Maternal Mortality: An Urgent ProblemBy Miriam Bello | Mon, 05/10/2021 - 14:40
Maternal mortality is a worldwide problem that takes the lives of 830 women per day. Most of the victims (95 percent) are from low- and middle-income countries, predominantly in Africa, and the COVID-19 pandemic only worsened conditions for expectant mothers.
In 2016, maternal mortality was named the second leading cause of death for women of reproductive age, after HIV/AIDS, and was the leading cause among women between 15–29 years old. The complications responsible for 75 percent of maternal deaths are severe bleeding (mainly after delivery), post-delivery infections, gestational hypertension (pre-eclampsia and eclampsia), childbirth complications and dangerous abortions. The remaining causes are associated with HIV/AIDS and malaria.
The risks of maternal death can be reduced through better access to modern methods of contraception and by ensuring that women have access to high-quality care before, during and after childbirth, explains WHO. A UNICEF study states that despite the complications showing without warning, most maternal deaths can be prevented within an equipped facility with skilled medical professionals. “Complications require prompt access to quality obstetric services equipped with life-saving drugs, including antibiotics, and the ability to provide blood transfusions needed to perform Caesarean sections or other surgical interventions,” explained UNICEF.
In 2019, Mexico’s maternal mortality rate was 31.2 deaths per 100,000 estimated births, representing a decrease of 12.8 percentage points compared to the previous year. However, the scenario changed during the COVID-19 pandemic. In 2020, Mexico registered a 37.8 percent increase on maternal mortality to reach 46.6 deaths per 100,000 estimated births
According to epidemiological data from Mexico’s Ministry of Health, prior to COVID-19 the main causes of death were: obstetric hemorrhage (22.5 percent), hypertensive disease, edema and proteinuria in pregnancy, childbirth and postpartum (20 percent) and respiratory system disease (15 percent). However, by 2020 the leading causes of maternal mortality were confirmed SARS-CoV-2 virus, COVID-19 with no virus identified, hypertensive disease, edema and proteinuria in pregnancy, childbirth and postpartum and obstetric hemorrhage.
The states that reported the highest number of deaths are State of Mexico, Chiapas, Puebla, Jalisco, Chihuahua and Mexico City. These states are among the poorest in the country or showed the highest rates of COVID19 contagion.
Mexico has taken concreate actions to approach the subject. Among those stand out:
- NOM-047-SSA2-2015 for healthcare for women between 10-19 years of age.
- NOM-007-SSA2-2016 for the care of women during pregnancy, delivery and postpartum and of the newborn.
- NOM-035-SSA2-2012 for the prevention and control of diseases in perimenopause and post menopause in women.
- NOM-005-SSA2-1993 for family planning services.
- NOM-007-SSA2-1993 for the care of women during pregnancy.
- NOM-014SSA2-1994 for the prevention, treatment and control of cancer of the uterus neck and of the breast in primary care.
- NOM-026-SSA2-1998 for epidemiological surveillance, prevention and control of nosocomial infections.
- NOM-031-SSA2-1999 for children's healthcare.
- NOM-041SSA2-2002 to address breast cancer.
- NOM-046-SSA2-2005 to fight prevent sexual violence against women.
The government’s Sectorial Health Program 2019-2024 aims to achieve effective, universal and free access to healthcare to guarantee access to health services for those not affiliated to any social service, especially for groups in situations of vulnerability, marginalization or discrimination. As part of this goal, the government aims to “strengthen care models that coordinate the training and work of medical personnel and midwives for the care of women in rural communities.” The government’s main target for maternal mortality is to reduce the number of maternal deaths from 30.6 for every 100,000 inhabitants to 25 per 100,000 inhabitants by 2024.