High maternal mortality and stillbirths

The health profile of Bangladesh's population, particularly with women and children being the most vulnerable, is the most disconcerting aspect of its human development indicators. A good number of women in the country still die during the act of giving birth. The latest data on stillbirths (the death of babies in the womb at or after 28 weeks of pregnancy), shows a disheartening situation --- the third highest in the world and the second highest in Asia, according to the recent issue of the medical journal, The Lancet. And this is often due to causes that could be prevented if enough attention were paid to reach pre- and post-natal care to the child bearers. Unfortunately, such services are not easily available for poor women in Bangladesh, although there is no dearth of publicity undertaken by both government and non-government organizations in the field of mother and child health care, family planning, or reproductive health care, as it is called these days. Maternal mortality and still births could be reduced considerably if child marriages could be brought down. But despite prohibition, the practice is still common in rural Bangladesh, with malnourished child-women getting pregnant and suffering the dangerous consequences. The state of the nation's health in fact begins in the womb, with malnourished mothers unable to provide adequate nourishment to their fetuses, and delivering weak underweight babies. This is undeniably perpetuated by situations of poverty as well as the 'poverty of understanding', one might say. The lack of wherewithal to provide the family with the basic nutrition and health needs is a major factor but the inability of most of the masses to benefit from appropriate information, even if it is available, is another problem that defies solution. Both macro- and micro-nutrient deficiencies stalk the nation. Obviously those who live in poverty or below are worse off. The worst off, in such a situation of deprivation, is understandably the females of a family, including female adults and children. They are, to all intents and purposes, the underdogs of the underdogs and their suffering is compounded by conscious or subconscious gender bias with regard to food intake and medical attention. It has been seen that when resources are scarce, parents 'invest' whatever little medical attention they can afford, on the son first. The daughter is left to Providence, getting due attention only after the first priority has been met. This behaviour is the norm. The un-intended foundation for obstetric and gynecological complications are therefore laid early on, in childhood ---- or rather in the womb, as mentioned earlier. And if pregnant women are still subjected to the very restricted food intake that old-timers used to impose on them, the health of both the mother and baby is further compromised. Countless surveys in South Asian countries, including Bangladesh, have established beyond doubt that it is this ' second class' status of females that is the cause of high child mortality and maternal deaths. Nearly 60 per cent of pregnant women in Bangladesh are severely malnourished and anemic, which not only reflect on the health of the often underweight newborns, but also lead to complications during delivery, and death, if medical assistance is delayed or denied altogether. There are far-reaching implications of such negligence for the nation at large for fetal malnourishment leaves its stamp on the minds and bodies of future citizens, producing adults who fail to be at par with their better nourished counterparts elsewhere.