According to the academic papers, while the presence of midwives and maternity support workers at births are increasing in low-income countries, the quality of care has been considered poor.
It was also highlighted that there was a lack of basic facilities such as water, sanitation and electricity in low-income countries. “It is unethical to encourage women to give birth in places with low facility capability, no referral mechanism, with unskilled providers, or where content of care is not evidence-based,” said Professor Oona Campbell from the London School of Hygiene & Tropical Medicine.
The Series also stated that one third of the world’s overall maternal death rate in 2015 occurred in India and Nigeria.
In India, 45,000 women (15%) died during pregnancy or childbirth, with Nigeria seeing 58,000 (19%) deaths in the same period.
Lancet Series Author from the London School of Hygiene & Tropical Medicine, Professor Wendy Graham, said: “In all countries, the burden of maternal mortality falls disproportionately on the most vulnerable groups of women. This reality presents a challenge to the rapid catch-up required to achieve the underlying aim of the Sustainable Development Goals [SDGs] – to leave no one behind.
The papers highlight two broad areas that describe poor maternal health care – the access to timely quality care that is “too little, too late” and over-medicalisation of postnatal care that is “too much, too soon”.
In one paper it stated: “The problem of over-medicalisation has historically been associated with high-income countries, but it is rapidly becoming more common in low and middle-income countries, increasing health costs and the risk of harm. For instance, 40.5% of all births are now by caesarean section in Latin America and the Caribbean.”
The Lancet Series Maternal Health 2016 can be found here.
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