Maternal mortality: A silent crisis

Photo Courtesy: Dann Tardif/AFP via Getty Images

By Ivan Lucy

Maternal mortality remains a haunting reality in many parts of the world, echoing with the silent urgency of unfulfilled potential and shattered dreams.

Beyond statistics lies the profound tragedy of lives lost in the sacred journey of childbirth. Each number represents a story of resilience and struggle—a life that began with hope but ended in sorrow.

According to a World Health Organization (WHO) report published in March 2023, a woman dies of pregnancy-related complications every two minutes. In 2020, Africa recorded a maternal mortality rate of 531 deaths per 100,000 live births.

The continent accounted for 69% of global maternal deaths that year, with major complications—such as severe hemorrhage, infections, eclampsia, preeclampsia, and unsafe abortions—responsible for 75% of the total.

In Kenya, the maternal mortality rate stood at 530 deaths per 100,000 live births in 2020—more than double the global average of 223 deaths per 100,000 live births.

In line with Sustainable Development Goal 3, nations have committed to reducing the maternal mortality ratio to less than 70 per 100,000 live births by 2030. However, the continued rise in maternal deaths poses a serious threat to achieving Kenya’s Vision 2030. Between 2017 and 2020, Kenya experienced a 55% increase in maternal mortality.

According to the 2023 Kenya Demographic and Health Survey, Homa Bay County registered 29 maternal deaths that year, with 13 of those occurring at the Homa Bay County Teaching and Referral Hospital.

Roselyn Omollo, the County Executive Committee Member for Health, noted that Homa Bay records between 310 to 380 deliveries monthly—an average of 27 deliveries daily—contributing to the rising maternal death toll.

“Increasing numbers of deliveries heighten the risk of maternal deaths. While we average 310 to 380 monthly deliveries, the nurse-to-mother ratio remains alarming due to a critical shortage of nurses,” said Omollo.

One tragic story is that of Eric Barasa, a father of two, who lost his wife and newborn son during childbirth. The ordeal continues to haunt him.

Eric recalls the fateful morning of July 12, 2022—a cold, chilly day when he rushed his wife to the Homa Bay Teaching and Referral Hospital after her water broke and she began bleeding.

Upon arrival, the nurse conducted several examinations and informed them that the cervix had dilated to only 6 cm, not yet ready for delivery. By 3 p.m., Eric left briefly to attend to his other children and prepare food for his wife.

When he returned around 8 p.m., he found her missing from the waiting bed. He panicked and was told she was in labor, but the nurse denied him entry to the delivery room. That’s when he knew something was terribly wrong.

Eric anxiously paced the corridor, troubled by the cries he heard from inside. Then there was silence. A nurse later informed him that his wife was unresponsive and that both mother and child had passed on.

“I don't think my wife received the medical attention she needed. If a cesarean section had been considered, maybe my wife and baby could have been saved,” he lamented.

Dr. Ondigo, an obstetric gynecologist at the Homa Bay County Teaching and Referral Hospital, affirmed that maternal hemorrhage is the leading cause of death during pregnancy, childbirth, and the postpartum period.

“Haemorrhage is often caused by uterine atony, placental complications, trauma, or clotting disorders. With proper antenatal care, skilled birth attendants, and access to emergency obstetric services, it can be prevented,” said Dr. Ondigo.

Interventions may include uterine massage, medication to induce contractions, artery ligation, hysterectomy in severe cases, and blood transfusion when necessary.

He also identified maternal sepsis as another leading cause of death. According to WHO, sepsis is the third most common cause of maternal mortality worldwide. It results from the body’s extreme response to infection, causing tissue damage, organ failure, and death if untreated.

“Sepsis often goes undetected during pregnancy, post-abortion, or the postpartum period. Timely diagnosis is critical,” he noted.

Obstructed labor is another threat. Normally, labor involves rhythmic uterine contractions that guide the baby through the birth canal. But complications—such as pelvic abnormalities, fibroids, fetal malposition, or large fetal size—can hinder this process and lead to death.

Obstructed labor results in prolonged labor, exhaustion, dehydration, hemorrhage, uterine rupture, fetal distress, and birth trauma—potentially causing death for both mother and baby.

Hypertensive disorders like preeclampsia and eclampsia are also major contributors to maternal deaths. These conditions can lead to seizures or organ failure due to elevated blood pressure, especially in cases involving chronic hypertension or late detection.

To combat these challenges, Homa Bay County’s Department of Health has taken steps, including restocking the county blood bank for emergency transfusions.

“Hemorrhage remains our biggest challenge. To address this, we’ve ensured a fully functional and reliable emergency blood bank,” said Dr. Kevin Osuri, the Chief Officer for Health.

He added that emergency obstetric care has been introduced in local health facilities to reduce the distance between mothers and critical medical services.

“We have basic and emergency obstetric care units in every health facility, so that mothers across the county can access professional healthcare for safe deliveries,” Dr. Osuri emphasized.

The imperative to reduce maternal deaths transcends data—it reflects humanity’s commitment to safeguarding life from its very beginning.

Through advocacy, education, and empowerment of women with knowledge and resources; by addressing systemic barriers and ensuring equitable access to care—we can change the maternal health narrative.

Every preventable maternal death is a call to action. We must prioritize maternal health and build a future where no woman fears childbirth, and every mother has the chance to thrive alongside her child.