1. Other than the factors discussed in the lecture, what do you think are other factors affecting maternal mortality rate in the Philippines?
From the discussion, I think the driving factor affecting the maternal mortality ratio in the Philippines is the women’s socioeconomic status and their associated financial constraints. Consequently, this also influences the other factors discussed in the lecture.
The socioeconomic status of a person virtually affects all aspects of one’s life. In the case of maternal mortality, multiple literatures will explain to us time and time again that poor women and women in rural areas are at a disadvantage (Rau, 2015; IRIN, 2009) because their socioeconomic status mainly accounts for why prospective mothers do not get the optimal prenatal & postpartum care they should be receiving, and why having a skilled birthing attendant to aid with delivery is simply out of the question. Ever since then, financial constraints have affected the extent of proper antenatal, delivery, and postpartum care that the woman is getting. This is exemplified in a study done by Pambid (2015) which revealed that the main reasons why pregnant women (particularly for his study, in region I) preferred home deliveries were because they had less expenses at home, and that they were convinced during their last checkup that their risk for normal delivery was low hence wanting to deliver at home. Furthermore, the study also showed that mothers who were capable of availing health services from local government health facilities ultimately chose to do so because payment was minimal or had no pay at all, and because they can sometimes get medicine and vitamins for free as well. As a result of financial constraints in relation to their current socioeconomic status, the rate of maternal mortality significantly increases.
In addition, I believe that the age at which a female gets pregnant and gives birth also influences the maternal mortality ratio as “the risk for maternal mortality is highest for adolescent girls under 15 years old and complications in pregnancy and childbirth are higher among adolescent girls age 10-19” (WHO, 2019) when compared to other women who are aged 20-24. Especially in rural areas where many women begin having children at a young age, they face many complications surrounding their pregnancy simply because their bodies are not developed enough for childbirth (Rau, 2015). Aside from young women, our recent health statistics also show that women among the age of 35 to 50 years and over had the highest maternal mortality rates for the year 2019 (DOH, 2021). This implies then that an increase in maternal age also increases the risk for life-threatening complications and/or maternal deaths. The mentioned evidences also imply that it is safer to plan for pregnancy during the age of 20’s to early 30’s, however this does not erase the fact that women of this age group may still experience maternal morbidity or mortality especially if proper care is not given before, during, and after pregnancy.
Hopefully, with the continuing education on proper prenatal, delivery, and postpartum care, along with the country’s efforts for ensuring Safe Motherhood in women who plan to get pregnant, who are currently pregnant, and who have given birth, we can reduce the rates at which maternal mortality and morbidity occur.
2. What are the top 3 causes of maternal mortality ratio in the Philippines? Top 3 causes of maternal morbidity?
Based on the 2019 Philippine Health Statistics (DOH, 2021), the top three causes of maternal mortality are: eclampsia (16%); gestational [pregnancy-induced] hypertension with significant proteinuria (14.7%); and other maternal diseases classifiable elsewhere but complicating pregnancy, childbirth, and the puerperium (10.5%). Other causes mentioned were abnormality of forces of labor, postpartum hemorrhage, obstetric embolism, and ectopic pregnancy.
While data on causes of maternal morbidity are not available, the 2019 Philippine Health Statistics showed the following three leading causes of morbidity in females: acute respiratory tract infections, hypertension, and urinary tract infections with rates of 1129.8, 522.3, and 270.9 per 100,000 population, respectively.
From our discussion, the top three leading causes of maternal morbidity are: hemorrhage (31%), infection (19%), and unsafe abortion (16%). It was noted that the third leading cause, abortion, is quite alarming as it is still illegal in the country, and it may also contribute to the mother developing hemorrhage and/or infections.
References:
Department of Health (DOH). (2021, September 23). PHILIPPINE HEALTH STATISTICS 2019. https://doh.gov.ph/node/32777
Pambid, R.C. (2015, December 17). Factors Influencing Mothers’ Utilization of Maternal and Child care (MCC) Services. Asia Pacific Journal of Multidisciplinary Research, 3(5), 16-28. http://www.apjmr.com/wp-content/uploads/2016/04/APJMR-2015-3.5.3.03.pdf
Rau, A. (2015, June 18). MATERNAL MORTALITY IN THE PHILIPPINES. The Borgen Project. https://borgenproject.org/maternal-mortality-philippines/
The New Humanitarian (IRIN). (2009, April 07). Philippines: Maternal Mortality Rates Not Making Sufficient Progress to Meet MDGs. United Nations Population Fund (UNFPA). https://www.unfpa.org/news/philippines-maternal-mortality-rates-not-making-sufficient-progress-meet-mdgs
World Health Organization (WHO). (2019, September 19). Maternal mortality. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality