Most dangerous day of life is birth as million babies die
A muffled squawk from under her capulana, a piece of cloth traditionally worn sarong-style, signaled the arrival of the 5-pound boy last month in a flood-damaged hospital of rural Mozambique. The nurses casually lined up balls of cotton wool on a steel dish and drew up a shot of the hormone oxytocin for the mother before noticing the newborn wasn't breathing, Bloomberg reports. He required a nail-biting 10 minutes of resuscitation to survive. In the next bed lay a woman who hemorrhaged after delivering a stillborn. Already one baby had died that day at the maternity ward in Chokwe, southern Mozambique. Birth remains a stubbornly deadly affair in the former Portuguese colony and 74 other developing nations, eroding their human capital and keeping billions of people entrapped in a cycle of poverty that a new United Nations-backed plan says can be reversed with spending just over $1 a person more on health. "We should judge the progress in humanity and the progress of any society or country by the way they treat their women and children," Margaret Chan, the director general of the World Health Organization, said in an interview. "They have been lagging behind in the last 20 to 30 years of development. We should give them special attention." Girls and women are a pillar of population health, according to the Geneva-based WHO. Femalesundernourished during infancy, adolescence and especially pregnancy are more likely to deliver babies which are preterm or small at birth. Low-birthweight babies, in turn, are at higher risk later in life of type-2 diabetes, heart attack and other chronic diseases that kill breadwinners and are expensive to treat. Haunting Legacy "If we don't take care of all these issues, it's going to come back to haunt us," Chan said. "Many countries' health system will go into insolvency." Last year, 289,000 women died giving life and about 1 million newborns didn't survive their first day amid a dearth of high-quality, skilled maternity care. Their plight is gaining attention with only 500 daysto go before the world is scheduled to meet the eight Millennium Development Goals for improving the health and wellbeing of the world's most vulnerable people. The targets least likely to be met include a two-thirds reduction in child mortality from 1990 levels and a 75 percent drop in the rate women die from childbirth. ‘Most Dangerous Day' "The day of birth is the most dangerous day of your life," said Joy Lawn, director of the Centre for Maternal, Adolescent, Reproductive & Child Health at the London School of Hygiene & Tropical Medicine. "Most of these deaths are preventable with simple approaches, but a sense of urgency is key." The delivery at the hospital in Chokwe last month caught by surprise the two nurses who were busy explaining the hemorrhage patient's hospitalization. That woman almost bled to death after delivering an 8-pound boy, born dead in a village clinic about 50 kilometers away. The woman in the bed beside her by the window had only minutes earlier ended a call on her mobile phone. Her cervix was less than 2 inches dilated when it was checked less than 20 minutes earlier, a nurse said later. "Parto!" (or "delivery!") one of the nurses yelled in Portuguese after a gushing sound and a brief wail signaled the birth. The mother had dropped her bent knees and laid motionless on her back. When the nurses extricated the baby from his mother's capulana after having spent crucial minutes preparing a kidney dish with cotton and the oxytocin shot, it was obvious he wasn't breathing. Nearly Died He was taken to the delivery room and laid on his back on a table draped with a green surgical sheet. One nurse ventilated him with a squeezable bottle attached to a facemask covering his nose and mouth, while another connected a fine nasal tube to a suction machine to vacuum fluid from his airway. Finally, 15 minutes after birth, the newborn started breathing. Two baby deaths were recorded that day, including the stillbirth. The other occurred in the hospital as a consequence of its mother's pregnancy-induced hypertension. For every 1,000 babies born alive in Mozambique, 21 are dead within a week, according to a study published in The Lancet medical journal in May. That's 50 percent more than the global neonatal mortality ratio of 14 deaths per 1,000 live births. Investing an additional $1.15 a person in high-burden countries like this one on the eastern edge of southern Africa would save 3 million women, stillbirths and newborns by 2025, according to the Every Newborn Action Plan, a roadmap for faster progress on maternal and child health.