Pakistan is one of the unfortunate countries that failed to achieve two of the most important MDGs, i.e. 4 and 5, that bound governments to ensure maternal and child health. When we think about the growing monster of maternal mortality rate in Pakistan, we often question ourselves if there are not women in the rest of the world who suffer from pregnancy related complications? The matter of fact is that women across the world also go through pregnancy related issues including septicemia, postpartum hemorrhage and anemia etc., but these issues are prevented in initial stages elsewhere. Unfortunately, in Pakistan maternal health is a totally under estimated case. Although, women from the elite backgrounds can access health care facilities but women from marginalized class suffer a lot during their pregnancy, and majority of the deceased mothers belong to the lower-income groups.
UNICEF, Pakistan claims that almost 1, 00,000 women die each year in Pakistan, which makes it three dead mothers per hour. If we analyze the causes of increasing maternal deaths in Pakistan, it becomes clear that postpartum hemorrhage, septic shock, unsafe abortions, untrained birth attendants, undernourishment and anemia stand on the top of the list. We can’t look into these causes superficially. These causes have their roots into some indirect entities as well. For example, lack of awareness, religious and cultural fundamentalism, gender-based discrimination and non-involvement of women in decision-making can be counted as the issue generators.
In my opinion, women suffer mostly because they cannot make decisions for themselves. They cannot decide about getting education, choosing a life partner and having children. A research result shows that in Pakistan “females having under taken post-graduate education have a probability of 25.29% of making uninfluenced decisions”.
This implies that if women don’t have the power to decide for their basic needs, then how can they decide for their sexual and reproductive rights, which are the direct causes of maternal mortality.
Being a part of an occupied rural territory of Pakistan, I have closely observed the condition of women in my area. Women are not allowed to take decisions for themselves and for their families. I witnessed many mothers giving birth to their children in washroom, in open fields and in cattle houses. They are unaware about the complications of unhygienic deliveries, thus choosing death for themselves. I witnessed a case of a friend and with her consent I am sharing it.
Her sister was pregnant, it was her first pregnancy and she was only 20 years old. She used to be verbally abused within the family and she was the only one to do all the home chores from lifting heavy loads to sweeping floors. She never went to hospital from conception till the day of delivery. At the time of delivery she asked her family to take her to the doctor but she was not taken to the hospital. The family called the traditional birth attendant for delivering the baby. The shocking event was the delivery of the child in the washroom under highly unhygienic and unsafe conditions. This was a greater risk for the mother and child both and unfortunately the mother could not survive due to pregnancy induced septicemia.
Women are not aware of complications related to pregnancy and most of them are illiterate. They have been kept inside the boundaries of religious and cultural fundamentalism. For example, in our culture women are not allowed to get education. Moreover, they are being made responsible to do the house chores and to feed their children and husbands. The cultural taboos have created a large gap between the males and females within the same family. In addition to that, women cannot dare to share their health problems to men or head of the family, so they prefer to treat the issues through unhealthy means.
Let me share a very disappointing scenario which could have been prevented. A pregnant mother was in her last trimester and had never been taken to the hospital before. While delivering the baby her mother in-law used knife to cut the umbilical cord which is normally attached to the mother and the baby. This act resulted in heavy bleeding and due to negligence of the family, the new mother died within 24 hours.
It is very disappointing to know that an average of almost three mothers die every hour in Pakistan due to maternal health complications. This is a matter of shame for all the active stakeholders of this country. It is the responsibility of the state that it should make pro-motherhood policies. Mothers are the producers of next generation. If safe motherhood policy will be introduced and implemented, mothers will be raised and nourish in a healthier environment thus creating a healthy next generation. Additionally, the stake holders of Pakistan should enhance awareness about pregnancy related emergencies and their management.
The contributor is a student at the Aga Khan University, Karachi.