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Rebound maternal deaths in the country
Health authorities recognize lack of timely care for pregnant women
Ruth Rodriguez
El Universal
Monday May 10, 2010
@ eluniversal.com.mx ruth.rodriguez
They are those who seek to give life, but die. They are moms who stay on the road. Women whose profile has changed.
In recent years, the face of united death as the fate of the indigenous poor as ever that of pregnant teenagers, with the professionals over 35 years and that of those who give everything to get pregnant, even Despite having a terminal illness like cancer or heart disease, knowing that they risked their lives.
Today, women are almost not to give birth or to die at home. Now come to give birth in clinics and hospitals. However, the problem is that half of pregnant women in Mexico only come once or not the doctor or show up at the last moment when they have serious problems.
They are in clinical and public health hospitals, where officials acknowledge that they must work to improve health care to pregnant women and to decrease mortality.
In the past 20 years, maternal mortality had been declining in Mexico, until in 2008 and 2009 figures skyrocket again slightly. In particular, in 2009 which joined the influenza A H1N1 victims among pregnant women.
In total, according to estimates, last year 2,035 maternal deaths occurred, of which 207 were due to atypical pneumonia.
In previous years, maternal mortality associated with severe acute respiratory disease did not exceed 30 cases.
The government had committed to the Millennium Development Goals at the UN, to achieve a reduction in Mexico the maternal mortality rate by 2015, to 22.5 deaths per 100 000 inhabitants. But the goal is far from being achieved. The rate is 59 maternal deaths when these numbers should be at 40.
Failure to improve care
At home, Campeche, Colima, Nayarit and Tabasco, have not registered a single maternal death in their territory in the last year, according to figures provided by Roberto Ruiz, head of the Division of Obstetrics and Gynecology, Mexican Institute of Perinatal Social Security.
The IMSS medical officer considers that despite government efforts women continue to die because there is an oversight on their part in pre-pregnancy health. Also, at the time of being attended at birth there are some inconsistencies in handling medical, or after delivery also cause a number of phenomena that make the woman has a fatal outcome.
This coincides Javier Mancilla, director of the National Institute of Perinatology (INP) of the Ministry of Health (SSA), who said that the problem of maternal mortality results in the quality of care.
For the control of a pregnancy is appropriate, according to World Health Organization (WHO), should register at least five prenatal visits, and in Mexico, half of pregnant women did not even reach one, and the other half falls short the requirement, but with consultation of dubious quality, recognizes the medical director.
"It is not enough to reach the doctor and just tell the woman how she feels, but to do an adequate examination, testing that there is no urinary tract infection and no diabetes. In short, a series of measures that we do reduce the risk of pregnancy, "he reflects.
Attention to pregnant women, continues to change, says Javier Mancilla. "They do not stay in their homes or die on the routes to the hospital, now 86% are treated in a medical unit, but they come in terms of severity and some do not adequately address."
The problem, says Patricia Uribe Z??iga, director general of the National Center for Gender Equity and Reproductive Health of the SSA, is that some cases are not complied with the protocol established by the doctors in the hospital management of pregnant women.
Therefore, since last year, remember that there is a signed agreement from the Presidency of the Republic between the various health institutions to address obstetric emergencies, as a woman if only beneficiary of the IMSS, ISSSTE or Health, must be served, no charge.
However, he admits, sometimes pregnant women are "rolled from one medical unit to another," because there are hospitals that do not have the capacity to meet either the mother or baby.
Causes of maternal mortality
For Roberto Ruiz, IMSS, and Javier Mancilla, the INP, the causes of maternal mortality are concentrated in three groups:
In women who develop hypertension during pregnancy high blood pressure, preeclampsia, those who suffer obstetric haemorrhage (abortions cause premature death) and those with diseases such as cancer, HIV / AIDS, kidney problems and heart disease complicating pregnancy and put life threatening.
INP director said that the two leading causes of death have been declining in recent years, while the third, which are indirect, has become a risk group and "focus" for the health sector.
"These are patients with diseases that dare to get pregnant when not recommended, some die and others do manage to keep their children," the head of the Division of Obstetrics and Gynecology and Perinatal Social Security.
During 2009, killed 172 pregnant women in the various medical units of the Institute, whose main causes of death were preeclampsia-eclampsia (high blood pressure) and influenza virus A.
This latter phenomenon caused the maternal mortality rate of 34 pass IMSS maternal deaths per 100 000 live births in 2008 to 36 per 100 000 in 2009. And it can be prevented only the vaccine against the virus.
Deaths that occurred throughout the country last year, appeared at risk women aged under 19 years and over 35.
According to figures from the IMSS and Health, one in five pregnancies is women aged 20 living in metropolitan areas, while in women over age 35, every day increase more cases of pregnancy.
From your experience, Javier Mancilla believes that prompt medical attention during pregnancy will be avoided in the future to more deaths. So, he says, is working to not allow them to be rejected in the medical units when there is a complicated pregnancy.
"What we're looking for is that when a woman comes to a unit, not let her go, that you locate the drive where it can be addressed, and I think that we have begun to move forward."
But, most importantly, he says, and without so you can not reduce the mortality rate is that women become aware of the importance of care and attention throughout your entire pregnancy.