1. Other than the factors discussed in the lecture, what do you think are other factors affecting maternal mortality rate in the Philippines?
- High numbers of teenage pregnancies. Pregnant teens or adolescents may result in complications during gestation or labor and delivery as their bodies are not adequately developed to give birth (Rau, 2015). Young women who usually undergo teen pregnancies are those living in rural areas which can add to their lack of access to prenatal care. Thus, adolescent pregnancies contribute to the high maternal mortality rate in the country.
- Lack of contraceptive use. This may be related or connected to unwanted pregnancies and unsafe abortions. Pills and condoms were limited for public access due to the country’s primary religious perception of contraception; consequently, these became inaccessible even in clinics (Rau, 2015). Lack of contraceptive use may lead to unplanned pregnancies that would cause women to pursue unsafe abortions. As mentioned before, unsafe abortion is one of the leading causes of maternal mortality rate in the Philippines.
- Reproductive health care service disruption due to pandemic. With the COVID-19 pandemic still presently at large in the country, both local and national health system services and resources have been diverted to accommodate COVID-19 patients (UNFPA, 2020). This has led to the declined provision of both family planning and maternal and newborn health services. These may have indirect effects on the increasing number of unplanned pregnancies and maternal mortalities yearly.
- Insufficient household incomes and poverty. According to Paredes (2016), there are present inequalities in maternal and child health care services as they tend to be “pro-rich” or cater only towards higher household income. Those who are poor were found to still lack reception of complete antenatal care and caesarean births. Inaccessibility to pregnancy care services may lead to unhealthy gestation or complications; hence, contributing to the maternal mortality rate.
2. What are the top 3 causes of maternal mortality ratio in the Philippines? Top 3 maternal morbidity?
According to the Department of Health (2013), from 1992 to 2010, the top 3 main causes of maternal mortality ratio are (1) “complications related to pregnancy occurring in the course of labor, delivery and puerperium, (2) hypertension complicating pregnancy, childbirth and puerperium, and (3) postpartum hemorrhage”.
The top 3 causes of maternal morbidity in the country, on the other hand, are (1) hemorrhage, (2) infection, and (3) unsafe abortion according to the lecture.
However, the top leading factors contributing in both maternal mortality and morbidity include (1) poor birthing practices in which deliveries are conducted without a skilled birth attendant, (2) socioeconomic status and income, and (3) the “urban-rural divide” (Papp & Kleiman, 2016).
References:
Department of Health [DOH]. (2013, December 9). Maternal Deaths by Main Cause. https://doh.gov.ph/Statistics/Maternal-Deaths-By-Main-Cause
Papp, L. & Kleiman, M. (2016, October). Maternal Morbidity and Mortality. http://philippineshealthdata.blogs.wm.edu/sample-page/maternal-morbidity-and-mortality/#
Paredes, K.P. (2016). Inequality in the use of maternal and child health services in the Philippines: do pro-poor health policies result in more equitable use of services? International Journal for Equity in Health, 15(181). https://doi.org/10.1186/s12939-016-0473-y
Rau, A. (2015, June 18). Maternal Mortality in the Philippines. https://borgenproject.org/maternal-mortality-philippines/
United Nations Population Fund [UNFPA]. (2020, August 17). Significant rise in maternal deaths and unintended pregnancies feared because of COVID-19, UNFPA and UPPI study shows. https://reliefweb.int/report/philippines/significant-rise-maternal-deaths-and-unintended-pregnancies-feared-because-covid