Preventable loss of lives


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On Mother’s Day last Sunday, troubling news broke out anew: Around six to seven Filipino women die while giving birth or during pregnancy.

“Women die because sexual and reproductive health services are unavailable, inaccessible, unaffordable or of poor quality,” according to Dr. Leila Saiji Joudane, country representative of the United Nations Population Fund (UNFPA) Philippines.

Citing data from the Philippine Statistics Authority, she said that maternal deaths totaled 2,478 in 2021 alone, a significant increase from the 1,458 deaths in 2019.
For a better grasp of the current situation whereby many women do not get the needed support or crucial medical assistance, resulting in maternal death, here are excerpts from the Mother’s Day statement of Dr. Joudane:

“There are not enough trained health care workers that provide quality sexual and reproductive health information and services. For every 1,300 women and girls in reproductive age, there is only one public health midwife. In the Philippines, 14 percent of pregnant women do not get regular check-ups and the other necessary medical care that they need during their pregnancy. One in 10 women do not give birth in health facilities or receive assistance from skilled healthcare personnel during childbirth.

“The top five causes of maternal deaths included complications in pregnancy, childbirth and puerperium, eclampsia, pre-eclampsia, and hemorrhage. Many of these deaths are preventable if only there were accessible proper medical interventions and adequate health-care systems that are also resilient to emergencies.

“The high cost of health care makes it more inaccessible to poor Filipinos. According to the 2021 National Health Expenditure Survey, Filipinos in rural areas pay more for health care services and medicines compared to those living in urban areas and those with better income.”

The grim reality confronting our poor mothers in the countryside is linked to the plight of Filipino midwives who belong to the most neglected and marginalized licensed professional health workers in the country.
More than 30 years ago, I authored the Philippine Midwifery Law of 1992 to protect and promote the welfare of our midwives and improve the state of midwifery profession. But after three decades, the law needs amendments to be more responsive to changing times. Midwives are presently confronted with many challenges pertaining to how they are treated, their onerous work load, and meager pay, among many others.
The typical midwife serves as the “lifeline” of people in dire need, often doing work not within the scope of the midwifery profession. As I’ve said before, it isn’t surprising that in the Philippines where six to seven out of every 10 impoverished Filipinos die without ever seeing a doctor, the only healthcare professional ever encountered by the rural poor is the midwife, commonly known as komadrona.

Primarily tasked to assist and care for mother and child during pregnancy, birth and postnatal period, the komadrona performs other functions – from attending to children getting immunized and circumcised, to providing post mortem care for the deceased.

From the beginning of life to the end of life, the heroic komadrona is there. Not only to serve selflessly, but to persist amid an oppressive work environment – plagued with low pay, slow promotion, among others.
Clearly, the plight of our midwives needs to be improved and government leaders need to act quickly. In 2021, organizers of the Midwifery Week celebration came up with the theme, “The midwives are truly worth investing for.”

That year’s theme was absolutely right. As much as 4.3 million lives per year worldwide could be saved by investing in midwife-led interventions, according to a 2020 study by the United Nations Population Fund, World Health Organization, and the International Confederation of Midwives.

“About two-thirds of maternal deaths, newborn deaths and stillbirths could be prevented by 2035 if the current level of care by professional midwives educated and regulated to international standards was scaled up to provide universal access,” the WHO said about the study. “These findings should leave no doubt in the minds of ministers of health, education and finance that midwife-led interventions have the potential to save the lives of women and their newborns at a vast scale.”

Amid the grim situation of maternal deaths in the Philippines, there’s no doubt that the komadrona who is hero to many poor Filipinos is “truly worth investing for.” (Email: