Maternal Morbidity

Surviving Childbirth, But Enduring Chronic Ill-Health

Maternal mortality statistics are indicative of the overall state of maternal health for a particular population. But they are only the tip of the iceberg. For every woman who dies, some twenty others face serious or long-lasting consequences. Women who survive severe, life-threatening complications often require lengthy recovery times and may face long-term physical, psychological, social and economic consequences. The chronic ill-health of a mother puts surviving children, who depend on their mothers for food, care and emotional support, at great risk.

Obstetric fistula is one of the most devastating complications of childbearing, but there are many others. These may include anaemia, infertility, damaged pelvic structure, chronic infection, depression and impaired productivity. These problems, in turn, may lead to others, including marital problems, household dissolution, social isolation, shortened life spans and suicide. Costs of medical care and lost productivity may drive women and their families into poverty.

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The hidden problem of uterine prolapse

Sometimes called a ‘fallen womb’, uterine prolapse is a debilitating condition in which the supporting pelvic structure of muscles, tissue, and ligaments gives way, and the uterus drops into or even out of the vagina. This can limit a woman’s mobility, making it impossible for her to perform routine household chores or have sex. The condition is often accompanied by chronic back pains and urinary incontinence. Many women who suffer from it are abandoned by their husbands and end up as social outcasts in their own communities.

Uterine prolapse can be triggered by difficult, prolonged labour, frequent pregnancies, inadequate obstetric care, and carrying heavy weights. In Nepal, where fertility is high and women carry heavy loads on their backs, one out of ten women are estimated to suffer from the condition. A UNFPA-supported programme in Nepal is working to bring attention to this issue and supporting health camps in six of of its most remote districts to treat it and other reproductive health problems. In less severe cases, a rubber ring, or pessary, can be inserted to stabilize the womb. For more severe cases surgery is required.

The pain of perinatal depression

Depression is one of the most prevalent complications of pregnancy and childbirth. About 10 to 15 per cent of women in developed countries, and an even higher percentage in developing countries, experience serious depression during pregnancy of after childbirth.

Perinatal depression is a severe disorder, which needs appropriate treatment and care. It differs from postpartum blues, which are experienced by nearly half of women following childbirth, but which spontaneously disappear, usually within a few days. Perinatal depression is associated with maternal physical morbidity, substance abuse and suicide. Gender-based violence can be a cause of depression and can also increase a woman's risk of it.

The consequences of maternal depression on the child can be severe as well, including premature delivery, low birth weight, malnutrition, poor growth and stunted emotional, cognitive and behavioural development.

UNFPA at work 

Making motherhood safer is a top priority for UNFPA in all countries where women face high risks of maternal death and illness. The Fund’s work on obstetric fistula is helping prevent and raise awareness about other risks of pregnancy as well. In Nepal, UNFPA supports reproductive health camps that reach out to women in rural areas for treatment of uterine prolapse and other problems. In recent years, UNFPA has emphasized and supported sensitive psychosocial support for women recovering from fistula and other maternal disability.

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