Even when maternal health facilities are available,
expectant mothers in Africa do not always get timely care. A study by the
Africa regional office of the World Health Organization (WHO), Reducing
Mortality Rates, reports that sometimes women or birth attendants “fail to
recognize danger signals and are not prepared to deal with them.” One answer,
argues Dr. Yves Bergevin, senior adviser on reproductive health for the UN
Population Fund (UNFPA), is to improve the skills of birth attendants and the
knowledge and capacity of women, their families and their communities.
Involving men is important, says Lucy Idoko, UNFPA’s former
assistant representative in Nigeria. Most men, she says, do not know the risks
of going through labour. “Maternal health is not only a woman’s issue but also
a man’s issue, and important to society as a whole.”
Cultural practices can also affect women’s health risks. WHO
cites genital mutilation, early marriage and multiple pregnancies. Women who
have undergone infibulation, a form of genital mutilation where the external
genitalia are stitched, are more likely to suffer from obstructed labour. UNFPA
data show that girls who give birth between the ages of 15 and 20 are twice as
likely to die in childbirth as those in their twenties, while girls under 15
are more than five times as likely to die.
“Adolescent girls face the highest risk of premature
delivery,” says Dr. Grace Kodindo, former chief of maternity at the Ndjamena
general hospital in Chad. “Because their bodies are not yet fully mature, they
risk obstructed labour. This is why we encourage young women to postpone their
first pregnancy.”
Dr. Kodindo argues that both young age and the low status of
women in society often leave them with little power to determine if, when and
with whom to become pregnant. They also have little choice in the number and
timing of their children.
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