Alvine Kapitako
Windhoek-In Namibia six babies die every day and every fifth day a mother dies due to pregnancy-related complications, latest statistics show.
This was revealed by the head of department for obstetrics and gynaecology for Katutura and Windhoek Central hospitals, Dr Shonag Mackenzie, who said these statistics are from a 2016 report that would soon be made public.
She spoke at the International Day of the Midwife celebration held on Saturday.
Mackenzie revealed that between 2012 and 2015, 5 484 babies died in the country.
She broke down the figures by indicating that 1 154 cases were fresh stillbirths, 2015 were marcerated (a term used to describe autolytic changes which occur when the foetus remains in utero after its demise) stillbirths, while 2 315 were neonatal deaths.
“Most deaths were avoidable,” Mackenzie told midwives, who reacted with shock to the statistics.
Dr Leonard Kabongo, who is in charge of Gobabis State Hospital, explained that haemorrhage (bleeding), hypertension and sepsis (infection) are some of the causes of maternal deaths in Namibia. Some of these are a result of unsafe abortions.
Mackenzie said the alarming statistics present a unique opportunity to make a difference. “We can introduce change very well.”
She said in Namibia there is a difference in care depending on whether a patient has medical aid or not.
Even at Windhoek Central Hospital, where some private patients opt to deliver their babies, this difference in care can be observed as some things are reserved just for private patients, even if they are not necessarily paying for them.
“Culturally, private is better. But there should be no reason why women shouldn’t have access to care in state (hospitals). We (state health practitioners) have to be doing the best.”
She further explained that the most dangerous time to be in hospital is a hand over time because that is when people do not account for their patients.
She further said that some deaths were as a result of Caesarean sections but not all of them. She added that some doctors, especially those in private practice, often recommend to women that they go for a Caesarean, even if that is not necessarily the best option.
The reason is that they get to cash in on huge amounts of money, explained Mackenzie. “There is a culture of doctor knows better,” said Mackenzie, adding that in her case most of the things she knows about midwifery she learnt from a midwife.
“In the UK (United Kingdom) pregnancy-related care is done by midwives.” The reasons doctors in Namibia encourage women to opt for a Caesarean section includes ‘your pelvis is too small’, ‘your baby is too big’, ‘eclampsia (a condition in which one or more convulsions occur in a pregnant woman suffering from high blood pressure, often followed by coma and posing a threat to the health of mother and baby) and ‘patient request’, she said.
“In Namibia women died while being rushed to C-section before stabilising them,” said Mackenzie.
She said the real reasons are not necessarily those that doctors give, rather it is finance, convenience for the doctor and lack of ethics.
New Era established that pregnant women can pay up to N$14 000 to deliver a baby at a private hospital for a normal vaginal delivery. That excludes doctor’s fees. Also, expecting mothers pay more for babies delivered through Caesarean section.
“Doctors are cashing in on Caesarean section, but women are not crying foul,” said Mackenzie who also explained in depth under what circumstances a pregnant woman should go for an elective (by choice) Caesarean section. She said doctors should abide by professional standards such as ‘do no harm’.
Women who repeatedly undergo C-section to deliver a baby are at risk of stillbirths and maternal deaths. They also run the risk of infertility and hysterectomy (a surgical operation to remove all or part of the uterus).
“Women who have had C-section are five times more likely to die in a high-income country,” added Mackenzie.
She pointed out that other problems resulting from Caesarean section include breastfeeding, bonding, and depression.
Maternal risks further include haemorrhage (bleeding), sepsis (infections), internal organ damage, and decreased mobility.
She said that vaginal births should be normalised and hospitals should be staffed adequately, and good and regular training should take place while health professionals must be taught to react to abnormalities.
Meanwhile, the United Nations Population Fund officer in charge, Loide Amukugo, said more than 300 000 women die during pregnancy and childbirth worldwide.
“Some three million babies do not survive the first month of life, and another two and a half million babies are stillborn. Most of them could have been saved by the care of well-trained midwives within the framework of strong health systems,” said Amukugo.