A Tragic Story

Sometimes, despite the noblest intentions, best preparations, and even the best medical intervention available nowadays, tragic things happen. Sometimes they hit us without warning. We don’t know why they happen. We tear our clothes and cry to the heavens asking why, why on earth God allowed these things to happen. Some may even begin to doubt the existence of God.

Sometimes we hear of women dying from childbirth. Statistically this is quite low, given the recent advances in the field of obstetrics and medicine. Until recently, I have thought that this was something that could only happen in the small barrios in the provinces of the Philippines. In those places, more often than not, the women give birth in their homes, attended only by a midwife. Thus, when life-threatening emergencies happen, medical treatment is not readily available; the nearest hospital may be kilometers away. The baby is saved, but the mother loses the battle. We are all familiar with this story.

In a developed country like Japan, it is almost unthinkable that something like that could happen here.

Until last week, that is. When we heard of the story, we were shocked at first, then profoundly sad next. A Filipino woman, who also headed a church in Chiba prefecture, died after giving birth to her third baby in a clinic last Easter Sunday. She was en route to the hospital when she died. She was only 42 years old. She is survived by her husband, her newborn infant, and two elder children.

The cause? Postpartum hemorrhage. It is so unbelievable at first. What should have been an occasion for rejoicing became a terrible tragedy for the family. As the news sank in, we felt the terrible loss, not only for the bereaved family, but also for the church who lost their beloved Pastora. I haven’t personally her – such a shame really -but I mourn her passing with much regret and sadness. As a mother myself, I am greatly distressed for the newborn infant, whose entrance into this world has been unfortunatley marred by this misfortune, and who will grow up never knowing the one person who risked her life for him or her.

The last I heard was that the family was preparing for their trip back to Davao, where the remains of the mother would be interred.

Reality check. Women still die from childbirth. Even in Japan. It brings a sorely needed attention to the fact that childbirth, no matter how we look at it, should never be taken lightly. Lives are always at stake. Sometimes, as in the case of my sister’s harrowing experience, the baby could be lost, too.

I have shamelessly copied the following information from the website of POPHI (Prevention of Postpartum Hemorrhage Initiative) concerning postpartum hemorrhage and death in women:

The risk of maternal death from childbirth represents one of the greatest inequities in global health. Women in developing countries are more than 40 times more likely than women in developed countries to die in childbirth (1 in 61 women in developing countries versus 1 in 2,800 women in developed countries).1 This rate is significantly higher than the ten-fold difference in risk for infant mortality between developed and developing countries, which is 5 per 1,000 live births versus 61 per 1,000 live births respectively.2 Even within developing countries there is a striking differential risk of maternal death for women who have access to basic essential obstetrical care compared to those who do not. Within a country, as poverty increases so does the proportion of women dying of maternal causes.3

Obstetric hemorrhage is the world’s leading cause of maternal mortality, causing 24% of, or an estimated 127,000, maternal deaths annually. Postpartum hemorrhage (PPH) is the most common type of obstetric hemorrhage and accounts for the majority of the 14 million cases of obstetric hemorrhage that occur each year.4

In the developed world, PPH is a largely preventable and manageable condition. In developing countries, however, mortality from PPH remains high despite international efforts. While data are limited, studies have shown that PPH causes up to 60 percent of all maternal deaths in developing countries. For example, PPH accounts for 59 percent of maternal deaths in Burkina Faso, 53 percent in the Philippines, and 43 percent in Indonesia.5 PPH also causes considerable suffering for women and their families and creates major demands on health systems.4 (Emphasis mine.)

1 WHO. Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors. WHO/RHR/00.7. Geneva: WHO; 2000.

2 Cunningham F, MacDonald P, Gant N, Leveno K, Gilstrap L. Williams Obstetrics. Nineteenth Edition. Norwalk, Connecticut: Appleton & Lange; 1993.

3 Rogers J, Wood J, McCandlish R, Ayers, S, Truesday A, Elbourne D. Active versus expectant management of third stage of labour: the Hinchingbrooke randomized controlled trial. Lancet. 1998; 351: 693–699.

4 World Health Organization (WHO) Department of Reproductive Health and Research. Maternal Mortality in 2000: Estimates Developed by WHO, UNICEF, and UNFPA. Geneva: WHO; 2004. Available at: www.childinfo.org/maternal_mortality_in_2000.pdf.

5 Child mortality page. UNICEF Monitoring the Situation of Children and Women. Available at: www.childinfo.org/areas/childmortality/infantdata.php. Accessed July 11, 2004.

The rest of the article can be found here.

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