Reducing preventable maternal deaths Rising levels of teenage pregnancies Reproductive health care for women beyond 49 years of age Inequities in access to quality reproductive health care International Comparisons Know the Facts What is UNFPA Doing?
Menu
1
REDUCING PREVENTABLE MATERNAL DEATHS
Sri Lanka has invested heavily in maternal health since the beginning of the last century and has reaped positive dividends in bringing down the maternal mortality over the years to boast of the lowest maternal mortality rate in South Asia at 38.6 per 100,000 live births (2009-2010).
What is
the issue?
When drilling down on maternal deaths the leading causes are found to be the following, and they contribute to over 40% of maternal deaths:
  • Unstoppable bleeding following a delivery (post-partum hemorrhage)
  • Abortions
  • Heart diseases
  • Hypertensive disorders
All these are preventable with the right interventions. The skill set of public health midwives play a crucial role in the early detection of high risk pregnancies and referral to care. What is interesting to note is that 83.1% of maternal deaths occur in health institutions where the most comprehensive facilities for deliveries are available, which we refer to as comprehensive emergency obstetric care as outlined in the recent National Emergency Obestetric and Neonatal Care Needs Assessment.
The Paradox of
Abortion and
Family Planning
  • The graph above illustrates that the need for family planning has almost been met as indicated by the low unmet need at 7%
  • However, abortions continue to be a leading cause of maternal deaths highlighting a continuing gap in family planning
  • Anecdotal evidence suggests that an estimate of 1,000 abortions occur per day around the country
  • Recent research suggests that the longer the duration since completion of desired family size, the more vulnerable women are to induced abortions as couples tend to rely on traditional methods of family planning
  • Fear of side effects is found to be the main reason for avoiding modern methods of contraception at the time of conception while experiencing side effects is the main reason for discontinuing a contraceptive method (Rajapaksa & De Silva 2000)
What can
be done?
  • Providing additional human resources, equipment and developing policies and guidelines, for the management of the leading causes of maternal deaths in health institutions where most deliveries take place
  • Developing a robust and centralized data system in order to generate updated data on reproductive health
  • Improving the capacities of public health midwives for the early detection of high risk pregnancies
  • Changing the behaviours of couples to seek modern methods of family planning through a comprehensive behavioural change communication strategy