Becoming pregnant and giving birth should be a joyous and celebratory experience, but for some women, it can be a potentially life-threatening one.

Pregnancy and childbirth are associated with a small but significant risk of mortality, especially in low-income countries and marginalized communities. According to the World Health Organization (WHO), about 295,000 women died during and following pregnancy and childbirth in 2017.

The risk of maternal mortality varies depending on various factors, but two key indicators have been found to play a significant role in increasing the risk of maternal death. These are maternal age and the quality of maternal health care received before, during, and after childbirth.

Maternal Age

Maternal age is one of the most critical determinants of maternal mortality risk, with both very young (35) facing a higher likelihood of dying during or after childbirth.

According to the WHO, pregnancy-related mortality ratios (the number of maternal deaths per 100,000 live births) are, on average, four times higher for adolescent mothers (<20 years) than for women aged 20-29 years. Similarly, pregnancy-related mortality ratios are 1.4 times higher for women aged 35-39 years and two to three times higher for women aged 40 years and above than for younger mothers.

There are several reasons why maternal age is associated with a higher risk of maternal mortality.

For adolescent mothers, physiological immaturity, inadequate nutrition, and incomplete physical development may all contribute to a higher risk of maternal complications, such as obstructed labor, hypertensive disorders, and sepsis. Adolescent mothers may also face social and economic challenges, such as stigma, discrimination, and lack of access to health care, that increase their risk of maternal death.

For older mothers, underlying health conditions, such as hypertension, diabetes, and heart disease, may increase the risk of complications during pregnancy and childbirth.

Additionally, older mothers may have had previous C-sections or other forms of complicated deliveries, which can make subsequent pregnancies riskier. Social and economic factors, such as delayed childbearing due to career concerns or infertility, may also contribute to higher maternal mortality risk among older mothers.

Quality of Maternal Health Care

The second key factor that can increase the risk of maternal mortality is the quality of maternal health care received before, during, and after childbirth.

Access to quality maternal health care is a basic human right, but millions of women worldwide do not receive the care they need to ensure safe pregnancies and deliveries. According to the WHO, approximately 62% of all maternal deaths worldwide could have been prevented with proper antenatal, intrapartum, and postpartum care.

High-quality maternal health care involves several components, including timely antenatal care (ANC), skilled attendance during delivery, and postpartum care.

Pregnant women who receive adequate ANC, including regular check-ups, screening for complications, and guidance on nutrition and lifestyle, are more likely to have positive birth outcomes and avoid life-threatening complications such as pre-eclampsia, eclampsia, and postpartum hemorrhage.

During delivery, skilled attendance is essential to reducing the risk of maternal and neonatal morbidity and mortality.

Skilled birth attendants, such as midwives, obstetricians, and nurses, can identify and manage obstetric emergencies promptly, such as obstructed labor, hemorrhage, and infections, to prevent maternal complications and death. Additionally, these professionals can provide essential counseling and support to mothers and their families during and after childbirth to facilitate the transition to postpartum care.

Finally, postpartum care, which involves the provision of services and support to women and their newborns for up to six weeks following delivery, is critical in reducing maternal mortality risk.

Postpartum care should include monitoring of the mother’s health status, screening for postpartum complications such as infections and depression, counseling on breastfeeding and infant care, and support for family planning and contraception.

Conclusion

Maternal mortality remains a significant public health concern worldwide, with millions of women dying each year due to preventable causes related to pregnancy and childbirth.

While several factors contribute to maternal mortality risk, two key indicators stand out: maternal age and the quality of maternal health care.

Adolescent and older mothers face a higher risk of complications and death during and after childbirth, while women who do not receive adequate maternal health care, including antenatal, intrapartum, and postpartum care, face a significantly higher risk of maternal mortality.

Addressing these factors by investing in high-quality maternal health care and improving access to family planning and contraception can reduce maternal mortality rates and ensure that pregnancy and childbirth are safe and positive experiences for all women.