Not a Motherhood Statement

Its hard to imagine, what with pregnant women sharing beds at the government-run Fabella Hospital and more mothers waddling their way to make the Philippines one of the most populous nations this side of Catholic Asia.

But according to a report issued by the international agency Save the Children, 11 Filipino mothers die everyday due to childbirth and other pregnancy-related complications. That would total some 4,000 maternal deaths annually, according to the report titled The State of Filipino Mothers 2008.

There are six reasons why mothers fall on the wayside, cited the report:

1. Limited access to health facilities and quality maternal care

Mothers must have their deliveries in hospitals or other health facilities such as lying-in clinics so they can be assisted at once when they experience complications, noted Stephanie Anne Sison, project director of the report. But in fact, according to the report, less than four out of 10 births (or 38.8 percent) in the Philippines are delivered in a health facility. Most mothers, especially in rural areas, still deliver their babies at home.

That means that few mothers are attended to by skilled doctors, or have access to emergency obstetric care and blood supply, the report said, adding: Since hemorrhage, or blood loss, accounts for a large proportion of maternal deaths, mothers who are unable to get to a health facility in a timely manner are especially vulnerable.

2. The lack of access to a full-range of reproductive health care, including family planning information and services

Knowledge about family planning means knowing the advantages of birth spacing, low fertility, and planned pregnancy, the report said.

Childbirth is a traumatic experience for the body. It is best to space pregnancies so the mothers body can recover and return to good health. After a live birth, the next pregnancy should at least be after 24 months. High fertility, on the other hand, is risky for a mother since each successive pregnancy after the fourth one increases the risk of complications, Sison explained.

3. Unplanned pregnancies could lead to induced abortion, and consequently, maternal deaths

According to the report, almost half of all pregnancies are unplanned. Planned pregnancies will lessen the number of those who resort to abortion, which results in 800 maternal deaths annually, the report quoted from an earlier study on unintended pregnancy and induced abortion in the Philippines made by the Guttmacher Institute.

Almost all of the 400,000 induced abortions annually are performed under unsanitary conditions or through medically-unsound practices that increase the risk of hemorrhage and infection.

4. The lack of political will to provide maternal health services

Government should answer to Filipino mothers on why a significant number among them die from childbirth and pregnancy-related complications. Political support is often vague, biased or absent as exemplified by a lack of adequate local and national policies that ensure sustained provision of maternal health services, the report pointed out.

5. The health sector, according to the report, remains underfunded at 3.3 percent of the countrys Gross Domestic Product, lower than all Southeast Asian countries except Myanmar

This is way below the World Health Organizations indicators for adequate health coverage, which is at least five percent of a countrys GDP. The low investment on health means that the government is leaving it up to the private sector and individual households to take care of almost half of all expenses related to family planning, the report said.

6. The lack of a reproductive health law that would require appropriate funds to ensure full access to quality reproductive health information and services that include maternal health and family planning

This glaring omission, according to the report, undermines commitments made by the Philippines when it ratified several United Nations treaties, including the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). The UN Committee on the CEDAW, which reviews the countrys implementation of this international treaty on womens rights, has called on the Philippines to fulfill its obligations to advance womens reproductive and sexual health rights. It attributes the countrys high maternal mortality rates to induced abortions, high fertility rates, inadequate family planning services, the low rates of contraceptive use, and difficulties in obtaining contraceptives.

It doesnt have to be that way, said Save the Children country director Latha Caleb. The leading causes of mothers deaths in the Philippines can all be prevented or treated. (We must remember that) the deaths of mothers during pregnancy or childbirth have a profound impact on the survival of the children they leave behind. Newborns who have lost their mothers are ten times more likely to die than those whose mothers survive childbirth.

The report puts forward several recommendations to save the lives of more Filipino mothers.

First, lets make sure that all pregnant women have access to safe, quality health facility-based services and care, including deliveries. Local governments especially need technological and financial support so they can come with a health system that will provide these. Second, national and local policies, such as a comprehensive reproductive health law, must be put in place to allow access to maternal care before, during and after pregnancy. And third, policies and programs targeting mothers must be gender-responsive, rights-based, and culturally-sensitiv e, Sison said.

The report added: (T)he Philippines is an archipelago rich with several ethnic groups, varying religious beliefs, and diverse cultural practices. Maternal and reproductive health interventions must be designed and adapted appropriately to ensure maximum effectiveness. Furthermore, collaborating with other community stakeholders, like religious and non-government organizations, will make reproductive and maternal health care programs more effective.


Source: Philippine Daily Inquirer
Date: Sunday, May 10, 2009
Author: Elena Masilungan