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COVID and discrimination exacerbate maternal mortality in Latin America – Global issues

Adequate maternal care during pregnancy, childbirth and postpartum is essential to curb the high maternal mortality rate in Latin America, which has ceased to decline due to women’s health care problems. during the COVID pandemic. CREDIT: Government of Tigre / Argentina
  • by Mario Osava (rio de janeiro)
  • Joint press service

A total of 1,575 women died in childbirth or during the next six weeks in the year before the pandemic in Latin America’s largest and most populous country, with a population of 214 million. Two years later, the total has grown to 2,787, according to preliminary data from the Ministry of Health Mortality Information System.

In Mexico, the second most populous country in the region, with 129 million inhabitants, the increase is 49 percent, to 1,036 maternal deaths in 2021. And in Peru, a country of 33 million people, that total increases. 63 percent to 493 maternal deaths.

In Colombia, recent data are not available. But authorities admit that by 2021, COVID-19 has become the leading cause of death for mothers, just as it is in Mexico.

According to experts and women’s rights activists, Brazil is a prime example of many mistakes and stubborn denialism that lead to many avoidable deaths, especially of pregnant women. International Day of Action for Women’s Healthheld on May 28.

In Latin America maternal death still a big problem.

The Pan American Health Organization (PAHO)regional office of World Health Organization (WHO)states that “unacceptably high maternal deaths” and that these are “mostly preventable” deaths, particularly affect pregnant women in rural areas.

These levels will delay the achievement of goal 3.1 of ., the agency added 17 Sustainable Development Goals (SDGs): reduce the global maternal mortality rate to less than 70 per 100,000 live births by 2030.

Something smells rotten

Doctor and epidemiologist Daphne Rattner, professor at the University of Brasilia and president of Network of cloning in childbirth.

“Hypertension syndrome is the main cause of death in Brazil, while around the world it is hemorrhagic disease. In other words, there are some failures in the simple diagnosis of hypertension and in its management. during pregnancy and childbirth,” she said in an interview with IPS from Brasilia.

Of the 38,919 maternal deaths between 1996 and 2018 in Brazil, 8,186 were due to hypertension and 5,160 bleeding, according to the Health Ministry report. These are direct obstetric causes, accounting for just over two-thirds of all deaths. The rest have indirect, pre-existing conditions that complicate delivery, such as diabetes, cancer or heart disease.

Too many cesarean sections is another risk factor for mortality. The Ministry of Health admits this is a “pandemic” of 1.6 million operations per year. This equates to about 56% of total deliveries. This rate reaches 85% in private hospitals and 40% in public services, much higher 10 percent rate recommended by WHO.

“They don’t practice obstetrics, they practice surgery, they don’t know how to provide clinical care, and as a result more mothers die,” Rattner laments.

And the pandemic makes the situation even more tragic.

Storks don’t come anymore

Brazil missed its target of reducing maternal mortality by 75% by 2015, compared with 1990 levels, but it has moved in that direction. The maternal mortality rate (MMR) per 100,000 live births in the country fell from 143 to 60, a 58% drop.

The Stork Network, a government strategy adopted in 2011 to improve support for pregnant women and the infrastructure of maternity hospitals, humanize childbirth, ensure better family culture and child care, have helped lower MMR.

But COVID-19 and the government’s response to it have caused at least a two-decade setback in maternal mortality rates in Brazil.

Coronavirus has killed more than 2,000 pregnant and postpartum women in the past two years, and there are at least 383 other deaths from severe acute respiratory syndrome that can be caused by COVID-19, according to Feminist Health Networkan activist movement fighting for sexual and reproductive rights since 1991.

The way the government of far-right President Jair Bolsonaro has acted “is a maternal genocide, not just a disaster,” said Vania Nequer Soares, a nurse with a doctorate in public health. of the Feminist Health Network, said.

The government’s denial and its response to the pandemic have exacerbated the overall mortality rate, which has exceeded 666,000 deaths, as well as maternal deaths. It took health authorities more than a year to realize that pregnant women were a high-risk group for COVID-19, making it harder for them to get intensive care and delaying vaccinations, Soares said.

To make matters worse, they decided to dismantle the Stork Network, whose public policies have shown promising results, and to adopt new rules on “obstetric violence” to be included in the Network. brand new mother and child care (Rami), focusing all the power on the doctors and she told IPS by phone from Lisbon.

Notice of lack and negligence

But the number of maternal deaths is probably even higher. Brazil was slow to start using a diagnostic test for COVID-19 and did not test it widely. And because the clinical identification of the new disease is questionable, many mothers may have died without an accurate diagnosis, especially during the first year of the pandemic, Rattner argued.

A study published this month in the journal Science Lancet Regional Health – AmericasWith words from the families of 25 pregnant women who have died from COVID-19, three practices have led many women to sentence to death in childbirth.

First, doctors refused to admit or better examine people who complained, such as shortness of breath. They attributed it to late pregnancy and delayed diagnosis that could have saved at least one life.

In several other cases, medical centers turned away pregnant women because they were dedicated to the COVID-19 emergency, arguing that they could not accept pregnant women because of the risk of infecting others. surname. And in obstetrics departments, pregnant women are turned away because of the risk they could carry the coronavirus and affect other women.

In the end, pregnant women admitted to the hospital were denied intensive care, on the grounds of protecting the baby’s life. In other words, the choice is made to save the child, to the detriment of the mothers, without consulting the families.

This was confirmed by the fact that all 25 pregnant women died, but 19 infants survived. Four families told medical experts they wanted the mother’s life to be saved, and they even argued that she could have other children in the future, but this proved to be futile.

Research by three researchers from Anis . Institute of Bioethics, Human Rights and Genderbased in Brasilia, corroborates the complaint of Feminist Health Network that 20% of pregnant and postpartum women are not receiving intensive care and 32.3% are not receiving ventilators.

Ligia Cardieri, sociologist and coordinator of the Feminist Health Network, said: “Women must be empowered so that they can take control of the process of motherhood, including childbirth.”

She told IPS from Curitiba, the capital of Paraná state, less mechanical interventions, less mechanical interventions, less c-parts that increase risks, including anesthetics and more involvement of nurses and other maternal health care workers. .

In other Latin American countries, pregnant women with COVID-19 also suffer from lack of attention and similar problems.

Nearly a third of them did not receive intensive care or respiratory support during the pandemic, a study found 447 pregnant women from eight countries, including five from South America, two from Central America. and one from the Caribbean, according to PAHO . data.

The study was published in The Lancet Regional Health – Americas, from PAHO’s Latin American Center for Anatomy/Women’s Health and Reproductive Health (CLAP/WR).

© Inter Press Service (2022) – All rights reservedOrigin: Inter Press Service

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