A pregnant woman named Rahima Akter tragically passed away while attempting a homebirth in Rajbari's Goalanda upazila recently.
When she went into labor, a village midwife assisted with the delivery. However, Rahima Akter succumbed to excessive bleeding while being transported to the hospital, resulting in her unfortunate death.
Her newborn daughter also lost her life during the childbirth process.
Unsafe home deliveries like Rahima's are sadly very common in Bangladesh and various parts of the world. Despite global efforts to reduce maternal mortality, the persistence of such home deliveries poses a significant challenge to achieving this crucial goal.
According to experts, homebirths by unskilled midwives, post-partum bleeding, high blood pressure, infections during pregnancy and unsafe abortions are the major causes of maternal deaths.
Over the past 20 years, Bangladesh has witnessed a significant decline of 72% in maternal mortality rates. Nevertheless, the government remains committed to further reducing these numbers.
Hospitals across Bangladesh are conducting many normal deliveries with the help of experienced doctors and nurses completely free of cost and various gifts are also being given to them by the government for encouragement.
Still, many people unknowingly opt for home births, leading to these unfortunate outcomes.
When it comes to the causes of maternal mortality in the country, statistics show that hemorrhage contributes to 31%, eclampsia to 24%, indirect causes to 20%, unspecified causes to 8%, abortion complications to 7%, other causes to 7%, and unnatural labor to 3% of the cases.
Experts think that everyone should come forward to raise public awareness of unsafe homebirths and their risks.
Safe Motherhood Day
Sunday marks Safe Motherhood Day. The day was officially declared by Prime Minister Sheikh Hasina on May 28, 1997, and has been celebrated nationwide since 1998.
As per the United Nations, Bangladesh recorded approximately 3,088,000 live births in 2016.
According to the government's maternal health survey conducted in the same year, there were 196 maternal deaths for 100,000 births in the country.
In the joint report of the World Health Organization (WHO), Unicef, UNFPA, World Bank, and the United Nations titled “Trends of Maternal Mortality 2000 to 2020”, it is said in relation to Bangladesh that maternal mortality has decreased by 72% in 20 years.
Despite this progress, the report highlights the concerning fact that 10 mothers still lose their lives every day due to childbirth complications.
The report further states that as of 2020, approximately 123 mothers die for every 100,000 live births in Bangladesh.
Government targets
Bangladesh's government has undertaken several actions with a priority on population control and ensuring efficient services for mothers.
To achieve the Sustainable Development Goals (SDG) target, the government is working to bring down the maternal mortality rate in the country to 70 per 100,000 by 2030.
Currently, the maternal mortality rate stands at 165 per 100,000, demonstrating a significant decline of 94 per 100,000 over the last 10 years.
Experts' observations
Obstetrical and Gynecological Society of Bangladesh (OGSB) Secretary General Professor Dr Gulshan Ara said 30% of maternal deaths are postpartum hemorrhage.
Some 24% are due to high blood pressure during pregnancy, the rest are due to pregnancy-related infections and other infections, she noted.
She added that prenatal care is still not well taken in Bangladesh. “Antenatal checkups for pregnant women are highly significant. However, it is concerning that only 47% of our mothers undergo four antenatal checkups, unaware of the need for additional checkups.”
Dr Gulshan Ara also emphasized the need to increase hospital deliveries and postnatal care for new mothers.
Directorate General of Family Planning Director (Maternal and Child Health) Dr Md Mahmudur Rahman said last year 50% of deliveries were made at home, now it is 35%.
“We are actively discouraging home births due to the potential risks such as postpartum bleeding. Our focus is on promoting deliveries in safe healthcare settings to minimize these risks. If we can do it, we can reduce the maternal mortality rate to below 70 per 100,000 by the year 2030,” he added.
Health and Family Welfare Minister Zahid Maleque said that delivery is completely free in government hospitals. “We need to increase institutional child deliveries. Then infant and maternal mortality will decrease.”