By ANNIE NJANJA, anjanja@ke.nationmedia.com
Most stillbirths occur during delivery and labour
despite a child having survived in the womb for up to nine months,
doctors have said.
The burden of stillbirth affects women and families, with
many experiencing psychological problems that often persist long after
the death of the baby.
Incidence of stillbirth is high in Kenya despite
significant progress in reducing maternal, neonatal, infant and
under-five deaths, said Prof Zulfiqar Bhutta of Aga Khan University
Hospital.
But the mothers’ and families grief is often silent or hidden.
The preventable stillbirths occur in infants
carried to term and who would have been expected to survive, meaning
that despite an increase in the number of hospitals and skilled birth
attendants, the quality of care during delivery needs to be improved.
Prof Marleen Temmerman, the chair of the department
of Obstetrics and Gynecology at Aga Khan University Hospital says
pregnant women must be keenly monitored and the foetus assessed
during labour.
Haemorrhage, umbilical cord dropping through the
cervix, obstructed labour, breech birth– where a baby is born with
bottom first instead of head— complicate delivery, said Prof Temmerman
who was also a co-author of a Lancet study —Ending Preventable
Stillbirths.
Untreated malaria and syphilis also increase the
chances of a baby dying in the womb. Pregnant mothers should be treated
for infections, diabetes and hypertension which account for up to 10 per
cent of all stillbirths.
Around the time of birth, both mother and baby are
at greatest risk of dying or sustaining disability, Dr Justus Hofmeyr of
Effective Care Research Unit, University of Witwatersrand, said during
women and child health care conference in Kenya.
He said the chances of survival and emotional wellbeing depend on access to quality technical and interpersonal care.
“There is increasing evidence of the effect of the
quality of interpersonal care on birth outcomes, subsequent mother-child
interactions and the long-term wellbeing of the child.
In high-resource settings, continuity of care from a
midwife is associated with fewer caesarean-section births and fewer
babies admitted to high dependency care,” said Dr Hofmeyr.
Statistics from The Ending Preventable Stillbirths
report, indicate that 23 deaths in every 1,000 births happen every year
in Kenya, translating to 96 deaths every day when compared to three
occurring in 1,000 deliveries in Europe.
The statistics are disturbingly high even as the
government continues with aggressive campaigns to improve access to
maternal health care.
There has been a record success in free maternity
services in public health institutions as more pregnant women have
access to hospitals during delivery.
Special programmes tailored at reducing the number of
maternal and child deaths like Beyond Zero campaign have also averted
deaths. However, the number of preventable stillbirths happening in the
country is worrying.
Globally, Kenya is ranked 11th in the list of countries with
most stillbirths, with India leading with more than a half a million
and Nigeria in second position with more than 300,000 stillbirths.
The Kenya Demographic and Health Survey (KDHS)
shows that perinatal death rate was 29 deaths in 2014 compared to 37
happening per 1,000 births in 2008/09. Perinatal death are stillbirths
and babies dying within seven days after birth.
The statistics have made Kenya one of the most dangerous countries in the world for pregnant women.
More than 6,000 women die from childbirth every
year. About 50 per cent of deaths happening in the country occur in
Migori, Wajir, Marsabit, Isiolo, Lamu and Mandera—counties considered to
be hardship areas.
Half of the 2.6 million stillbirths from across the
world happen during labour and birth, but are preventable with the
access to quality health care and skilled birth attendants.
“The report highlights the huge burden of morbidity
and grief associated with stillbirths and also provides a template of
solutions that can end this preventable tragedy within our lifetime,”
said Prof Bhutta.
Childbirth being a period of unique physical and
emotional vulnerability, Dr Hofmeyr said that women who received
companionship had a positive labour experience as they were able to
positively deal with negative hospital environment and improve birth
outcomes
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