Hurdles to better maternal health are found in limited access
and social barriers to family planning
25th
February 2008
Source: Public Agenda (Ghana) - AAGM
Dr.
Kodindo, former chief of maternity at the Ndjamena general
hospital in Chad and now working at the maternal mortality
program of Columbia University in New York, argues that both
young age and the low status of women in society often leave
them with little power to determine if, when and with whom to
become pregnant. They also have little choice in the number and
timing of their children. "Women should be able to decide the
spacing of their children," she told Africa Renewal. "But in
Africa the
woman cannot make this decision freely. Her status in society is
often determined by how many children she has, and women often
have children even when they don't feel like having more. Many
men don't want family planning because they want the status that
more children bring."
In 2004,
WHO reported that about four million abortions take place
annually in Africa. Since abortion is illegal in most countries,
most of these are performed in unsafe conditions, contributing
to nearly 30,000 deaths, about 13% of all maternal deaths in
Africa.
WHO
believes that some 90% of all abortion-related deaths and
injuries could be avoided if women who wanted to avoid
pregnancies were able to use contraception, yet overall, less
than 25% of African women are able to obtain contraceptives. In
West Africa, fewer than 10% can. "If family planning could be
made available, we would reduce maternal deaths," says Dr.
Kodindo.
She is
optimistic. "We are seeing positive indications. The economic
burden of many children is making men more cooperative." Such a
shift is especially notable in the Democratic Republic of Congo,
Dr. Kodindo observes. “My only regret is that it is only in the
urban areas. There is much work to do in the rural areas."
Cultural
practices can also affect women's health risks. WHO cites
genital mutilation, early marriage, multiple pregnancies and
women who have undergone infibulation, a form of genital
mutilation where the external genitalia are stitched, are more
likely to suffer from obstructed labour. UNFPA data show that
girls who give birth between the ages of 15 and 20 are twice as
likely to die in childbirth as those in their twenties, while
girls under 15 are more than five times as likely to die.
"Adolescent girls face the highest risk of premature delivery,"
says Dr. Grace Kodindo, "Because their bodies are not yet fully
mature, they risk obstructed labour. This is why we encourage
young women to postpone their first pregnancy."
Article distributed by AllAfrica Global Media (www.allafrica.com)
and edited by PSN.
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