The Philippines: Maternal health concerns aired at meeting in Bali
14 August 2009
By Rina Jimenez-David, Philippine Daily Inquirer
Foremost in the minds of the Filipino delegates to the Asia and the Pacific Consultation on maternal health and human rights is a young mother who passed away just a day before we left for this island.
She may have died due to shock resulting from hemorrhage, but in essence, Kennely Ann died while giving life. She joins the 500,000 women around the world who die each year from causes related to pregnancy and child birth, and at least 11 Filipino women who die every day because of the same causes. What makes Kennely Anns death so worthy of examination and discussion is not that she died because maternal mortality is a common problem that disturbingly remains unaddressed in many parts of the world but that she did so despite enjoying health and medical services and obstetric care of the highest level possible in the Philippines.
There is a saying that every woman has one foot in the grave each time she gives birth. This is because pregnancy and the process of childbirth are fraught with risks every step of the way, and even a healthy pregnancy can suddenly turn life-threatening during or soon after delivery. And yet, despite the risks, maternal deaths are preventable, but measures to prevent these deaths must be taken long before a woman reaches a delivery room or bed. These measures include: basic good health to begin with, proper pre-natal care and consultation, access to quality health care, access to emergency obstetrical services, and immediate and proper post-partum care.
This menu of requirements also includes access to family planning. Some studies have found that one in every three maternal deaths could have been avoided if the woman was able to practice family planning, enabling her to delay or avoid subsequent pregnancies, especially when she is not ready for it, has decided she already has the optimum number of children, or is too sick, too old or too young for a healthy pregnancy and successful delivery.
Also a requirement is awareness of ones reproductive health, including the right to decide when, if and how often one would get pregnant, and the risks inherent in getting pregnant and how one would minimize these risks.
I do not know Kennely Anns reproductive history or plans, although her sister told the Inquirer that Kennely Ann had wanted a large family. She and Jun-jun already had three children: Jejomar Alexi, 6; Maria Isabel, 3 and Jejomar III, 1.
We could speculate, though that perhaps the latest baby, who was named Maria Kennely after her mother, was an unplanned baby, given how carefully Kennely Ann and Jun-jun had sought to space their children. But she is certainly a wanted baby, since her mother spent a month in the hospital, most likely in a bid to increase Baby Kennelys chances of survival outside the womb.
Part of the Philippine group in this gathering is Iloilo Rep. Janet Garin, who aside from being a reproductive health advocate is a doctor. Discussing Kennely Anns case, Garin says this fourth pregnancy could already be considered high risk, especially as it was coming less than a year after the birth of the youngest child.
With each pregnancy, says Garin, a woman's uterine lining thins, putting her at risk of bleeding uncontrollably during delivery. Indeed, 18 percent of maternal deaths have been traced to hemorrhage.
I met Kennely Ann some months ago, when Jun-jun and I guested at Che-che Lazaros Media in Focus show over ANC. Kennely Ann accompanied Jun-jun to the taping, and I remember being quite impressed by her youth, her slim physique and her fashion sense. I was also quite taken by their daughter Alexi, who was pert and charming and self-assured, and looked like a mini-me of her glamorous mother. Now my heart goes out to Alexi and her three siblings, especially Maria Kennely who is fighting for her life. In many cases, the death of a mother actually puts at risk the survival and health of the children. Even if this would not be the case with the Binays, it is still an extremely painful prospect for the four children to grow up deprived of the company and care of their lovely mother.
The theme of this gathering is maternal health as a human right. Nobuko Horibe, director of the Asia and Pacific Regional Office of the UN Population Fund, one of the sponsors of this consultation, points out that failure to address maternal deaths would cost our communities dearly.
Speakers, most of whom are parliamentarians from Asia and Pacific countries, have spoken repeatedly of the need for governments to act more purposively to prevent the deaths of mothers. The problem, they say, lies in the implementation of health programs, especially in areas where there are scarce resources, especially trained caregivers and midwives, life-saving drugs and family planning commodities, and facilities for emergency care. This inequality is firmly rooted in economic and social stature: only 25 percent of poor women get skilled attendance at birth, while 92 percent of rich women enjoy this facility, and indeed may even take it for granted.
That such a fate befell Kennely Ann Binay despite her advantages just goes to show that maternal mortality is a risk that all women face, and everyone who loves mothers should take its cause to heart.
