve and upgrade hospitals and birthing centers. Health centers should have the capacity to perform normal spontaneous deliveries, and to refer these patients to hospitals should complications arise. The referral system should be improved to ensure timely coordination between health facilities. The mother should be aware beforehand of which health facility (e.g. lying-in clinic, birthing center, government or private hospital) she plans to give birth in.

•Ready skilled health workers. One of the important factors in reducing maternal mortality is to increase the number of deliveries performed by skilled health workers. Doctors, midwives, and nurses should be trained to deliver babies. Mothers should get adequate prenatal care, which includes the management of anemia, high blood pressure, and diabetes during pregnancy. Health workers should be aware of high-risk pregnancies and when and where to refer the patients. One thorny issue is the need to reduce deliveries given by traditional birth attendants or hilots. A number of deaths were due to inadequate care given by these traditional healers. Hence, to be safe, the public is urged to be under the care of a skilled professional.

•Ready money. Having a baby carries an important responsibility for the parents. They should save enough money for the birth of their child. However, for very poor patients, the national government or LGUs gives PhilHealth membership for free. Having a PhilHealth card will provide free coverage of birthing expenses. For those who are not PhilHealth members, you should enroll in PhilHealth as early as possible to enjoy the benefits. In addition, the parents should prepare for the money to be used for transporting the mother to the hospital.

•Right knowledge. For women in the reproductive age group, there are things you should know should you decide to have a baby:

a) Be aware if yours is a high-risk pregnancy. Having a first baby, a fifth baby onwards, being under 18 years old, and being more than 35 years old are all considered high risks.

b) Get prenatal checkups. On the average, you need to see a doctor every two months. Your doctor will prescribe you vitamins and iron supplements, and teach you what foods to eat.

c) Stop smoking and drinking alcohol. Rest often.

d) Arrange early on which health facility (e.g. lying-in clinic or hospital) you plan to give birth in and who will deliver your baby.

e) Be aware of serious pregnancy symptoms such as pain in the abdomen, premature labor, any vaginal bleeding, any leaking of water, dizziness, fainting, shortness of breath, fast beating of the heart, and less activity of the baby. If you have any of these symptoms, consult your doctor.

Moreover, prepare for childbirth and breastfeeding.  Ask your doctor about the benefits of breastfeeding. Later on, you will have to work closely with your pediatrician or health center doctor for your baby’s vaccine and check-up needs.

•Responsible parenthood. Two strategies are needed to reduce the numbers of mothers dying. First, we must reduce teen pregnancies. This can be done through health education of the teens and also the parents. Parents can try to communicate with their teens about sex-related issues. A faith-based or community-based intervention can help in counseling teens to avoid risky behavior.

Second, we should advocate for the three-year birth spacing rule and reduce unplanned pregnancies. From a medical standpoint, a woman is advised to wait two or three years before getting pregnant again to help the body to recover from the stress of pregnancy. To achieve this goal, the couple may use natural or artificial family planning methods, depending on their preference. Since family planning education and methods entail some cost, the government is tasked to shoulder these expenses, especially for the poor.

Finally, let us teach and empower the community to protect the mothers, babies, and teens in their own barangays.