Stress Induced Maternal And Neonatal Mortality; The Leaking Bucket Syndrome

It’s a painful trail to go through nine months of pregnancy. Much excruciating the pain that follows. But whether it turns out rewarding or fatal remains a probability that sadly, differs according to the country and economy a pregnant woman finds herself with child.

Invariably, one single event that stands out for which reason maternal and neonatal deaths was put on the front burners, was the millennium development goals four and five which targeted reducing under five child mortality by two-thirds and improve maternal health by 2015

Sadly though the targets weren’t achieved.
Ghana loses 144 mothers to every 100,000 live births at its health facilities. This Fell short of the MDG target of 54 per 100,000 live births, the 2015 Ghana Millennium Development Goals reports.

The Ghana Demographic and Health Survey report of 2014 also suggests that out of a thousand children born alive 60 die. Again a failure to meet the 2015 MDG target of 40 deaths per thousand live births.

Over the past twenty years there has been the MDG Acceleration Framework (MAF), High Impact Rapid Delivery (HIRD) approach, Ghana VAST Survival Programme, Prevention of Maternal Mortality Programme (PMMP), Making Pregnancy Safer Initiative and the Emergency Obstetric and Neonatal Care (EmONC).

I set out into the under privolleged communities where medical doctors have proven to be, the place with the highest incidents of maternal and neonatal mortality.

My interaction with a few families who have lost their children at birth, or had children born with disabilities and families who lost mothers points to one thing.

The good health facilities have been put in place, the doctors and midwives have been efficiently and effectively trained on how to handle birth issues.

But what goes on with these pregnant women outside the health facility is the stress that lays waste, all that policy aims to correct.

I call it the leaking bucket syndrome.
That is exactly the case with Martha Frimpong, the mother of the deceased Violet Frimpong.

Thanks to government’s provision of good health facilities and well trained doctors, she delivered a baby girl.

After several months little violet Serwaa Antwi was diagnosed with down syndrome.

With no help from family, she couldn’t identify any of government’s intervention for babies with similar plight to her baby, and then the real pressure began to set in.

Talk of the emotional stress as well; unfortunately she lost Violet after four years of handling the pressure all alone she tells me.

Its heart breaking when people think you gave birth to a child with special needs because of the curse of sin. When I gave birth to my child, lots of people told me I was reaping the consequences of my sins

But these are the results of nature .One out of every ten women give birth to such children

There were times when people especially those who are not educated would not even want to touch my child.

They said they feared they will also have a child with Down syndrome if they touched her.

The stress alone could have compelled me to hide my child But I considered that my baby was also Gods creation. I took her to every place I went without shame .If not I would have thrown her away

But it hurts me that she never enjoyed life .She lived on medication all her life till she died.

Her story is slightly different from that of Madam Hawa Oti who, due to the stress she experienced during her pregnancy lost one of her twins leaving the surviving twin

Who Weighs below her age, compared to other healthy kids putting her health and live at risk. Now 11 months old Rabbi weighs 6 pounds.

Jobless, she husband and their 11 month old baby live in a container, at Buokrom Zongo.

She tells me despite how good the Doctor was she feels her situation would have been different if the Doctors and midwives she encountered during her pregnancy apart from medical attention had gone the extra mile to help reduce her stress.

After I delivered my first child, I got pregnant with twins. But I miscarried after seven months. I was advised not to get pregnant again until after one year. When I took seed again, it was twins. But the doctors at the Manhyia hospital where I attended antenatal, put me under keen observation because of the previous incident.

I had very high blood pressure I had to take a lot of drugs to suppress it.

At a point I had to walk with a walking stick. After six months of pregnancy my condition was worsening. Every part of my body was swollen. My doctor had to perform an operation to take the babies out premature. But this became difficult as I# had to pay for every cost for running the incubator. Oxygen alone for each twin was twenty cedis a day. We couldn’t keep up with all the medications .So the girl didn’t survive. It was the male who survived. But through all that I never had any encouragement from anyone .I can understand because the doctors are overwhelmed with numerous patients. The first time I met the doctor who took care of me, I expected him to give me some words of encouragement.

But no! He didn’t. At least that would have made me forget some of my woes.

Dr Ernest Kuako is a gynaecologist obstetrician with the Komfo Anokye Teaching Hospital in Kumasi. His department sees patients referred from peripheral facilities in the Ashanti, Brong Ahafo and northern regions. He corroborates the facts from experience, that stress has had some dire impact on pregnant women and their unborn babies.

“A pregnant woman just like any other adult can also have both physical and mental stress, she may even be stressed from financial difficulties not being able to cater for the pregnancy, antenatal and all that. If a pregnant woman is stressed, it can affect the amount of blood that goes to the baby and therefore the food and air that the baby can get , and therefore it can affect the baby’s growth, we call it growth restriction, it comes with so many problems including, later, the baby having mental disability”

A not for profit organisation, Pregnancy Stress Foundation Ghana is headquartered in Kumasi. Its founder Victoria Darko tells me she had a heartfelt desire to help out such women as she personally went through a similar experience like Martha and Hawa.

Pregnancy stress foundation, she tells me, looks out for less privileged pregnant mothers in society going through various forms of stress and manages them; an area she believes has been neglected.

There are a lot of areas that government is working on when we talk about this goal, But I believe this particular area has been ignored, looking at the fact that lots of pregnant women in Ghana go through extreme phsychological and emotional stress and the impact on their health and the baby is dire such that there is the need to pay attention to this area to be able to save the lives of these women and their children.

When it comes to building hospitals and all I think is much easier compared to identifying these women and talking to them about their problems and aligning their problems to their health needs .

The situation has also caught the eyes of the legislature. Elizabeth Agyeman is a member of parliament for Oforikrom and a member of the health committee of both the Ghanaian parliament and the ECOWAS parliament. She has set up an organisation called the Easy Birth Foundation to bring counseling and direct help to the homes of such targeted women.

What causes that stress, is the fact that sometimes the person doesn’t have money to go to the hospital, maybe the husband is refusing to support because some men refuse to take responsibilities after the pregnancy and that causes stress. Some of the men are killing some of the women.

The policy makers can draft their policies. Governments can build the best of facilities. But these conditions that stare the pregnant woman outside the health care system continue to drain efforts. What i call the leaking bucket syndrome.

If the goal is to ensure that no woman or baby should lose their lives before, during and after pregnancy. Then there is the need to leave no stone unturned in this quest.

This Production is with funding support from Media Foundation for West Africa and UNDP Ghana”

Theresa Oppong, Ultimate [email protected]