Postpartum Hemorrhage Deemed One Of The Most Common Cause Of Maternal Mortality In Developing Countries

While most women dream of the first year of her child’s birth to be the sweetest one, they fail to fathom the shadow of postpartum hemorrhage which is a rising concern causing maximum maternal mortality.

Postpartum hemorrhage (PPH) is primarily defined as a loss of approximately 500ml or more blood from the genital tract post normal vaginal delivery (NVD) or loss of 1,000 mL or more blood post a C-section. It starts within 24 hours of delivery and is a solemn concern in most of the developing countries, causing more than 30% of the maternal deaths annually. Hygiene, poor resources, and lack of emotional support are the major cause of PPH.

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According to a report published by WHO, “Every year about 14 million women around the world suffer from PPH. The risk of maternal mortality from hemorrhage is 1 in 1,000 deliveries in developing countries (100 per 100,000 live births). Most deaths (about 99%) from PPH occur in low- and middle-income countries compared with only 1% in industrialized nations. However, recent studies have shown an increase in the incidence of PPH in developed countries as well. Therefore, in order to reduce the MMR (maternal mortality ratio) and achieve MDG5 (Fifth Millennium Development Goal), it is essential to achieve a major reduction in the incidence of PPH.”Delivering a baby is a joyous moment in a woman's life. However, being a critical process, umpteen care should be provided to the mother and child, to ensure the well-being of both. Delivery consists of four labor phases: starts with the labor pain and continues through full dilatation of mouth of the uterus, then complete delivery of baby followed by complete expulsion of placenta and membranes. Post-delivery is the 4th and the most critical stage and it lasts for 2 hours; the postpartum stage begins and it lasts for 6 weeks.

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During this time the hormones and tissues which had gone through a lot of changes during the last 9 months start returning back to its pre-pregnancy stage. It involves physical, emotional, and physiological changes, and besides being a crucial stage it is also strenuous on the mother. It is the utmost responsibility of the family members and the caregiver to ensure that she can sail through this phase without any hindrance.Sadly enough, it is one of the most neglected phases in a women’s life as with the newborn in the house focus of the family members including hers in on the newborn’s well-bringing.

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The healthcare sector of the developing countries is majorly lagging behind the developed countries and thus 70% of the mothers do not get the desired infrastructure at the time of delivery. Moreover, the lack of proper care post-delivery adds on to the increase in number maternal mortality due to postpartum hemorrhage. While nutrition, rest and guided exercise are key factors during the first 6 weeks, most women in developing countries lack all of these.She is under the constant pressure of proving themselves to everyone around her, while herself fighting to retain her sanity. In spite of feeling ardently attached to the baby, she at times feels lost with the emotional turmoil and the frequent mood disorders. These if not taken care of at the initial stages can aggravate and can lead to more severe complexities.It is high time that we come out of the stigma and address PPH issue unanimously before it starts plaguing the developed countries like the developing countries on the world. Routine screening of mothers in the first years of childbirth should be made obligatory to ensure that she is psychologically and physically stable.

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