Other than the factors discussed in the lecture, what do you think are other factors affecting maternal mortality rate in the Philippines?
- Lack of promotion of/inaccessibility to preconception care services
- With non-communicable diseases having become the major cause of disease burden in the Philippines due to unhealthy behaviors (e.g., smoking) and compromised metabolism (e.g., high fasting glucose) and the worsening air pollution (air quality in the Philippines is considered moderately unsafe as per World Health Organization's guidelines) in the country, they come to show that Filipino reproductive-aged and, of course, pregnant women are not guaranteed with positive pregnancy outcomes, which therefore call for a stricter provision of preconception care (Ulep, Uy & Casas, 2020; International Association For Medical Assistance To Travellers, 2020). If lack of encouragement for Filipino women of reproductive age (especially adolescents who are often faced with age restrictions and discrimination), to avail of preconception care services (or sexual and reproductive health services in general) continues or if such services remain to be physically or financially inaccessible, especially to impoverished and isolated communities, adolescent pregnancies, unintended pregnancies, and preventable pregnancy-related complications will continue to afflict Filipino women of reproductive age, and worse, can contribute to maternal deaths (Melgar, J., Melgar, A., Festin, Hoopes & Chandra-Mouli, 2018).
- Prevailing trends/fads, superstitious or religious beliefs influencing pregnancy-related decisions
- These trends, fads, and beliefs related to pregnancy are mostly unsupported by science, and if strictly followed to the extent that medical advice is dismissed, these may endanger the health and well-being of pregnant women and may lead to maternal deaths. Take for instance human placentophagy or the postpartum ingestion of the placenta (e.g., in the form of pills, smoothies), which is claimed by some as a preventive measure against postpartum depression and postpartum bleeding, as a source of micronutrients like iron, and as a mood, energy, and milk supply booster (Marnarch, 2021). However, the public and even some clinicians who are advocating for placentophagy are unfortunately underestimating the serious risk of maternal infections (and even neonatal through breastfeeding) such as group B Streptococcus sepsis (Farr, Chervenak, McCullough, Baergen & Grünebaum, 2017).
What are the top 3 causes of maternal mortality ratio in the Philippines? Top 3 maternal morbidity?
Top 3 Causes of Maternal Mortality in the Philippines: Complication r/t Pregnancy (i.e., infection or cardiac problem) (38%) > Hypertension (35%) > Hemorrhage (17%)
Top 3 Causes of Maternal Morbidity in the Philippines: Hemorrhage (31%) > Infection (19%) > Unsafe Abortion (16%)
References:
Baccay, K. (2022). Prenatal Care [Slides]. UP Manila Virtual Learning Environment. https://vle.upm.edu.ph/pluginfile.php/171556/mod_resource/content/1/Prenatal%20Care%20Handouts%202020.pdf
Farr, A., Chervenak, F. A., McCullough, L. B., Baergen, R. N., & Grünebaum, A. (2018). Human placentophagy: a review. American Journal of Obstetrics and Gynecology, 218(4), 401.e1-401.e11. https://doi.org/10.1016/j.ajog.2017.08.016
Marnarch, M. (2021, December 11). Eating the placenta: A good idea? Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/expert-answers/eating-the-placenta/faq-20380880?reDate=16032022#:%7E:text=While%20some%20claim%20that%20placentophagy,to%20you%20and%20your%20baby.
Melgar, J. L. D., Melgar, A. R., Festin, M. P. R., Hoopes, A. J., & Chandra-Mouli, V. (2018). Assessment of country policies affecting reproductive health for adolescents in the Philippines. Reproductive Health, 15(1). https://doi.org/10.1186/s12978-018-0638-9
Ulep, V. G., Uy, J., & Casas, L. D. (2020, December). Primary Health Care for Noncommunicable Diseases in the Philippines. Philippine Institute for Development Studies. https://pidswebs.pids.gov.ph/CDN/PUBLICATIONS/pidsdps2039.pdf