By Dr. Duku Fred | The commonest cause of maternal deaths in developing countries including Uganda is bleeding especially after delivery which accounts for more than 40% of maternal deaths.
By statistics, about 17 mothers die of pregnancy related complications in Uganda daily. In addition to patient related factors, labor management skills of health workers and shortage of supplies like medicines for controlling/preventing bleeding like Oxytocin (drugs that enhance contraction of the uterus) or and blood for averting complications contribute immensely.
Mothers most at risk of severe bleeding or complications after delivery are those with prolonged labor, high parity (pregnancies above 6 or 7), twin or multiple pregnancies, mothers with bleeding disorders etc. The causes affect both the poor and rich or educated with a slight tilt towards the poor. Certainly, we have noted a rise in incidence of prolonged or obstructed labour occurring and being mismanaged in lower health facilities and commonly though unfortunately by traditional birth attendants (TBAs).
In the past over one-month health facilities including those in Kamuli district did not receive Oxytocin, a drug that aids contraction of the uterus after delivery to prevent or control bleeding. The sole supplier National Medical Stores reportedly recalled a batch that was supposed to be supplied and the substitute of Misoprostol tablets have not received to by many facilities. However, I don’t know what the situation is like in other districts.
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