In Latin America maternal mortality remains a major problem.
The Pan American Health Organization (PAHO), the regional office of the World Health Organization (WHO), states that “maternal mortality is unacceptably high” and that they are “mostly preventable” deaths, which especially affect pregnant women in rural areas.
These levels, the agency adds, will delay reaching target 3.1 of the 17 Sustainable Development Goals (SDGs): to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. Brazil missed the target of reducing maternal mortality by 75 percent by 2015, from 1990 levels. It was moving in that direction. The maternal mortality ratio (MMR) per 100,000 live births in the country fell from 143 to 60, a 58 percent drop but COVID-19 and the government’s response to it caused a setback of at least two decades in Brazil’s maternal mortality rate.
“Inadequate prenatal and obstetric care,” largely due to inadequate medical training in these areas, is the cause of the tragedy in Brazil, said physician and epidemiologist Daphne Rattner, a professor at the University of Brasilia and president of the Network for the Humanization of Childbirth.
“Hypertensive syndrome is the main cause of death in Brazil, while in the world it is hemorrhage. In other words, there is some failure in a simple diagnosis like hypertension and in managing it during pregnancy and childbirth,” she said in an interview with IPS from Brasilia.
Of the 38,919 maternal deaths between 1996 and 2018 in Brazil, 8,186 were due to hypertension and 5,160 to hemorrhage, according to a Health Ministry report. These are direct obstetric causes, which accounted for just over two-thirds of the deaths. The rest had indirect causes, pre-existing conditions that complicate childbirth, such as diabetes, cancer or heart disease.
An excess of cesarean sections is another factor in mortality. It is “an epidemic” of 1.6 million operations per year, the Health Ministry acknowledges. This is equivalent to about 56 percent of the total number of deliveries. The proportion reaches 85 percent in private hospitals and stands at 40 percent in public services, well above the 10 percent rate recommended by the WHO.
“They don’t practice obstetrics, they practice surgery, they don’t know how to provide clinical care, and the result is more maternal deaths,” Rattner lamented.
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