LAHORE: For low risk normal pregnancies, the benefits of home birth are now widely recognised the world over.
Being in familiar surroundings, with the same midwife they have seen throughout their pregnancy, would help many women feel more relaxed and better able to cope.
These views were expressed by experts during a seminar on “Maternal mortality in Pakistan” at the University of Health Sciences (UHS) on Wednesday.
Addressing the seminar, former dean postgraduate medical education of Cambridge University Prof John Biggs says the death of a woman in childbirth is a tragedy. “Pregnancy is not a disease and pregnancy related morbidity and mortality are preventable.”
Prof Biggs says nearly half a million women die each year due to pregnancy related complications and 95 per cent of them come from developing world. The lifetime risk of a woman dying of pregnancy related causes in developing countries is 1:40 as compared to 1:3600 in developed world.
He says haemorrhage, hypertension, unsafe abortion, infections and obstructed labour are some factors contributing to the higher mortality rate among women in rural areas. All of these causes are mostly preventable through proper understanding, diagnosis and management of labour complications.
UHS Vice-Chancellor retired Maj-Gen Prof Muhammad Aslam says: “Death of a mother is the death of a family. It is essential to strengthen primary healthcare infrastructure to reduce complications during pregnancy and labour. Provision of antenatal healthcare in the community by trained health personnel form the backbone of any such efforts.”
The UHS VC says the university will prepare a project to start a certification course in this regard for community midwives and lady health workers.
UHS Centre for Innovation in Learning and Teaching Director Dr Arif Rashid Khwaja says for healthy women with normal pregnancies, choosing a home birth is now seen as a perfectly safe option in the western world.
Every woman has the potential to have a home birth. What is important, he says, is the provision of adequate resources for good antenatal and postnatal care by trained midwives, fast access to emergency services and careful monitoring by the midwife at home.
According to Deputy Provincial Programme Co-coordinator for Maternal, Neonatal & Child Health (MNCH), Punjab, Dr Sajjid Ali, an estimated 30,000 women die each year due to pregnancy related causes. Recent estimates (WHO & Unicef) place the figures around 260/100,000 live births but in reality it may be higher because of under registration of deaths in the country and absence of cause of death information.
He says the government is integrating all services related to maternal, neonatal and child health at the district level and has introduced a new cadre of community midwives to increase skilled birth attendants.
“So far 4,200 qualified community midwives have been deployed in Punjab.”