A mother who gives birth and has severe obstetric complications is at a significantly greater risk of experiencing mental health problems and death, compare to women who give birth without complications. It is important that resources are channeled adequately to make sure that women with severe obstetric complications (SOCs) receive satisfactory care before and after they are discharged from hospital.

You can read about this in The Lancet, special issue called Women Deliver.

Dr Véronique Filippi, London School of Hygiene and Tropical Medicine, UK and team carried out a study of 1,014 women in hospitals in Burkina Faso. 337 of them had SOCs. 199 of them gave birth to a living baby, 64 lost their baby before completion of pregnancy, 74 of them lost their child shortly after birth. Each woman with a SOC was compared to two unmatched control women whose deliveries had no complications - they were all from the same hospital. The researchers followed them all up one year later.

Here are the researchers' findings:

-- Six women in the SOC group died within a year
-- Nobody died in the control group
-- The babies of mothers in the SOC group were 4.5 times more likely to die within twelve months, compared to the babies of the control mothers
-- The chances of experiencing depression within three months was 82% higher among the SOC mothers
-- The SOC mothers were twice as likely to have suicidal thoughts during the twelve months compared to the control mothers
-- 50% more SOC mothers reported that the pregnancy had a negative impact on their lives (within three months of the event)

"Women with severe obstetric complications are a high-risk group and resources need to be devoted to ensure that these women who - unlike many women in developing countries - have actually entered the health system receive adequate care before and after discharge from hospital. The fact that their risk of mortality remains high even after they have survived a life-threatening complication suggests that they are a group in great need. This need is further reinforced by the very high mortality of their children in the first year of life," the scientists explained.

The researchers concluded that more effort is needed to reduce maternal mortality and improve maternal health. This could start by targeting women with SOCs for social and financial interventions.

Accompanying Comment

"Provision of safe abortions can have a substantial effect on the primary prevention of maternal morbidity and mortality. A broad focus on the prevention of maternal morbidity and its short-term and long-term physical and mental consequences is needed. Better health care during pregnancy and at delivery should go hand-in-hand with efforts to prevent unwanted pregnancies," wrote Professor Michelle Hindin, Johns Hopkins Bloomberg School of Public Health, Baltimore, in an Accompanying Comment.

www.thelancet.com

Written by: Christian Nordqvist