Every day around the world, 1,000 women die as a result of pregnancy complications. Ninety-nine percent of these deaths occur in developing countries. In Nepal, a woman dies in labour every 4 hours and a baby, every 15 minutes. The large majority of these deaths are preventable.

A4WH is tackling maternal death and disease in a number of innovative ways.  In conjunction with several bodies, including the United Nations, the Nepal Ministry of Health, and University Teaching Hospitals, A4WH is helping make pregnancy and childbirth a safer time for mothers and their babies.

Medical Training

In conjunction with Dhulikhel Hospital and the University of Kathmandu, A4WH continues to provide clinical training in obstetrics and gynaecology to Nepalese medical and nursing staff.  Australian medical lecturers associated with A4WH have provided crucial education of trainee and qualified Nepalese doctors since 2010.

Midwife Training

The majority of mothers in developing countries do not have access to a skilled birth attendant.  A4WH provides interactive educational sessions for midwives from Nepal.

Haemorrhage Prevention

Postpartum haemorrhage is the leading cause of death in pregnancy in developing countries.  A4WH is currently undertaking research in the use of a medication called misoprostol.  This drug has been shown to significantly reduce the incidence of severe blood loss after delivery.  It is a simple, stable, and inexpensive medication that can be taken orally and does not require refrigeration.  Misoprostol may be the most suitable medication to be used following delivery in rural and remote areas of developing countries.

Maternal Mortality Facts

Maternal and neonatal deaths are clustered around the delivery and the postpartum period, with mortality risks strongly associated with the “three delays” in receiving skilled care at the time of an obstetric emergency—e.g.  delays in the decision to seek care, in reaching health facility, and receiving quality care on arrival.  A recent multi-country study has shown that these delays are often attributed to financial barriers, transportation challenges and distance to appropriate facilities. Ensuring that mothers have access to a skilled attendant during labour can dramatically reduce the risk of death for the mother and her newborn child.  In almost all countries where health professionals attend more than 80 per cent of deliveries, maternal mortality ratios are below 200 per 100,000 deliveries. In rural areas where doctors and nurses are scarce, women often give birth at home without the assistance of a skilled health worker with the medical skills or equipment to provide life-saving interventions in the case of emergencies.

Adapted from WHO (2008).