1.3 What do mothers and newborns in the postnatal period die from?
The main purpose of providing optimal postnatal care is to avert both maternal and neonatal death, as well as long-term complications. To be effective you therefore need to know the major causes of death in the postnatal period, so that you can provide quality and timely postnatal care at the domestic and Health Post level.
Knowing what mothers and newborns are dying from is important in order to identify the high impact interventions that address all the major causes of death during the postnatal period. Table 1.2 shows the percentage of maternal deaths from the major causes for women in Africa.
You learned about anaemia, hypertensive disorders and abortion in Study Sessions 18, 19 and 20 of the Antenatal Care Module. Obstructed labour and postpartum haemorrhage were taught in Study Sessions 9 and 11 of the Labour and Delivery Care Module.
| Causes of maternal death | Percentage (%) |
|---|---|
| Postpartum haemorrhage | 34 |
| Localised infection or disseminated infection (sepsis) | 16 |
| Hypertensive disorders of pregnancy (pre-eclampsia, eclampsia) | 9 |
| HIV/AIDS | 6.2 |
| Obstructed labour | 4 |
| Abortion | 4 |
| Anaemia | 4 |
| All other causes of death | 30 |
Table 1.3 shows the causes of newborn deaths in Ethiopia. You will learn about special care for preterm and low birth weight babies in Study Session 8 of this Module.
Infections, including diarrhoeal diseases and tetanus, are described in detail in the Communicable Diseases Module. Birth asphyxia and neonatal resuscitation were covered in Study Session 7 of the Labour and Delivery Care Module,
| Causes of newborn deaths | Percentage (%) |
|---|---|
| Infection: | 47 |
∙ Diarrhoea | 3 |
∙ Tetanus | 7 |
∙ Other infections, including neonatal infection (sepsis) | 37 |
| Birth asphyxia | 25 |
| Prematurity and low birth weight | 17 |
| Congenital defects (deformities present at birth) | 4 |
| All other causes | 7 |
Why is it really important for you to understand the main factors causing mothers and babies to die in the postnatal period?
You probably thought of many reasons, but the most obvious one is the huge difference that the delivery of appropriate and prompt postnatal care could have on Ethiopia's neonatal mortality rate: a reduction of between 10-27%, or up to 60,000 newborn lives saved every year.
Think for a moment about the main causes of maternal and neonatal death. Which ones do you expect to see most in your role as a Health Extension Practitioner?
If you use the numbers in Tables 1.2 and 1.3, then you probably said postpartum haemorrhage for mothers and some form of infection for babies and also for mothers. You might also have picked out eclampsia (mothers) and neonatal asphyxia (babies).
1.2 When do most mothers and newborns die in the postnatal period?