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Aside from the factors discussed in the lecture, the other factors that affect maternal mortality rate in the Philippines are as follows:
Socioeconomic status - Poverty
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Socioeconomic status is greatly linked to accessibility to education and basic needs. People who have a higher socioeconomic status have more access to health facilities, medications, and education. On the other hand, a low socioeconomic status and poverty may serve as a hindrance for accessing the needed care during pregnancy and childbirth. Many people who live in poverty do not seek medical care at the hospital or health clinics because they are afraid of the possible medical expenses. Since they do not have enough money for their basic needs, they would rather choose to spend their money on food and water instead of having a check-up during pregnancy. The lack of access to health facilities is also significant. People who live in rural areas, especially those who live far from the town may experience delays in seeking care. Nearby health facilities are essential especially during times of emergency where the mother needs to receive care or medication as soon as possible. However, they are not able to do so possibly because of difficulty in transportation. Lastly, they may also not have access to the proper information that they need during pregnancy such as preconception care. Therefore, they may not be fully aware of the practices that may or may not be done during pregnancy. These may then cause the mother to resort to harmful practices and self-medication, which may affect their health.
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Lack of reproductive health education and government policies
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- It cannot be denied that there is still an overwhelming amount of stigma surrounding topics on reproductive health in the Philippines. The lack of reproductive health education in schools and communities may contribute to unsafe methods of contraception which may eventually lead to unwanted pregnancies. Education in this aspect is greatly needed especially in adolescents because of their curiosity. These children or adolescents may become dependent on non-trusted resources that may spread false information about family planning and contraceptive use. It is also important to note that the government should support the implementation of reproductive health education in the country. However, because the Philippines is highly influenced by religion, most people, including government officials, oppose implementing these. By implementing reproductive health education in schools and communities, people are taught to become more sexually responsible. With people taught about reproductive health education, unwanted pregnancies may decrease.
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Unwanted pregnancies
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Unwanted pregnancies may contribute negative effects to the health of both the mother and the child. Since these pregnancies are unplanned, the preconception care of the mother is also usually not established. Although preconception care is supposed to be utilized by women of childbearing age, not everyone is aware of the consequences and proper care for pregnancy. Therefore, this may pose health risks for them. Another significant factor in unwanted pregnancies is teenage pregnancy. Pregnant teenagers who are under the age 15 are five times more likely to die during pregnancy as compared to women in their 20s. This is because their bodies are not fully developed to have children. Moreover, teenagers may also not fully understand the proper care that they need to receive during pregnancy. They may also resort to unsafe practices such as abortion to terminate their pregnancy. Thus, going back to the second point, it is very important to have comprehensive reproductive health education in communities and schools.
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The top 3 causes of maternal mortality ratio are
- Complications related to pregnancy occurring in the course of labor, delivery and puerperium.
- Hypertension complicating pregnancy, childbirth and puerperium.
- Postpartum hemorrhage
On the other hand, the top 3 causes of maternal morbidity are
- Hemorrhage
- Infection
- Unsafe abortion
References:
Department of Health. (2013). Maternal deaths by main cause. https://doh.gov.ph/Statistics/Maternal-Deaths-By-Main-Cause
Karlsen, S., Say, L., Souza, J., et. al. (2011). The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross-sectional WHO global survey on maternal and perinatal health. https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-606
The Alan Guttmacher Institute. (2003). Improving reproductive health in the Philippines. https://www.guttmacher.org/sites/default/files/report_pdf/rib1-03.pdf