Causes of Maternal Mortality in Ghana
Maternal mortality often refers to deaths occurring in women, while pregnant or within 42 days of aborting a pregnancy irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.
It continues to pose a great deal of concern with almost 99% of all maternal deaths happening in developing countries with over half in sub-Saharan Africa alone. One (1) in 180 pregnant women lose their lives during childbirth when compared to 1 in 4,900 in developed countries.
Per data available to the World Health Organization (WHO), Ghana has an estimated maternal mortality ratio of 310 deaths per 100,000 live births, a steep decline compared with the 760 deaths per 100,000 live births in 1990. A statistic very worrying still, and it is important to understand the underlying causes of maternal mortality in Ghana which are not at variance with facts in other parts of the continent.
- Poor access to healthcare services
Poor access to healthcare services is a major contributing factor to maternal mortality in Ghana. Many pregnant women in rural areas do not have access to quality healthcare services, and as a result, they do not receive adequate prenatal care. Limited access to quality healthcare services, including antenatal care, emergency obstetric care and postnatal care add to this phenomenon.
Ironically, the nearest health facility can be several miles away from the community where women in labor can be carried on bicycles and motorcycles to seek medical attention. As you will have it, this can lead to complications during pregnancy and childbirth, which ultimately result in maternal mortality.
- Lack of skilled birth attendants
The lack of skilled birth attendants is another major cause of maternal mortality in Ghana. As many health professionals refuse postings to communities outside the main towns and cities of the regions due to deplorable working conditions, many women give birth at home without the assistance of such skilled healthcare providers. This can result in complications during childbirth that can be fatal to both the mother and the baby.
- Hemorrhage
Hemorrhage, or excessive bleeding, is one of the leading causes of maternal mortality in the country. Hemorrhage, according to studies is the highest cause of maternal mortality and most of those who died were largely in the age range of 35-39 years. Interestingly, married women are at higher risk of dying from hemorrhage compared to single women. Hemorrhage can occur during pregnancy, childbirth, or the postpartum period. Women who give birth at home or in facilities without skilled birth attendants are at a higher risk of experiencing excessive bleeding leading to death.
- Infection
Infection is another common cause of maternal mortality. Women who give birth in unsanitary conditions or without access to antibiotics are at a higher risk of developing infections. Infections can lead to sepsis and postpartum infections, which can be fatal when not treated promptly. Lack of proper hygiene practices, inadequate infection prevention measures, and limited access to quality healthcare facilities increase the likelihood of maternal deaths caused by infections.
For instance, unsanitary environments give cause for mosquitoes to breed, and malaria has been found as the single highest cause of deaths (53.6%) due to infectious diseases among pregnant women in Ghana.
- Unsafe Abortion
Unsafe abortion is also a leading cause of maternal mortality in Ghana. Many women resort to unsafe abortions due to the prevailing restrictive abortion laws and the lack of access to safe and legal abortion services exposing them to the services of quack doctors. Unsafe abortions then result in complications that can be fatal for the mother.
- Anemia
Anemia, particularly severe anemia, increases the likelihood of maternal mortality. Iron deficiency, a common cause of anemia, can lead to complications during pregnancy and childbirth, such as postpartum hemorrhage and infections.
- Socioeconomic Factors
Socioeconomic factors have consistently determined that more men are economically stable than women, the average pregnant woman is predisposed to poverty, limited education, and lacks access to clean water and sanitation facilities which consequently contribute to maternal mortality. These factors can hinder women's ability to access healthcare services, afford transportation to health facilities, and make informed decisions regarding their reproductive health.
- Hypertensive Disorders (Pre-eclampsia and Eclampsia)
Hypertensive disorders during pregnancy, such as pre-eclampsia and eclampsia, contribute significantly to maternal mortality. These conditions involve high blood pressure, which, if left untreated, can lead to complications such as organ failure, seizures (eclampsia), or stroke.
Conclusion
The causes of maternal mortality in Ghana are complex and multifaceted. As studies have shown evidence of variations in the causes of maternal mortality among different socio-demographic subgroups, targeted solutions cannot be overlooked. The poor access to healthcare services, lack of skilled birth attendants, hemorrhage, infection, unsafe abortion, socioeconomic situation, and hypertensive disorders have all been contributing factors to maternal mortality. It is therefore important for the government and other stakeholders to address these several issues to adequately improve maternal healthcare in Ghana to prevent the unnecessary deaths recorded of expectant mothers and their babies.
Reference:
https://www.frontiersin.org/articles/10.3389/fpubh.2018.00101/full
